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Barriers To Diabetes Care Include Restaurants And High-risk Lifestyles, Says International Review – 01st April

Eating out, lack of social support and high-risk lifestyles are just some of the barriers that stop patients with type 2 diabetes from controlling their condition, according to a research review that covered 8,900 patients and 4,550 healthcare providers from 28 countries.

The study, published in the March issue of the Journal of Nursing and Healthcare of Chronic Illness, shows that psychosocial, socioeconomic, physical, environmental and cultural factors can provide major barriers to effective care. Researchers from Hong Kong and Northern Ireland studied research carried out between 1986 and 2007 to try and identify how treatment regimes could be improved. Their findings have enabled them to come up with a three-point plan for nurses involved in diabetes care.

"Diabetes is a chronic condition and patients need to modify their lifestyle on a longterm basis to cope with it" says Sandra Pun from the School of Nursing at The Hong Kong Polytechnic University. "According to the World Health Organization, up to 380 million people worldwide will suffer from diabetes by 2025 so it is important to identify and tackle any barriers that prevent people from making those changes."

Major barriers identified by the review included:

- Financial. Even if healthcare was free or funded by insurance, patients still had to spend more money on healthy food, home glucose monitoring kits and transport to and from healthcare appointments.

- Social support. Patients who received support from family, friends and diabetes clinics appeared to handle self-care better than those who did not - Patient provider gaps. Care was more effective when patients and healthcare providers worked together to devise treatment plans that patients could stick to.

- Meals out. Eating out in restaurants was a frequently mentioned problem and being offered inappropriate food when visiting others was also an issue.

- Favourite foods. Healthcare professionals did not always appreciate that patients disliked being denied their favourite foods and would cope better if they were incorporated in eating plans.

- Exercise. Attitudes toward exercise, physical limitations and discomfort prevented people from taking regular exercise. These need to be taken into account when devising exercise programmes.

- High-risk lifestyles. Behavioural and psychiatric disorders and cultural and language barriers, among both patients and family members, can impede effective treatment.

- Medication. Some patients forgot to take their medication and others ran out. Others were also reluctant to carry out regular glucose tests.

- Psychological well-being. Psychological problems are common among people with diabetes, but providers don't always have the resources to manage this aspect of their patient's care.

- Understanding. Patients often lack knowledge about their condition and don't always understand the relevance of diet and care plans.

- Frustration. Being unable to maintain good glucose control can cause helplessness and frustration, as can the progression of the disease

"Our review found that there are various barriers to achieving optimal self-care in type 2 diabetes" concludes co-author Professor Vivien Coates, from the Institute of Nursing Research at the University of Ulster, UK. "Some stem from limitations within the healthcare team, some from ineffective communication between providers and patients and some from the patient's lack of empowerment, motivation and involvement in their treatment.

"Better healthcare delivery systems and reforms that improve affordability, accessibility and efficiency of care are also essential to help both providers and patients to meet desirable standards of diabetes care."

As a result of the study, the researchers are advising that nurses to adopt a threepoint plan to overcome patients' barriers to self-care:

1. Nurses should provide patients with enough information about their condition and its treatment to enable them to make informed decisions about their care. 2. Patients need to be motivated to take action to ensure that they manage their diabetes and prevent complications. 3. Nurses need to approach diabetes care in a holistic way that takes account of a wide range of physical, psychosocial, cultural, financial and environmental factors. "Nurse need to address a number of key questions like what is important to the patient in terms of lifestyle changes and status quo and what patients would expect from the healthcare team" says Professor Coates. "Understanding the barriers that prevent effective self-care from the perspective of both the patients and the healthcare provider is a vital part of this process."

Is It Safe For The Blind To Use Insulin Pens? – 23th February

Ann Williams, a National Institute of Health-supported postdoctoral fellow at Case Western Reserve University, understands what it means to live with diabetes. So does her companion Yoda, a miniature service dog who scampers alongside her through the halls of the Frances Payne Bolton School of Nursing at Case Western Reserve University. Yoda is specially trained to alert Williams to a sudden drop in her blood sugar.

As a nurse diabetes educator, Williams self-diagnosed her own onset in 1991 when she began to have symptoms of the disease. After changes in her lifestyle didn't lower her blood sugar levels, she went to her doctor to develop a treatment plan that included diabetes medication. Eventually, Williams began a regimen of insulin. Initially, she used syringes, then insulin pens and now an insulin pump.

Managing the disease concerns Williams from a personal as well as professional perspective.

For people with diabetes who have a visual impairment, reading the small print on a syringe and getting the right dose can be difficult or impossible. Another method of delivering insulin, popular in Europe and Asia but less so in the United States, is the insulin pen. The fountain pen-like device is a self-contained applicator with 300 units of insulin.

What has currently interested Williams in the delivery of insulin is the disclaimer several drug companies have placed on insulin pen devices, warning against use by the visually impaired.

The National Federation of the Blind (NFB) has voiced its concerns about the legitimacy of the disclaimer, said Williams.

"No empirical evidence exists that the blind cannot use insulin pens accurately," she said.

Williams wants to urge insulin companies to remove the disclaimer by providing solid data about pen use by the blind. With a $6,000 grant from Sigma Theta Tau International and the American Association of Diabetes Educators, Williams will test the accuracy of insulin pen use by blind people.

She will travel to Detroit in July for NFB's annual meeting, where she will conduct the study.

Some 3.2 million people have both diabetes and visual impairments. According to the Centers for Disease Control that is about one-seventh of the nearly 22 million people with diabetes in the United States. Since the number of people who have diabetes and visual impairment is greater than the total number of people with type 1 diabetes (formerly called juvenile diabetes), Williams said more attention must be given to their needs.

According to Williams, the NFB has agreed to let her recruit 40 visually impaired people and 40 sighted people who have diabetes to test the insulin pen.

"If NFB did not allow me to recruit at their meeting, it would have taken me much longer to find people and conduct the study," she said.

Williams will examine manual dexterity skills as well as the ability to listen to digital recordings (for blind participants) or read written instructions (for sighted individuals) and then accurately administer a prescribed dose of insulin into a rubber ball, which is similar to giving oneself an injection.

Individuals can control their dosage by dialing in a set amount of insulin.

William says insulin pens are easily carried in purses or pockets. When insulin is needed, the pens can deliver the drug in a less intrusive or conspicuous way in public than the syringe delivery that requires a needle and bottle of medicine.

"It is a very discreet method to deliver the drug," said Williams, adding that, because of the lack of stigma of using it, may encourage more people to give themselves an injection when they absolutely need to take the drug.

Retinal Screening Still Not On Target, UK – 20^th February

Diabetes UK is still concerned that more than 700,000 people with diabetes in England are not being screened for retinopathy, the leading cause of blindness in the UK's working-age population.

The latest figures published by the Department of Health show that 28 per cent of people with diabetes aged 12 and over did not receive digital retinal screening in the period October 2007 to September 2008.

Almost two thirds of PCTs don't meet target

13 Primary Care Trusts (PCTs) failed to screen half of their diabetes population. Almost two thirds (98 out of 152) of PCTs are still failing to meet the target of screening 80 per cent of people with diabetes. This Government target was set in 2003 for PCTs to attain by December 2007.

Appalling situation

"It is appalling that hundreds of thousands of people with diabetes are still not having their eyes checked," said Simon O'Neill, Director of Care, Information and Advocacy Services at Diabetes UK.

Blindness can be prevented

"The tragedy is that if retinopathy is identified early enough, treated properly and diabetes managed well, blindness can be prevented in 90 per cent of cases.

"Retinal screening services in England are patchy. PCTs need to ensure they are reaching out to all these eligible people to invite them for screening, and provide a service that meets national quality standards as dictated by the National Screening Committee.

"In turn, people with diabetes must make every effort to get to these vital appointments. If they have problems attending they can talk to their healthcare team about what help and support is available."

Weight Loss More Effective Than Intensive

Insulin Therapy – 20th February

Weight-loss and major lifestyle changes may be more effective than intensive insulin therapy for overweight patients with poorly controlled, insulin-resistant type 2 diabetes, according to a diabetes researcher at UT Southwestern Medical Center.

The National Heart, Lung, and Blood Institute of the National Institutes of Health recently halted part of an ongoing clinical trial on diabetes and heart disease after more than 250 people died while receiving intense treatment to drive their blood glucose levels below current clinical guidelines.

The evidence is compelling that when insulin levels are high, certain tissues are overloaded with fatty molecules, which leads to insulin resistance. And yet, the high blood glucose levels of many obese patients with insulin-resistant type 2 diabetes are being treated with increasing amounts of insulin in an attempt to overpower that resistance. While high doses of insulin may lower glucose levels, it will also increase the fatty molecules and may cause organ damage.

