Main Focus of Research

FIDAM would like to contribute to an improved treatment, prognosis and quality of life to  people with diabetes. The intention of the research of FIDAM deals with the following subject areas:

 

If you would like to know more about the various main focuses of research, you can find literary references referring to the published work by FIDAM about these topics, or you can also directly download selected works.

 

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Problems with Hypoglycemia

Background: On the one hand the diabetes therapy faces the dilemma of preventing the cause of long-term complications by a normal glycemic adjustment and on the other hand of also avoiding the occurrence of acutely complicated hypoglycemia. In practice, to attain both therapy goals has often proven to be difficult because a normal glycemic blood sugar adjustment is associated with a higher risk of hypoglycemia. The reason for this is the formation of a hypoglycemic detection disorder. Hypoglycemic problems are a typical interdisciplinary problem area because of the significance of its cause and treatment, and not only endocrine and neurophysiological but also behavioral mechanisms and factors. The treatment of hypoglycemic problems require an interdisciplinary approach which is not only aimed at an optimization of the diabetes therapy but also the modification of and dealing with these problems.

 

Research Project:  Our studies are concerned with research of the cause and diagnosis of hypoglycemic problems. A further emphasis lies in the development and evaluation of training concepts of the treatment of people with hypolglycemic problems (i.e. HvPOS).

 



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Articles Poster

 

Diabetes and Depressionen

Background : People with the diabetes disease are twice as often affected with depression illnesses than non-diabetics. The simultaneous occurrence of diabetes and depression has unfavorable repercussions on self treatment behavior of the people affected; in their quality of life and blood sugar adjustment. On a long-term basis diabetic people who additionally suffer from a depression disorder have a distinctly higher risk for diabetic-related complications and with that a worse prognosis, than non-depressive diabetic people. Aside from general risk factors, which are also relevant for non-diabetics, such as forms of therapy, glycemic control or diabetic related complications seem to be significant for the cause of depression disorders.

 

Research Project: The recording of the prevalence of depression disorders as well as the cause of their risk factors are a relevant part of not only the research spectrum, but also for the development of the intervention concept of the treatment and prevention of depression disorders.

 

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Articles

Poster

Prevention of Type 2 Diabetes

Background:  The number of diseases of Type 2 diabetes are increasing in epidemic amounts. In industrial countries like Germany alone, the estimate for the  increasing numbers of diseases will be at 40%. Due to the high risk of diabetic related diabetes complications, this increase poses a threat to the quality of life for many people. Moreover, the drastic rise of diabetic prevalence also means a larger burden for the health system. Prospective studies were  able to verify that the occurrence of the disease can be prevented, or at least slowed down in high risk people when there is a change in lifestyle or a medicinal intervention. Interventions aimed at a change in diet and exercise habits have proven to be up to 58% more effective in reducing diabetic risks than in comparison to medicinal strategies. The cost-benefit relationship of such prevention measures is still ambiguous because the current evaluated measures have proven to be relatively expensive due to the individual interventions.

 

Research Project:  The development and evaluation of a group program of modification of diet and exercise. This program, PRAEDIAS – Prevention of Diabetes – things you can do yourself (Prävention des Diabetes - selbst aktiv werden), will be evaluated with regard to weight development, the course of the metabolic risk factors and the quality of life.

 

 



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Quality and psychological mental state

Background: A successful self treatment of diabetes is crucial for the prognosis. Psychological diseases or a reduced well-being could have a negative influence on the self treatment and the prognosis of the disease. Regardless, an important goal of diabetic treatment is managing an optimal quality of life. Recording of quality of life and also the diagnostics and treatment of possible psychological disorders is therefore an important prerequisite for a successful diabetes treatment. Aside from a reduced quality of life, therapy specific anxieties, i.e. fears with regard to an Insulin therapy create an important treatment hindrance.

 

 

Research Project: Apart from the development, transmission and evaluation of diabetic specific questionnaires to the record of the quality of life, an emphasis of the research project is the exploration of anxieties with regard to an Insulin therapy on people with Type 2 Diabetes. The colleagues at the research institute have been significantly involved in the production of the concept of the most optimal psychological care of people with diabetes disease.

 

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Development and Evaluation of Training Programs

Background:  The successful treatment of diabetes and possible diabetes complications is decisively dependent on self treatment behavior of the people affected. The importance of the training, in which people with a diabetes disease learn the important skills, is undeniable within the study of diabetes. The concept of training programs has changed from a pure conveyance of knowledge-oriented training to a self-managing oriented training within the last ten years. Modern training concepts point out that aside from the conveyance of necessary knowledge and skills, the focal content is primarily the personal experience, individual objectives as well as subjective assessments of the people affected and the motivation of self treatment of the diabetes disease, or rather diabetic related problems.

 

Research Projects /Projects:

MEDIAS 2 (Mehr Diabetes-Selbstmanagement Typ 2)  More Diabetes-Self Management Type 2- wants to offer help to middle-aged Type 2  Diabetics with no Insulin treatment.

WENUS stands for “Normal Again and Experience Spontaneous Sexuality“. It's directed towards men, who have erection problems and offers information about the cause, diagnostics and treatment of these problems.

NEUROS is a structured training program for people with diabetic related nerve disorders/ neurological problems.

HyPOS is a training and treatment program for Insulin treated diabetic people with hypoglycemic problems.

PRAEDIAS is a prevention program which wants to support people with a higher diabetes risk to change their diet and exercise routine.