In a commentary in the March 12 issue of The Journal of the American Medical Association, Dr. Roger Unger, professor of internal medicine, wrote about the recent findings of his own and other labs that link insulin resistance to excess accumulation of fatty molecules in liver and muscle.

Dr. Unger, who has investigated diabetes, obesity and insulin resistance for more than 50 years said intensive insulin therapy is contraindicated for obese patients with insulin-resistant type 2 diabetes because it increases the fatty acids that cause diabetes. Instead, the most rational therapy eliminates excess calories, thereby reducing the amount of insulin in the blood and the synthesis of the fatty acids stimulated by the high insulin. Giving more insulin simply increases body fat.

"Evolution was unprepared for the change in the American diet to processed fast food and drive-through lanes," he said. "There's no way that our genes could evolve to gird themselves against the superabundance of very, very high-calorie foods that have flooded the U.S."

Before the discovery of the hormone insulin, starvation was the only treatment for diabetes, said Dr. Unger, who is a member of the National Academy of Sciences.

"Today there are many treatment options, including bariatric surgery, if necessary, to lower the fat content in the body before you start giving insulin," he said. "The fat is causing insulin resistance and killing the insulin-producing beta cells in the pancreas that is what is causing type 2 diabetes."

Giving more insulin simply channels the glucose into fat production. There is now a spectrum of therapies that improve diabetes by correcting the insulin resistance by reducing the body fat. Insulin treatment would be indicated only if all these fail.

Dr. Unger said insulin should be given to patients with insulin deficiency, but not if the insulin levels are already very high but ineffective. "Giving more insulin to an insulin-resistant patient is akin to raising the blood pressure of a patient with high blood pressure to overcome resistance to blood flow. Instead, you would try to reduce the resistance," he said.

In the commentary, Dr. Unger said the increase in the number of patients with insulin-resistant type 2 diabetes can be traced to the epidemic of obesity that began in the U.S. after World War II, when food preparation was moved from the family kitchen to factories and companies that produce high-fat, calorie-dense foods, leading both men and women to consume substantially more calories on a daily basis. In addition, technological advancements such as televisions, computers and automobiles reduced the number of calories burned per day.

Type 2 diabetes occurs when the body is unable to make enough insulin to compensate for insulin resistance. The condition affects between 18 million and 20 million people in the U.S.

Factors that increase the risk of type 2 diabetes include obesity, age and lack of exercise. Over a period of years, high blood sugar damages nerves and blood vessels, leading to complications such as heart disease, stroke, blindness and kidney disease.

Dr. Unger's research is supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases, the Department of Veterans Affairs, and the Juvenile Diabetes Research Foundation.

Fresh Vegetables, Fruits Reduce Diabetes Risk – 16th February

Eating just one serving of green leafy vegetables or three servings of fruit a day reduces the risk of developing Type II diabetes, say researchers at Tulane School of Public Health and Tropical Medicine and the Harvard School of Public Health. The research team also found that one serving of fruit juice a day increased the risk of Type II diabetes in women.

Tulane epidemiologist Dr. Lydia Bazzano says, "Based on the results of our study, people who have risk factors for diabetes may find it helpful to fill up on leafy greens like lettuces, kale and spinach and whole fruits, like apples, bananas, oranges and watermelon rather than drink fruit juices, which deliver a big sugar load in a liquid form that gets absorbed rapidly."

Bazzano and her team analyzed 18 years worth of diet and health data from 71,346 nurses who participated in the Nurses' Health Study from 1984 to 2002. The study was published in the April 4, 2008 online issue of Diabetes Care.

In addition to emphasizing the importance of eating whole fruits and green leafy vegetables to prevent diabetes, the team also recommends replacing refined grains and white potatoes with whole fruit or green leafy vegetable servings. White flours and potatoes have been associated with an increased risk of diabetes.

Nerves Healed By Bone Marrow Cells In Diabetes Model

Transplanting cells that replenish blood vessels can also restore nerve function in an animal model of diabetic neuropathy, Emory researchers have found.

The results are described online this week in the journal Circulation.

The majority of people with diabetes have some form of neuropathy--damage to the peripheral nerves that can cause a loss of sensation in hands, arms, feet or legs. The damage, caused by high blood sugar, occurs gradually and in advanced cases can lead to amputation. Scientists have connected the damage to problems with peripheral nerves' blood supply.

Cultured cells from the bone marrow can promote the regrowth of both blood vessels and the protective lining of nerves in the limbs of diabetic animals, a team led by Young-sup Yoon, MD, PhD, associate professor of medicine (cardiology) at Emory University School of Medicine, found.

Bone marrow is thought to contain endothelial progenitor cells (EPCs), which can divide into endothelial cells, forming a "patch" for damaged blood vessels.

Yoon's team cultured bone marrow cells in a way designed to enrich them for EPCs and injected them next to the sciatic nerves of diabetic mice. The sciatic nerve is a large nerve that runs from the back to the rear leg. The mice were made diabetic by giving them streptozocin, a drug that poisons insulin-producing cells in the pancreas.

The team found that over several weeks, nerve signal speed and sensitivity to temperature were restored to normal in diabetic mice injected with the bone marrow cells.

A fraction of the bone marrow cells appear to become endothelial cells although many of them retain characteristics that make them look like white blood cells. However, they secrete molecules that stimulate the growth of both endothelial cells and Schwann cells, which protect and insulate peripheral nerves, the authors found.

Bone marrow-derived EPCs have also been used in studies of heart muscle repair after heart attack. However, most previous studies indicate that they disappear from the heart muscle after a few weeks.

"We were surprised to find that in this specific environment, they engraft and survive longer than in other tissues," Yoon says. "These cells appear to home to peripheral nerves."

Pancreatic Cells' Destruction In Diabetes - New Clues – 13th February

Researchers have found what appears to be a major culprit behind the loss of insulin-producing β cells from the pancreases of people with diabetes, a critical event in the progression of the disease.

The discovery could lead to new therapies for preventing the death of β cells or restoring those that have already been lost, Kathrin Maedler and colleagues report in the February 4th issue of Cell Metabolism, a Cell Press publication. The inflammatory factor they uncovered, which they call CXCL10, might also offer a warning sign of early or impending disease, they said.

" Previously, the idea was that insulin resistance makes one diabetic, but loss of β cells occurs in both type 1 and type 2 diabetes," Maedler said, noting that among those who are insulin resistant, only 10-20 percent will go on to develop type 2 diabetes due to a failure of β cells. "We've found an inflammatory marker for both types of diabetes. If we can protect cells from CXCL10 expression, we might prevent the decline in β cell mass and, with it, the disease."

Type 1 diabetes is usually diagnosed in children or young adults and stems from an inability to produce insulin. The more common type 2 diabetes generally arises later in life when the body fails to produce enough insulin or grows unresponsive to the hormone.

In type 1 diabetes, β cells are known to be destroyed by the immune system and its production of high concentrations of inflammatory signals. While scientists had floated many ideas, exactly what causes β cell loss in type 2 diabetes remains a matter of debate.

Maedler's team suspected that inflammatory factors might play a key role there as well. Indeed, inflammatory markers are found in obesity, insulin resistance and diabetes, they explained. Earlier studies also showed that low-grade inflammation and activation of the innate immune system - the body's first line of defense - can lead to beta cell failure in type II diabetes.

They've now found that the inflammatory factor CXCL10 (also known as Interferon-gamma-inducible Protein-10, or IP-10) is an important trigger for β cells' destruction. They found that hormone-producing cells isolated from patients with type 2 diabetes secrete CXCL10 and contain more than 30 times the amount of the CXCL10 message in the form of RNA than do cells from patients without diabetes.

Pancreatic sections taken from obese people without diabetes as well as those with type 1 or type 2 diabetes showed CXCL10 in the β cells, they found. Moreover, treatment of isolated human pancreatic cells with CXCL10 decreased β cell viability and impaired the production and secretion of insulin. They traced those effects of CXCL10 to a well-known pathway of the innate immune system involving a protein known as toll-like receptor 4 (TLR4).

The new data suggest a potential mechanism for the switch from β cells' proliferation to their programmed cell death, the researchers concluded. "To prevent such a progression using anti-inflammatory targets of the TLR4 signaling pathway will be of high importance to rescue the β cell from inflammation-induced self-destruction and [to] preserve β cell function and mass."

Insulin May Protect Brain Against Alzheimer's – 09th February

Scientists have discovered that insulin may slow or prevent the damage and loss of memory of Alzheimer's disease by blocking the action of abnormal proteins that attack brain cells, leading to the suggestion that Alzheimer's may actually be a third type of diabetes caused by weakening of insulin signalling in the brain.

A characteristic symptom of Alzheimer's disease is the formation of abnormal proteins called Aβ-derived diffusible ligands (ADDLs) that attach themselves to particular sites on synapses (the junctions between brain cells that are important for memory formation) and stop the synapses from relaying messages between brain cells. It was scientists at Northwestern University that discovered these toxic proteins.

In this study the researchers were able to show that treating brain cells with insulin and an anti-diabetic drug effectively stopped the ADDL proteins from attaching themselves to the cells. They also showed that the anti-diabetic drug enhanced the protective effect of even low levels of insulin.

Through a series of steps the insulin reduced the number of binding sites by which the ADDL proteins could attach themselves to the synapses.

"The mechanism of insulin protection entailed a marked reduction in pathogenic ADDL binding," wrote the researchers, who concluded that:

"The finding that synapse vulnerability to ADDLs can be mitigated by insulin suggests that bolstering brain insulin signaling, which can decline with aging and diabetes, could have significant potential to slow or deter AD [Alzheimer's Disease] pathogenesis."

They used lab-matured cultures of neurons taken from one of the brain's important memory centres, the hippocampus, and treated them with insulin and the insulin-sensitizing drug rosiglitazone (Avandia from GlaxoSmithKline), which is used to treat type 2 diabetes. Scientists often use cells from the hippocampus to study the chemistry of memory. These cells are particularly vulnerable to damage by ADDL proteins.

Senior author William L Klein, a professor of neurobiology and physiology in the Weinberg College of Arts and Sciences who also does research at Northwestern's Cognitive Neurology and Alzheimer's Disease Center, said in a statement that drugs to enhance insulin sensitivity in the brain could open up new treatments for Alzheimer's.

"Sensitivity to insulin can decline with aging, which presents a novel risk factor for Alzheimer's disease," he explained, adding that, "our results demonstrate that bolstering insulin signaling can protect neurons from harm".

ADDLs form when bits of protein clump together and in Alzheimer's disease they bind to nearby brain cells and cause loss of structures that are important for signalling, including insulin receptors. They also make the cells more vulnerable to attack by free radicals. This results in memory loss and other symptoms characteristic of Alzheimer's.

Studies have shown that the Alzheimer's drug Namenda partly protects neurons against damage from ADDL proteins.

Lead author Fernanda G De Felice said:

"The discovery that anti-diabetic drugs shield synapses against ADDLs offers new hope for fighting memory loss in Alzheimer's disease."

"Recognizing that Alzheimer's disease is a type of brain diabetes points the way to novel discoveries that may finally result in disease-modifying treatments for this devastating disease," said Sergio T Ferreira, a professor of biochemistry who also worked on the study.

In this and other studies, the researchers showed that ADDL proteins do their damage by removing insulin receptors from brain cells, in effect making them insulin resistant. They suggested this could be the mechanism that decides whether a person develops Alzheimer's.

"Protection of synapses against Alzheimer's-linked toxins: Insulin signaling prevents the pathogenic binding of Aβ oligomers."

Fernanda G. De Felice, Marcelo N. N. Vieira, Theresa R. Bomfim, Helena Decker, Pauline T. Velasco, Mary P. Lambert, Kirsten L. Viola, Wei-Qin Zhao, Sergio T. Ferreira, and William L. Klein.

Silver Star Patron wins Diabetes UK Parliamentary Champion  Award

Silver Star Patron Keith Vaz MP was announced as winner of the inaugural Diabetes UK Parliamentary Champion Award at a House of Commons Parliamentary Reception on Tuesday 20 January.

 The eight nominations for the award were announced throughout 2008 and the winner was chosen by Diabetes UK campaigners, staff and website visitors.  The award aims to recognise politicians who have gone above and beyond the call of duty in raising awareness of diabetes in Parliament.  The reception formally launched a year of events that will mark the anniversary and recognise the progress that has been made in diabetes care over the last 75 years. 

 Diabetes UK Chief Executive Douglas Smallwood, said: “Keith’s contribution to raising awareness of diabetes in parliamentary circles has been invaluable.  I would like to convey my sincere thanks to him on behalf of everyone at Diabetes UK.

 “With four hundred people being diagnosed with diabetes every day in the UK - equal to one person every three minutes - the condition is one of the biggest health challenges currently facing the UK.”

 Mr Vaz said ‘It’s a great honour to accept this award on behalf of Silver Star. Raising awareness of diabetes is vital if we are to successfully address the impact the condition has on people’s lives.’

    Photo shows Keith Vaz MP receiving his award from Douglas Smallwood (L) (Diabetes UK

    Chief Executive) and Dr Rowan Hillson MBE (R) (National Clinical Director for Diabetes).

Under-The-Skin Sensor Helps Understand How Physical Activity Affects Diabetes Control, UK – 05th February

A hi-tech under-the-skin sensor is to be used to monitor people with diabetes' glucose levels in a pioneering new study by Southampton clinicians, funded by leading health charity Diabetes UK.

Diabetes experts based at Southampton General Hospital will fit the tiny devices to participants' stomachs and use them in conjunction with watch-like armbands, which will check participants' physical activity.

The trial will be the first of its kind in the UK, studying how much of an impact exercise has on blood glucose levels while also taking diet and insulin intake into account.

Led by Professor Christopher Byrne and Dr Andrew Chipperfield, it is hoped the study will shed new light on the management of Type 1 diabetes.

Thirty volunteers aged between 18 and 75 will be supplied with a glucose sensor and armband.

The glucose sensor consists of a tiny electrode, which is inserted under the skin and can take nearly 300 readings a day. This connects to a transmitter which is attached to the skin with an adhesive patch.

Weighing less than a quarter of an ounce, the waterproof electrode and transmitter can be worn by patients for up to two weeks at a time, with the inserted sensor replaced every three days.

Meanwhile the physical activity armband will be worn for two blocks of two weeks during the 12-month study to record continuous data, which can then be downloaded electronically.

Volunteers will wear the bands on their right upper arm and can sleep with them in place.

rofessor Byrne, head of endocrinology and metabolism at Southampton University Hospitals NHS Trust, said: "At the moment, it is uncertain how day-to-day variation in physical activity influences blood glucose in people with Type 1 diabetes.

"But thanks to the introduction of sophisticated, light, user-friendly monitoring devices, such as the two we are trialling, we will gauge a better understanding of the link between physical activity and glucose control in diabetes."

Professor Byrne added: "People with diabetes need help to understand the powerful influence of physical activity and exercise on glucose control and how it can play an essential part in avoiding the complications diabetes can bring."

Dr Victoria King, Research Manager at leading health charity Diabetes UK, said: "Diabetes UK is really pleased to be funding this research as currently the relationship between physical activity, energy expenditure and blood glucose levels in people with Type 1 diabetes is not fully understood.

"Physical activity is an essential part of managing Type 1 diabetes and protecting against the serious complications of the condition such as heart disease, stroke, kidney failure, blindness and amputation. We hope that this study will equip people with Type 1 diabetes with the information they need to make pragmatic decisions about physical activity and how it is likely to affect their blood glucose control. This in turn will help to protect both their short- and long-term health."

Type 1 diabetes occurs when the body produces no insulin at all. It usually develops before the age of 40 and often in the teenage years.

Fighting The Epidemics Of Obesity And Diabetes - 30th January

Diabetes is exploding - it now afflicts some 200 million individuals worldwide and is fast becoming the No. 1 epidemic of our time. In the U.S. alone, more than 22 million people have diabetes, which is the leading cause of end-stage renal disease, preventable amputations and blindness.

Now, thanks to a $2.5 million grant from the prestigious Burroughs Wellcome Fund, UCLA's next generation of scientists will be trained in multiple disciplines to fight diabetes through the newly established Burroughs Wellcome Fund Inter-school Training Program in Metabolic Disease (BWF-ITP-MD).

The BWF-ITP-MD, a Ph.D. education and research training program devoted entirely to the understanding of metabolic diseases, will bring together researchers and educators from the UCLA School of Public Health, the David Geffen School of Medicine at UCLA, and other UCLA entities.

"Our hope is to develop an integrative training and research framework where students can learn to assess the many seemingly distinct aspects of dietary, lifestyle and genetic factors that cause these prevalent phenotypes," said Dr. Simin Liu, program co-director and a professor of epidemiology and medicine. "Once trained, these scientists will be able to develop better insights and system strategies to curb this epidemic."

In short, Liu said, the goal of the program is to "provide comprehensive, interdisciplinary education and research training in all facets, attacking such metabolic diseases across the board, from sick molecules to sick populations."

The BWF-ITP-MD is the first-ever Ph.D. program to combine multiple disciplines in its approach to the study of metabolic diseases.

"We live at a point in time when metabolic diseases are rising faster than we can keep up, even as breathtaking scientific discoveries are being made that are unprecedented in the history of biomedical sciences," said Dr. Thomas Drake, program co-director and a professor of pathology and laboratory medicine at the Geffen School of Medicine. "So the question many of us often ask is, how can we harness the major advances in biomedical sciences to bring out preventive and treatment measures to conquer what appears to be the public health nemesis of our time?"