 

 

 







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Diabetes and CNS

Background: The results of the influence of diabetes on the central nervous system are not the same and partly contradictory. In Type 1 Diabetes, negative effects of recidivating hypoglycemia on neuro-psychological functions as well as structural changes in the CNS have been found in some studies. In other examinations of younger Type 1 diabetics for example in the DCCT, unfavorable effects of hypoglycemia on the cognitive performance cannot be proven. Results for Type 2 Diabetes have similar contradictions. Because older people are predominantly affected by this form of diabetes, it can be assumed that a negative interaction of diabetes and possible vascular complications are connected with the general aging process. A reduced cognitive performance can be a considerable barrier for a successful diabetes therapy in regard to a consequential diabetic treatment and the participation in training.

 

Research Project: In our institute studies will be conducted, dealing with acute and medium-term neuro-psychological effects on hyperglycemia in Type 1 diabetics. In addition a diabetic specific performance test was developed in the Diabetes Center Mergentheim for use by patients with Type 2 Diabetes to screen them for possible cognitive-reduced performance.

 

 

 

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Nephropathy

Background:  Terminal kidney failure presents grave complications for Diabetes mellitus. Aside from therapy related factors such as blood sugar and blood pressure levels, genetic factors also seem to play a role in the cause or rather progress of kidney failure.

 

Research: Together with the University Clinic Regensburg, studies about hereditary causes of terminal kidney failure will be conducted, in which the genotype, as well as selected clinical parameters of the diabetics with and without kidney failure will be compared to each other. Additionally we will take part in multi-center studies, which support the importance of various blood pressure medication to prevent diabetic related kidney failure.

 

 

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New Technology in Diabetology

Background: New technologies, such as the constant blood glucose measurements, improved Insulin pumps or the use of PDA can be a help to optimize diabetic therapy. Also new developments of devices for blood sugar self-tests, as well as an IT-supported processing of the measuring data could produce an important contribution for the improvement of the quality of treatment.

Research: An emphasis of FIDAM is to set up an investigation of constant glucose readings. Besides studies of the measurement accuracy of glucose sensors, this method was also used to test the quality of the hypoglycemic detection. A further case of application using new technologies is a project to correlate blood glucose levels with moods. Additional projects refer to the verification of the measurement accuracy and easy handling of new devices for glucose reading by the patients.

 

 

 

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Articles Poster

 

Macroangiopathic disease and Diabetes mellitus

Background: People with diabetic disease have a significantly higher risk of developing  a serious macro-angiopathic  disease, such as heart attacks, strokes, peripheral and/or cerebral arterial occlusion. Alongside hyperglycemia other risk factors for the development of macro-angiopathic complications are hypertonia, hyperlipidemia or hyperinsulinism. Besides treatment for hyperglycemia there is a great matter on therapy with anti-hypertension, lipid minimizers and thrombosis aggregate blockers to prevent macro-angiopathic complications.

 

Research Project: Participants in a multi-center study (Charisma) test the effectiveness of a treatment with a thrombosis aggregate blocker (Colpidrogel) in the event of cardio and cerebrovascular occurrences on patients of a high risk group. Another multi-center study (Ontarget) tests the effect of an A1-Blocker (Telmisartan) in comparison to Ramipril and a placebo on the occurrence of macroangiopathic complications in high risk patients.

 

 

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Insulin resistance

Background: Type 1 and Type 2 Diabetes have a very different genesis. In the case of Type 1 Diabetes auto-immune processes play a major role whereas in Type 2 Diabetes, the development of Insulin resistance is of great importance. Besides lifestyle related reasons (lack of exercise or obesity) a hereditary disposition seems to be  responsible for the development of Insulin resistance, too. The clinical significance as well as possible reasons for a higher Insulin resistance in Type 1 Diabetes is not clear. The Insulin treatment in Insulin resistant Type 2 diabetics is a further problem in practical diabetology.

 

Research Project: With the help of a hyperinsulin euglycemic glucose clamp, the Insulin resistance was determined in Type 1 Diabetes patients with or without hereditary burden with a Type 2 Diabetes probably by the glucose rate of disappearance. A parallel in body weight of both tested groups was observed. Three years later in a prospective test, a further spot check was performed to determine the metabolic effects of different Insulin resistance (weight development, glycemic controls, lipid status, blood pressure, Insulin requirement).

 

 

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Articles Poster

 

Diabetes Therapy

Background: The goal of diabetes therapy is the reduction of hyperglycemia and risk factors as well as  the treatment of already existing risk factors.  In oral diabetes medication there is different substance classes available with different effect assessments (reduction of Insulin resistance, blockage of hepatic glucose release, absorption delays, stimulation of the endogen Insulin secretion). Also various kinds of Insulin are available for use for the Insulin treatment, which have different effect profiles (analog Insulin with different times of effect, NPH-Insulin, human Insulin, animal Insulin). Aside from medicinal strategies, non-medicinal forms of treatment also play an important role, of course, such as diet and physical activity. Lifestyle factors like physical activity have an influence on the Insulin therapy.

 

Research Project: FIDAM is taking part in or is rather initiating studies to examine clinical effects of various forms of therapy or their combinations. In one study the effect of a fast effective Insulin analog was tested on Insulin resistant Type 2 Diabetic patients in comparison to normal Insulin. A further test is related to the effectiveness of the combination of Insulin Lispro and Acarbose to reduce post prandial blood sugar levels and to positively influence an Insulin resistance. Besides that, FIDAM has dealt with the effects of physical activity on blood sugar during this time on Type 1 diabetics.

 

 

Publications:

Articles Poster