Unfortunately, Liu and Drake said, diabetes has a wide reach. For example, the incidence of major cardiovascular events has increased two- to four-fold due to diabetes, with women and minorities disproportionately bearing the largest burden. If this trend continues, they say, it is estimated that children who were born in the U.S. in 2000 will, on average, live shorter lives than their parents.

"Talented young people who are well-trained in the concepts, strategies and advanced tools of both population and lab-based research remain a rarity, particularly in the field of metabolic diseases and disciplines of epidemiology and pathology," Drake said. "This program intends to fill that gap."

Liu and Drake are leaders in translational research, pursuing multidisciplinary initiatives from the basic science of molecular mechanisms all the way to the genetic and nutritional epidemiology of metabolic diseases. The BWF-ITP-MD at UCLA is one of only three programs nationwide to be funded by the Burroughs Wellcome Fund (BWF), following a highly selective multistage process that was based on the quality, innovation, and logic of the proposed training program and its relevance to the goals of this award program, said Dr. John E. Burris, BWF president.

UCLA demonstrated that kind of breadth with an existing program, which had already been set in motion by Liu. Three years ago, he established the Program on Genomics and Nutrition within the UCLA School of Public Health (http://nutrigen.ph.ucla.edu), which employs an integrative approach to training and research in the discipline of molecular epidemiology and the field of metabolic diseases.

Specifically, the new training program's mission is to bring the best population and lab-based sciences to bear by assessing the impact of genes and their interactions with behavior, nutrition and the environment on health and diseases, and to critically and systematically evaluate the significance of genetic and dietary variations within populations, ultimately applying that knowledge to improving the public's health.

"This new cross-disciplinary program represents the future of training in biomedical sciences," said Dr. Linda Rosenstock, dean of the UCLA School of Public Health. "We are excited about our role in training the next generation of scientists about the various genetic and environmental factors that cause obesity and diabetes, one of the most serious public health threats of our time."

"I am delighted this innovative program is being implemented," said Dr. Gerald Levey, vice chancellor of UCLA Medical Sciences and dean of the Geffen School of Medicine. "Drs. Liu and Drake are respected leaders in translational science who care deeply about education and training a new generation of biomedical leaders capable of unifying the many technical and biological facets of modern biomedical science."

 Help NHS Direct Support People With Diabetes, UK – 27^th January

NHS Direct, the 24/7 telephone and online health information service, needs your help to improve the support it offers people with diabetes.

NHS Direct and the National Diabetes Support Team are carrying out a review of its services for people with diabetes that aims to provide appropriate referrals and deliver self-help care.

Could you attend an event on 13 February?

As part of the review, they are looking for people with diabetes to attend a stakeholder event in London on Friday 13 February.

About the event

The event will be a very practical day focused on exploring and developing ideas and practical proposals for the future. In assessing how NHS Direct can best support people with diabetes, the stakeholder conference aims to explore the current issues and ways to further improve the call system both in and out-of-hours.

Where and when

The event will be held at the Millennium Gloucester Hotel and Conference Centre in Kensington, London, from 10am to 4pm on Friday 13 February. Full details and a programme for the day will be sent out nearer the time.

Book online or find out more

To book your place please register online at the NHS website.

UnitedHealthcare Launches First Diabetes Plan With Incentives For Preventive Care – 20thJanuary

UnitedHealthcare, a UnitedHealth Group (NYSE:UNH) company, is introducing a health care plan designed to help the rapidly growing numbers of diabetics and pre-diabetics manage their conditions more effectively while controlling employers' escalating costs of insuring them.

The first-of-its-kind Diabetes Health Plan will reward diabetic and pre-diabetic individuals who routinely follow independent, medically proven steps to help manage their condition - such as regular blood sugar checks, routine exams and preventive screenings - and use wellness coaching. Benefits include some diabetes supplies and diabetes-related prescription drugs at no charge, as well as lower co-payments for related doctor visits, at an estimated savings of up to $500 a year.

"The Diabetes Health Plan provides incentives to empower diabetics and pre-diabetics to take charge of their health and well-being, helping them delay or prevent the onset of dangerous diabetic complications later in life, which in turn should help employers lower the cost of providing health benefits," said Sam Ho, M.D., UnitedHealthcare's executive vice president and chief medical officer.

According to the American Diabetes Association (ADA), in 2007 nearly 24 million people in the U.S. had diabetes, 24 percent of whom were undiagnosed. Another 57 million are considered pre-diabetic, with about a fourth of them unaware of their condition.

Data from the Centers for Disease Control and Prevention show that two-thirds of all diabetics do not follow their physicians' advice on how to manage their disease. Experts say out-of-pocket costs for recommended supplies, medicines and physician-visit co-pays are a key reason why many diabetics do not follow treatment guidelines. Another is lack of knowledge about diabetes and pre-diabetic conditions. By lowering financial barriers and providing wellness coaching, training and information, and a real-time compliance monitoring system and personal health record, UnitedHealthcare's Diabetes Health Plan provides many new incentives to help people better manage their health.

UnitedHealthcare anticipates that increased preventive steps by Diabetes Health Plan participants can help lower health care costs for employers. Total estimated annual cost of a diabetic is greater than $22,000 a year, which is 13-times higher than the average cost of a "healthy" employee (defined as an individual with no chronic disease), according to UnitedHealthcare data.

Targeting a bigger population segment

"Disease-management programs have traditionally focused on complications for people already known to have diabetes," said Deneen Vojta, M.D., UnitedHealthcare's vice president, clinical innovation. "We are targeting a much bigger segment of the population with the Diabetes Health Plan. Our objective is to slow the progression of the disease for people with diabetes, and in as many cases as possible to reverse the condition for people in the pre-diabetes stage."

Progress on both fronts could save U.S. employers billions of dollars, she said, and could help slow or reduce the escalating costs for health care. The cost of diabetes to the U.S. economy has increased 32 percent since 2002, or $8 billion a year, reaching $174 billion in 2007, according to estimates by the ADA. The disease also takes a significant toll on the resources of the U.S. health care system. One out of every five health care dollars is spent caring for someone with diagnosed diabetes, while one in 10 health care dollars is attributed directly to diabetes, according to the ADA.

UnitedHealthcare employer-specific studies show that the estimated average cost for treating pre-diabetic patients is $5,000. For previously undiagnosed diabetics, the expected annual cost is $12,000; and for diabetics without complications that often afflict people with the disease, the annual cost is $10,000. The average annual cost for diagnosed diabetics with complications, such as heart disease or kidney failure, can soar to $30,000.

Early detection and self-management are key

"The key to our program is to engage individuals as soon as possible and design personalized, specific self-management steps for them that can decrease the odds they will move into higher-cost categories of treatment," Dr. Vojta said. "For example, research shows that a typical person in the pre-diabetic group who reduces body weight by 7 percent through activities such as adopting better eating habits or walking 150 minutes per week reduces the risk of becoming diabetic by 58 percent."

A decades-long epidemic of obesity in the U.S. is a major reason for the sharply rising numbers of diabetic and pre-diabetic adult Americans. Diagnoses of people with diabetes increased by 13.5 percent between 2005 and 2007, with 1.6 million new cases reported in 2007 alone, according to the ADA.

"There is a massive, untapped opportunity for millions of American who have pre-diabetes diagnoses to stop, and perhaps even reverse, the progress of the disease before it's too late," Dr. Ho said. "By encouraging them to take the right preventive steps, with clear incentives including lower out-of-pocket costs, we can help people improve the quality of their lives."

No charge for self-care training, diabetes-related drugs and services

Diabetes Health Plan participants who regularly follow their treatment plans can receive access to online monitoring and education tools at no charge, in addition to self-monitoring training and certain diabetes-related drugs (insulin, oral anti-glycemics, ARB and ACE, anti-depressants and statins) and services. In addition, the plan provides a voluntary screening model to help individuals determine if they have undiagnosed diabetes or suffer from pre-diabetes conditions. To remain enrolled in the program, participants must comply with diabetes and preventive care evidence-based guidelines.

The Diabetes Health Plan is available to self-insured commercial health plan customers and their family members with diabetes or pre-diabetes.* Employers have the option of offering the program as a standalone health plan or as an enhancement to an existing traditional plan.

Read this Diabetes Fact Sheet from the Centers for Disease Control and Prevention to learn more about the disease.

About UnitedHealthcare

UnitedHealthcare provides a full spectrum of consumer-oriented health benefit plans and services to individuals, public sector employers and businesses of all sizes, including more than half of the Fortune 100 companies. The company organizes access to quality, affordable health care services on behalf of more than 26 million individual consumers, contracting directly with more than 570,000 physicians and care professionals and nearly 4,900 hospitals to offer them broad, convenient access to services nationwide. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.

* Self-insured plans generally are used only by larger employers, with claims administered by an insurance company. The employer itself is responsible for paying covered health care costs for participating employees and family members.

UnitedHealthcare

New Blood Glucose Target Ranges, UK – 19th January

Diabetes UK has updated its blood glucose target ranges for people with diabetes, following recommendations from the National Institute for Clinical Excellence (NICE).

In November 2007, the International Diabetes Federation (IDF) suggested changes to the post-meal target ranges.

In 2008, NICE published their guidelines for Type 2 diabetes, again with changes to the target ranges.

As part of Diabetes UK's policy to continually review and update advice for people with diabetes, we have now reviewed our recommendations in line with NICE.

Details of our new recommendations can be found by following the related links on this page.

Diabetes UK

Is There A Relationship Between Sleep-wake Rhythm And Diabetes? A New Gene Variant Influences Fasting Glucose Levels Via The Melatonin Metabolism

An international research team with German participation including Helmholtz Zentrum München, among other institutions, has succeeded in identifying a new gene variant which is associated with elevated fasting glucose levels and a high risk for type 2 diabetes.

The gene mediates insulin secretion indirectly via the release of melatonin, which implicates a previously unknown relationship between the sleep-wake rhythm and the fasting glucose level. The finding could open up new possibilities of treatment which go far beyond the primarily symptomatic therapy approaches to diabetes that have been practised until now.

Diabetes mellitus and diabetes-associated late complications are among the most frequent chronic diseases and causes of death worldwide. In Germany there are approximately six million people with type 2 diabetes who are aware that they have the disease. In addition, there is a relatively high estimated number of undiagnosed diabetics. Besides lifestyle factors such as overweight and lack of exercise, genetic factors play an important role in the pathogenesis of this disease.

The international MAGIC Consortium (MAGIC = Meta-Analyses of Glucose and Insulin-related traits Consortium) combined the data from 13 case-control studies with over 18,000 diabetic and 64,000 non-diabetic study participants and was able to identify a variant of the MTNR1B gene which is associated with both elevated fasting glucose levels as well an elevated risk for type 2 diabetes. The goal of the MAGIC Consortium is to identify gene variants which regulate the fasting glucose levels in healthy individuals.

The study results were published in the January issue of Nature Genetics.

Germany is represented within the framework of the KORA studies by scientists of the Helmholtz Zentrum München (Assistant Professor Thomas Illig; Director of the KORA studies: Professor H.-Erich Wichmann) and the German Diabetes Center in Düsseldorf (Dr. Wolfgang Rathmann, Dr. Christian Herder; Direktor: Professor Michael Roden).

The MTNR1B gene is expressed in insulin-producing islet cells, among other cells, and encodes one of the two known melatonin receptors. It is assumed that this receptor inhibits the release of insulin via the neural hormone melatonin. The melatonin level in the body is high at night and declines in daylight, whereas the insulin level is higher during the day than in the night. Taken together, these new data implicate an association between the sleep-wake rhythm, the so-called circadian rhythm, and fasting glucose levels, which was not known previously.

Until now an efficient strategy for prevention and for therapies to treat the cause of the disease has been missing in diabetes research. The Helmholtz Zentrum München is working intensively on new approaches in the study and treatment of diabetes. Further studies will show which role melatonin plays in the regulation of insulin secretion, fasting glucose levels and the development of diabetes and whether this finding will lead to new treatment options.

Investigation Of Urodynamic Characteristics And Bladder Sensory Function In The Early Stages Of Diabetic Bladder Dysfunction In Type 2 Diabetes Women – 14th January

UroToday.com - For decades, scientists believed that the diabetic cystopathy is a result of vesical sensory dysfunction. But, how could the vesical sensory dysfunction affect the emptying function in diabetic patients? The overdistention due to sensory loss of the bladder filling in diabetes is the most popular explanation. Is it true? There is little evidence in human research to suggest it is. The other question is the role of C fiber neuropathy in the pathophysiology of the diabetic bladder dysfunction. In humans, the physiological function of vesical C fiber is still unclear. Traditionally, urologists only can evaluate the vesical C fiber neuropathy by ice water test and thus obtain a rough result. Most neurourologists could support the notion that activation of C fiber is contributed to detrusor overactivity in some pathophysiological conditions. Could the sensory loss of vesical C fiber in diabetes impair the emptying function or not? It is an interesting question.

We sought to validate the hypothesis that vesical sensory dysfunction can directly affect the emptying function without the overdistention process in diabetes. We designed this cross-section study by using urodynamic studies along with intravesical current perception testing to examine the early stages of diabetic bladder dysfunction. Because the mean age of diabetic patients in developed countries is around 60 years, we avoided the confounder of benign prostatic hyperplasia and selected the diabetic woman as our study population. Our study design was based on the concept that unrecognized and compensated diabetic bladder dysfunction is in the early stages. In the section of materials and methods, the phrase "had not sought treatment for DBD" is an exclusion criterion to exclude the patients in the late stage of diabetic bladder dysfunction.

Our study proved the concept that vesical C fiber as well as Aδ fiber neuropathy could cause the detrusor underactivity directly without the process of overdistention. Therefore, the C fiber in the human bladder may have its physiological role in initiating micturition. In addition, we suggest that the intravesical current perception testing is an appropriate technique to evaluate the progression of diabetic bladder dysfunction.

Written by Wei-Chia Lee, MD as part of Beyond the Abstract on UroToday.com

UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice.

Controlling Type 2 Diabetes With Low-Carb Diets – 13th January

In a six-month comparison of low-carb diets, one that encourages eating carbohydrates with the lowest-possible rating on the glycemic index leads to greater improvement in blood sugar control, according to Duke University Medical Center researchers.

Patients who followed the no-glycemic diet experienced more frequent reductions, and in some cases elimination, of their need for medication to control type 2 diabetes, according to lead author Eric Westman, MD, director of Duke's Lifestyle Medicine Program. The findings are published online in Nutrition and Metabolism.

"Low glycemic diets are good, but our work shows a no-glycemic diet is even better at improving blood sugar control," he says. "We found you can get a three-fold improvement in type 2 diabetes as evidenced by a standard test of the amount of sugar in the blood. That's an important distinction because as a physician who is faced with the choice of drugs or diet, I want a strong diet that's shown to improve type 2 diabetes and minimize medication use."

Eight-four volunteers with obesity and type 2 diabetes were randomized to either a low-carbohydrate ketogenic diet (less than 20 grams of carbs/day) or a low-glycemic, reduced calorie diet (500 calories/day). Both groups attended group meetings, had nutritional supplementation and an exercise regimen.

After 24 weeks, their glycemic control was determined by a blood test that measured hemoglobin A1C, a standard test used to determine blood sugar control in patients with diabetes. Of those who completed the study, the volunteers in the low-carbohydrate diet group had greater improvements in hemoglobin A1C. Diabetes medications were reduced or eliminated in 95 percent of the low-carbohydrate volunteers, compared to 62 percent in the low-glycemic group. The low-carbohydrate diet also resulted in a greater reduction in weight.

"It's simple," says Westman. "If you cut out the carbohydrates, your blood sugar goes down, and you lose weight which lowers your blood sugar even further. It's a one-two punch."

The diet is not easy for everybody. "This is a therapeutic diet for people who are sick," says Westman. "These lifestyle approaches all have an intensive behavioral component. In our program, people come in every two weeks to get reinforcements and reminders. We've treated hundreds of patients this way now at Duke and what we see clinically and in our research shows that it works."

University Lecturer Warns Of Rising Prevalence Of Type 2 Diabetes, UK – 12^th January

With the New Year inevitably comes the resolution of millions to get in shape. But shedding the pounds is now more important than ever - being overweight is the top factor in developing Type 2 diabetes.

Just over 2 million people currently suffer from diabetes in the UK, and shockingly there could be a further 1/2 million people who are unaware they have the disease, says Phil Holdich, Senior Lecturer at the University of Huddersfield, which is to hold a conference on diabetes in association with charity Diabetes UK and York University on Thursday 8th January.

The conference, New Clinical Solutions in Diabetes Care, will involve practitioners from across the region and look at ways of improving care for diabetes sufferers in primary care settings. Presenters will also put forward new ways of supporting general practices in the development of care planning for people with Long Term Conditions - one of the key recommendations of the recent Darzi report.

Key presentations will look at making the best use of current diabetes treatments (Professor Steve Atkin from the Michael White Diabetes Centre at Hull Royal Infirmary and Dr Paul Jennings from York Hospital), cultural perspectives on delivering diabetes care (Julie Wood, Diabetes and Renal Programme Manager, Kirklees PCT ) and developing services for people with diabetes over the next five years (Bridget Turner, Head of Policy, Diabetes UK).

"Diabetes is a potentially dangerous disease because people are still relatively unaware of the harm it can do," explains Mr. Holdich. "Being overweight is a strong risk factor in developing the disease, and once you have it, you have it for life. At the University, we are currently researching ways of not only managing the long-term condition, but ultimately preventing it."

Despite long-running government campaigns calling for healthier diets and more exercise, obesity levels in the UK continue to rise every year. Studies undertaken throughout the world indicate that managing weight gain and maintaining a healthy diet can decrease the risk of Type 2 diabetes by up to 80%. The risk increases for those over 40 years of age, of Black or South Asian origin, and those who have a family history of the disease.

Diabetes UK is celebrating its 75th anniversary in 2009. Diabetes UK is a patient focussed organisation which offers services for people with diabetes and support to healthcare professionals in providing the best diabetes care they can.

University of Huddersfield

Get Fit For Free, UK – 9th January

If you are one of the many who've resolved to get fitter this year, then this is the one resolution you should try to keep. Only 40% of men and 28% of women take the recommended amount of exercise and according to the British Medical Journal, regular exercise reduces the risk of conditions such as heart disease and Type 2 diabetes by 20 to 30 per cent. It can also help trim off extra pounds, keep your heart healthy and best of all, you don't have to put your hand in your pocket to get results.

Walk your way to fitness

Walk to work if you can or get off the bus a few stops early and save on the fare. Parking out of town and walking the rest of the way will save pounds in parking, reduce the stress of rush hour traffic and help the environment too.

Run for fun

Going out for your first run can be a little daunting, so try alternating running and walking between lamp posts and gradually increase the running sections. Entering a fun run is a great way to motivate yourself and really is fun, especially if you do it in a group.

Get some wheels

Cycling, skateboarding and rollerblading are fun ways to improve your cardiovascular fitness, balance and coordination. Whatever your age, get out there and give it a go.

Speak to your doctor about any medical conditions first and if you haven't exercised for a while, start slowly. Always warm up before you start and take a little time to cool down. Most of all, remember that exercise is fun, free and full of benefits for you and your heart.

Diamyd Medical: New Study Application To Vaccinate Against Juvenile Diabetes With Diamyd®

Diamyd Medical AB (publ.) (Pink Sheets:DMYDY) (STO:DIAMB): A renowned research group at Lund University has filed an application with the Swedish Medical Products Agency to carry out a study of the diabetes vaccine Diamyd® for the prevention of type 1 diabetes in Swedish children. This is the second prevention study with the diabetes vaccine Diamyd® for which approval has been sought in a short period.

Several independent research groups plan prevention studies using the diabetes vaccine Diamyd® with the aim of vaccinating children at risk of developing type 1 diabetes, before disease onset. The company has previously announced that a Nordic prevention study is being planned. Today's announcement concerns a Swedish prevention study that is being planned under the leadership of Dr. Helena Elding Larsson, pediatrician and researcher at Lund University.

"We are on the threshold of an eventful period, in which Diamyd Medical's diabetes vaccine is evermore sought after for various studies", says Elisabeth Lindner, President and CEO of Diamyd. "There is an optimistic aura about Diamyd. We end this year with two world news within the last ten days; the planned start of two independent prevention studies. We have also reached all of our goals for 2008".

Type 1 diabetes, is a very serious life-long disease that normally strikes at an early age and is increasing rapidly among children. The only treatment that is currently available for those with the disease is daily insulin injections and a strict control of blood sugar levels. Patients with type 1 diabetes are often subject, unfortunately, to serious complications, despite receiving modern insulin treatment. A treatment that can prevent the disease would be extremely valuable not only for those at risk of developing the disease, but also for society.

"Type 1 diabetes is preceded by an often slow destruction of the insulin-producing cells. It has been shown that Diamyd® can protect the insulin producing cells from destruction in recent-onset patients. By giving Diamyd® before the breakdown process has advanced to the stage of disease outbreak, we now hope that the disease could be prevented or at least delayed", says pediatrician Helena Elding Larsson.

The Diamyd® vaccine is already being tested in Europe and the US in the Company's own Phase III studies of children and adolescents with recent-onset type 1 diabetes. It has been shown in a study published in the leading medical journal New England Journal of Medicine earlier this fall that Diamyd® has good efficacy in recent-onset children and adolescents. The first results from the ongoing Phase III studies, which should result in a market application for the Diamyd® diabetes vaccine, are expected to be available in the fall of 2010. At the same time, Diamyd Medical is developing additional diabetes-related products, including products for LADA (Latent Autoimmune Diabetes in Adults) and products for diabetes-related complications.

Diamyd Medical is a Swedish biopharmaceutical company focusing on development of pharmaceuticals for treatment of autoimmune diabetes and its complications. The company's most advanced project is the GAD-based drug Diamyd® for type 1 diabetes and for which Phase III trials are ongoing in both the US and Europe. Furthermore, the company has initiated clinical studies within chronic pain, using its Nerve Targeting Drug Delivery System (NTDDS). The company has also out-licensed the use of GAD for the treatment of Parkinson's disease.

Diamyd Medical has offices in Sweden and in the US. The share is quoted on the OMX Stockholm Nordic Exchange (ticker: DIAM B) and on OTCQX in the US (ticker: DMYDY) administered by the Pink Sheets and the Bank of New York (PAL). Further information is available on the company's web site: www.diamyd.com

This information is disclosed in accordance with the Securities Markets Act, the Financial Instruments Trading Act or demands made in the exchange rules.

Cellular Reprogramming: Science's Breakthrough

Of The Year – 7th January

In its annual list of the year's top ten scientific break -throughs, the journal Science has given top honors to research that produced "made-to-order" cell lines by reprogramming cells from ill patients. These cell lines, and the techniques for producing them, offer long-sought tools for understanding -- and hopefully someday curing -- difficult-to-study diseases such as Parkinson's disease and type 1 diabetes.

Science and its publisher, AAAS, the nonprofit science society, now salute cellular reprogramming as the Breakthrough of the Year and recognize nine more of the year's most significant scientific accomplishments. The top ten list appears in a special feature in the journal's December 2008 issue.

"When Science's writers and editors set out to pick this year's biggest advances, we looked for research that answers major questions about how the universe works and that paves the way for future discoveries. Our top choice, cellular reprogramming, opened a new field of biology almost overnight and holds out hope of life-saving medical advances," said deputy news editor Robert Coontz.

Two years ago, in experiments with mice, researchers showed that they could wipe out a cell's developmental "memory" by inserting just four genes. Once returned to its pristine, embryonic state, the cell could then be coaxed to become an altogether different type of cell.

This year, scientists built on this work with spectacular results. Two research teams took cells from patients suffering from a variety of diseases and reprogrammed them into stem cells. Many of these diseases are difficult or impossible to study with animal models, making the need for human cell lines to study even more acute.

The transformed cells grow and divide in the laboratory, unlike most adult cells, which don't survive in culture conditions. The cells could then be induced to assume new identities, including those cell types most affected by the diseases afflicting the patients who had donated the initial cells.

A third research team skipped the embryonic state altogether and, working with mouse cells, turned one type of mature pancreas cells, called exocrine cells, directly into another type, called beta cells.

The new cell lines will be major tools for understanding how diseases arise and develop, and they may also prove useful in screens for potential drugs. Eventually, if scientists can master cellular reprogramming so that it's more finely controlled, efficient and safe, patients may someday be treated with healthy versions of their own cells.

The other nine scientific achievements of 2008 follow. Except for the first runner-up, the direct detection of extrasolar planets, they are in no particular order.

Exoplanets - Seeing Is Believing: For the first time this year, astronomers directly observed planets orbiting other stars, using special telescope techniques to distinguish the planets' faint light from the stars' bright glare.

Expanding the Catalog of Cancer Genes: By sequencing genes from various cancer cells, including pancreatic cancer and glioblastoma, two of the deadliest cancers, researchers turned up dozens of mutations that remove the brakes on cell division and send the cell down the path to cancer.

New Mystery Materials: High-temperature superconductors are materials that carry electricity without resistance at inexplicably high temperatures. In 2008, researchers created a stir by discovering a whole second family of high-temperature superconductors, consisting of iron compounds instead of copper-and-oxygen-compounds.

Watching Proteins at Work: Biochemists encountered major surprises this year as they watched proteins bind to their targets, switch a cell's metabolic state and contribute to a tissue's properties.

Toward Renewable Energy on Demand: This year, researchers found a promising new tool for storing excess electricity generated from part-time sources like wind and solar power, on industrial scale. A cobalt-phosphorus catalyst that's relatively easy to come by can use electricity to split water to free its hydrogen, which can in turn be fed into fuel cells to produce electricity again.

The Video Embryo: In 2008, researchers observed in unprecedented detail the dance of cells in a developing embryo, recording and analyzing movies that trace the movements of the roughly 16,000 cells that make up the zebrafish embryo by the end of its first day of development.

"Good" Fat, Illuminated: In a study that may offer new approaches to treating obesity, scientists discovered that they could morph "good" brown fat, which burns "bad" white fat to generate heat for the body, into muscle and vice versa.

Calculating the Weight of the World: Physicists now have the calculations in hand to show that the standard model -- which describes most of the visible universe's particles and their interactions -- accurately predicts how much mass protons and neutrons have.

Faster, Cheaper Genome Sequencing: Researchers reported a flurry of genome sequences this year - from woolly mammoths to human cancer patients - aided by a variety of sequencing technologies that are much speedier and cheaper than the ones used to sequence the first human genome.

Areas to Watch: Science's predictions for hot science topics in 2009 include plants genomics, the elusive Higgs boson, speciation genes, ocean acidification, and neuroscience in court.

The special news features also looks at how the financial meltdown - the Breakdown of the Year - affected scientific research, and the major scientific collaborations getting off the ground in Europe

One Person Diagnosed With Diabetes Every Three Minutes In The UK – 6th January

One person is diagnosed with diabetes every three minutes* in the UK, according to new figures from Diabetes UK. The leading health charity, which has released the shocking statistic to mark its 75th Anniversary, says the number of people diagnosed with the condition is growing faster than ever. This is particularly worrying for Black and minority ethnic groups as Type 2 diabetes is up to three times more common in Black people and up to six times more common in South Asian people. In the UK more than 300,000 people from Black and minority ethnic groups have diabetes5.

Diabetes UK has looked in detail at official figures and found that almost 150,000 people were diagnosed with diabetes in 2008. In the previous year this number was 100,000. This is a conservative estimate as, when taking into account the people with the condition who have died in the past year, the number of new cases could be as high as 180,000. Other figures suggest that 20 per cent of the South Asian community and 17 per cent of the Black African and Caribbean communities have Type 2 diabetes in contrast to three per cent of the general population6.

The charity is especially keen to reach people from Black and minority ethnic groups as they are likely to develop the condition and its various complications at a younger age than the rest of the population. There are currently 2.5 million people in the UK with diabetes and it is estimated that more than half a million people have the condition but do not know it.

Douglas Smallwood, Chief Executive of Diabetes UK, said: "This week 75 years ago, Diabetes UK was created and although we continue to work tirelessly to improve people's health, diabetes remains one of the biggest health challenges of our time. We must protect the health of the nation by taking urgent steps to further raise awareness of diabetes and its complications.

"Diabetes UK wants the Government to put diabetes at the top of the health agenda in 2009. People need to be supported to make changes to their lifestyle, such as eating healthily, losing weight if appropriate and being physically active, in order to reduce their risk of developing Type 2 diabetes. We also need to make sure that anyone diagnosed with the condition has access to the best possible care, information and support in order to reduce their risk of developing the serious complications of the condition."

Diabetes is a serious condition that can lead to long-term complications such as heart disease, stroke, blindness, kidney failure and amputation. Short-term complications include hypoglycaemic episodes, known as 'hypos', which can lead to unconsciousness and hospitalisation if left untreated, and persistent high blood glucose levels can lead to diabetic ketoacidosis (DKA) which if untreated can be fatal. For those with diabetes morbidity is also much higher, especially heart disease (two to three times higher in South Asians)7, renal failure (four times higher in Asians)8 and stroke (three times higher in African-Caribbeans)9.

2009 is Diabetes UK's 75th anniversary and the charity wants to use this special year as an opportunity to further raise awareness of diabetes and its complications. Events to mark this special occasion will be taking place around the country. Diabetes UK's mission is to improve the lives of people with Type 1 and Type 2 diabetes and work towards a world without diabetes. This year the charity is committed to spending around Ł8 million funding a variety of research projects.

Diabetes UK was set up on 10 January 1934 by the novelist HG Wells - Author of The Time Machine and The War of the Worlds - and Dr RD Lawrence, both of whom had diabetes. The charity's aim was to ensure that everyone in the UK could gain access to insulin, whatever their financial situation. This was a ground-breaking initiative prior to the existence of a national health service. The organisation (previously called the Diabetic Association and then the British Diabetic Association) has always challenged ideas of how people with diabetes should be treated and from the start believed in a partnership working between the people with diabetes and healthcare professionals to support active self-management of the condition. The organisation actively campaigned for the establishment of the NHS and our underlying principles of proactive control and lobbying continue to this day.

Notes:

*Figures based on the findings of a Diabetes UK report, Diabetes in the UK 2008: key statistics, to be published in January 2009.

100,000 People With Diabetes Call '999' A Year – 5th January

People with diabetes made more than 100,000 emergency calls in the UK last year, according to Diabetes UK.

The charity warns that although the ambulance service has recently experienced an unprecedented volume of calls with many for non-emergency situations, most calls from people with diabetes are for severe hypoglycaemia (hypo).

Hypos and DKA

A hypo is a serious short term diabetic complication caused by low blood glucose levels, which in severe cases lead to unconsciousness and require emergency medical intervention.

Other '999' call-outs from people with diabetes will be due to diabetic ketoacidosis (DKA), caused by high blood glucose levels, which if not treated quickly can lead to diabetic coma. Last year over 12,000 people with diabetes in England were rushed to A&E because of DKA.

A vital service

"Diabetes UK recognises that the ambulance service does an amazing job and is currently under immense pressure due to increased call-outs and non-emergency calls," said Douglas Smallwood, Chief Executive of Diabetes UK.

"For people with diabetes, illnesses such as flu can play havoc with diabetes management causing blood glucose levels to fluctuate. This can leave people with diabetes at higher risk of DKA and more exposed to the complications of flu such as pneumonia and bronchitis.

"For people with diabetes, '999' calls will invariably be genuine emergencies and the continued excellent service of ambulance crews is vital for their health."

Type 1 Diabetes May Be Triggered By Common Infant Virus – 5th January

Human parechovirus is a harmless virus which is encountered by most infants and displays few symptoms. Suspected of triggering type 1 diabetes in susceptible people, research methods need to take this "silent" virus into consideration. This comes from findings in a study from the Norwegian Institute of Public Health.

This study was part of a long-term project at the Norwegian Institute of Public Health to investigate if environmental risk factors affect type 1 diabetes. Faecal samples and questionnaires about the health of 102 children were sent in monthly by their parents for closer study.

Researchers wanted to see how common human parechovirus infections were among Norwegian infants. Existing research indicates that a related virus which only affects rodents, Ljungan virus, has been linked to the development of rodent diabetes.

Common virus

By studying stool samples from 102 infants and comparing feedback from parents about their child's health over three years, no significant link could be found between infection episodes and typical symptoms such as coughing, sneezing, vomiting, diarrhoea or fever. By the age of two, 86 percent of the infants had evidence of parechovirus in their faeces, and 94 percent by the age of three. Human parechovirus 1 was the most prevalent type (76 percent) followed by human parechoviruses 3 and 6 (13 percent and 9 percent respectively).

The researchers also noticed an increase in parechovirus infection between the ages of 6 and 18 months. This could be due to the loss of maternal antibodies by 6 months of age or the exposure to nursery/play groups that often begins at this age in Norway. Most infections occurred during September to December.

The 102 infants were recruited from babies born in 2004, with half from the high risk group for diabetes type 1 and the rest from a low risk group. The "high-risk" group included babies who had been identified at birth to carry the HLA genotype conferring the highest known risk for type 1 diabetes. The group not carrying the high-risk genotype included babies born at the same time and in the same area to the high risk babies.

The researchers conclude that most infants are infected by human parechovirus without displaying symptoms and so the total number of previous infections should be considered when looking for triggers for type 1 diabetes among those who are genetically at risk. Perhaps too few infections or infection at a too late time point could be important.

High Blood Sugar's Impact On Immune System Holds Clues To Improving Islet Cell Transplants - 19th December

A biological tit for tat may hold clues to improving the success of islet cell transplants intended to cure type 1 diabetes, according to a Medical College of Georgia scientist.

In type 1, the immune system attacks insulin-producing cells causing high blood glucose levels that may temporarily reduce the attack, said Dr. Rafal Pacholczyk, an immunologist in the MCG Center for Biotechnology and Genomic Medicine.

He just received a three-year, $495,000 grant from Juvenile Diabetes Research Foundation to find out whether this counteraction offers insight for transplants.

High blood glucose, or hyperglycemia, causes all sorts of dysregulation throughout the body. "It throws off metabolism, hormonal interplay and increases the risk of severe infections," Dr. Pacholczyk said. A shot of insulin or an islet cell transplant normalizes blood glucose levels, enabling, among other things, restoration of the usual balance between effector T cells which mount an immune or autoimmune response and regulatory T cells which suppress attacks.

He's obviously not saying hyperglycemia is good; in fact if diabetics were to get a transplant while their blood glucose was high the procedure alone could be lethal. But Dr. Pacholczyk hypothesizes it causes a temporary shift in the immune playing field that gives advantage to regulatory T-cells long enough for the body to accept the transplanted cells. One reason may be that suppressive regulatory cells recover differently or are less influenced by hyperglycemia.

Researchers at Canada's University of Alberta were the ones to find high blood glucose causes a short-lived suppression of the attack mode of the immune system followed by a slow return of homeostasis. The result: Islet cell transplants done in mice immediately after a blood glucose spike were dramatically more successful than those done days later, according to the research published in 2007 in the Scandinavian Journal of Immunology. In fact, the early recipients did not require immunosuppression, which transplants patients receive to reduce the risk that their new insulin-producing cells also will become targets for their immune system. However, this generalized immune suppression puts patients at increased risk for infections, cancer and other diseases. "Basically, your guard is down," Dr. Pacholczyk said.

Seventy percent of mice that got transplants two days after they became hyperglycemic did not need immunosuppression, the Canadian researchers found; after nine days, the acceptance rate was reduced to about 10 percent. "The question is why?" Dr. Pacholczyk said.

Typically the path isn't easy for transplanted cells. Many die from the stress of transplantation or immune system attack either because they are rejected as invaders or because the same autoreactive mechanism that led to destruction of the patient's own cells is resurrected. "Cells that survive are the ones being counted on. Over time, they should increase in mass to a level that should produce sufficient amounts of insulin," the researcher said.

Type 1 diabetes results from the wrong mix of genes and environmental triggers. For example, early exposure of a genetically predisposed child to cow's milk and a viral infection could trigger an immune response to bovine insulin which, in turn, leads to islet cell destruction.

The researcher's animal model reflects the human condition fairly well; it's inbred to have diabetes but Dr. Pacholczyk developed a system to chemically induce the disease when he wants so he'll know exactly when islet cells are destroyed by the immune system. He'll document hyperglycemia's impact on all immune cells with the long term goals of identifying the magic that enables acceptance of islet cells and finding a safer, more direct way to replicate it.

In 2007, he and colleague Dr. Leszek Ignatowicz caused a stir in the scientific community when they found that regulatory T cells, which always suppress the immune response, can recognize invaders as well as body tissue. That means they could technically keep the immune system from attacking a foreign substance, such as transplanted islet cell. But researchers cautioned then that manipulating T-cell levels to treat autoimmune diseases, such as type 1 diabetes and lupus, must be done cautiously and selectively to ensure patients are not put at the same risk as those on traditional immunosuppressive therapy. MCG news categories related to this story:

Diabetes and Obesity

School of Medicine

Diabetes Drugs Could Be Linked To Bone Fractures

18th December

New research claims long-term use of Thiazolidinediones, a class of drugs used to manage Type 2 diabetes, could potentially double some women's risk of breaking a bone.

The research by British and American scientists analysed the findings of ten studies involving almost 14,000 people with Type 2 diabetes. The researchers, from the University of East Anglia and Wake Forest University in North Carolina, compared the bone health of those on the drugs with others who were not.

Bone density in spine and hip affected

The study showed that use of thiazolidinediones affected bone density in the spine and at the hip. It found no increased fracture risk among men.

Thiazolidinediones, which includes the drugs rosiglitazone and pioglitzone, have been linked to a raised risk of fractures as well as heart problems.

Further evidence needed

"The results of this meta-analysis suggest that there might be an increase in fractures through the use of thiazolidinediones in certain groups of people who are at greater risk of fractures in the first place, said Dr Victoria King, Research Manager at Diabetes UK.

"However, we really do need further evidence through properly controlled trials before we can conclusively link thiazolidinediones to increased risk of various bone conditions in humans and determine which groups of people may be at greater risk.

Don't stop taking medication - consult your doctor

"Both the MHRA and the European Medicines Agency say that people should certainly not stop taking thiazolidinediones and if concerned they should consult their doctor.”

In Patients With Diabetes, Low-Glycemic Diet Shows Greater Improvement In Glycemic Control Than High-Fiber Diet – 17^th December

Persons with type 2 diabetes who had a diet high in low-glycemic foods such as nuts, beans and lentils had greater improvement in glycemic control and risk factors for coronary heart disease than persons on a diet with an emphasis on high-cereal fiber, according to a study in the December 17 issue of JAMA.

One dietary strategy aimed at improving both diabetes control and cardiovascular risk factors is the use of low-glycemic index diets, but there is disagreement over their effectiveness, according to background information in the article.

David J. A. Jenkins, M.D. and colleagues assessed the effects of a low-glycemic index diet vs. a high-cereal fiber diet on glycemic control and cardiovascular risk factors for 210 patients with type 2 diabetes. The participants, who were treated with antihyperglycemic medications, were randomly assigned to receive 1 of the 2 diet treatments for 6 months.

In the low-glycemic index diet, the following foods were emphasized: beans, peas, lentils, nuts, pasta, rice boiled briefly and low-glycemic index breads (including pumpernickel, rye pita, and quinoa and flaxseed) and breakfast cereals (including large flake oatmeal and oat bran). In the high-cereal fiber diet, participants were advised to take the "brown" option (whole grain breads; whole grain breakfast cereals; brown rice; potatoes with skins; and whole wheat bread, crackers, and breakfast cereals). Three servings of fruit and five servings of vegetables were encouraged on both treatments.

The researchers found that hemoglobin A1c (HbA1c; a substance of red blood cells tested to measure the blood glucose level) decreased by -0.50 percent absolute HbA1c units in the low-glycemic index diet compared with -0.18 percent absolute HbA1c units in the high-cereal fiber diet. Significant treatment effects were observed for high-density lipoprotein cholesterol (HDL-C) and the low-density lipoprotein cholesterol (LDL-C):HDL-C ratio. HDL-C increased in the low-glycemic index diet group by 1.7 mg/dL and decreased by -0.2 mg/dL in the high-cereal fiber diet group. The LDL-C:HDL-C ratio showed a greater reduction in the low-glycemic index diet group compared with the high-cereal fiber diet group.

"Lowering the glycemic index of the diet improved glycemic control and risk factors for coronary heart disease (CHD). These data have important implications for the treatment of diabetes where the goal has been tight glycemic control to avoid complications. The reduction in HbA1c was modest, but we think it has clinical relevance," the authors write. "Low-glycemic index diets may be useful as part of the strategy to improve glycemic control in patients with type 2 diabetes taking antihyperglycemic medications."

"Pharmacological interventions to improve glycemic control in type 2 diabetes have often failed to show a significant reduction in cardiovascular events. In view of the 2- to 4-fold increase in CHD risk in participants with type 2 diabetes, the ability of a low-glycemic index diet to address both glycemic control and CHD risk factors increases the clinical relevance of this approach for patients with type 2 diabetes, such as those in this study, who are overweight and also taking statins for CHD risk reduction."

Probing The Prevalence Of Disordered Eating Behaviors

In Diabetics – 11th December

Children with diabetes are at an increased risk for developing eating disorders and researchers want to know if it's their disease or treatment that's to blame.

"Diabetes treatment prescribes obsessive food behavior, such as carbohydrate restriction," said Dr. Deborah Young-Hyman, pediatric psychologist. "We want to know if those prescribed behaviors contribute to disordered eating and/or whether there are physiological mechanisms which prevent children with diabetes from controlling their eating behavior. For example, treatment with insulin makes you hungry and can cause you to gain weight."

There is some unfortunate synergy: diabetes makes it difficult to control blood glucose and disordered eating behavior does as well, Dr. Young-Hyman said.

Over the next three years she and researchers at Emory and Harvard universities will study 90 children age 10-17 newly-diagnosed with diabetes or transitioning to an insulin pump. They will monitor treatment patterns, weight, psychological adjustment and attitudes about weight and eating. They'll also look at changes in eating patterns and blood sugar levels in response to insulin.

Children and their parents will answer computer-based questionnaires about eating behaviors and psychological adjustment - in the context of their disease and its treatment.

These include questions about parental attitudes, family factors, personality of the child and parents and perceived societal attitudes.

"As they are diagnosed and are adjusting to diabetes treatment, children are already dealing with all sorts of issues that put them at an increased risk for eating disorders. The psychological issues that come with the diagnosis can add to that risk," she said. "There is also the existing drive for thinness that exists in our society, dealing with the diagnosis and management of a long-term illness and the psychological adjustment that comes with that."

Even the insulin the children must take may be a factor. "Large doses can lead to uncontrolled hunger, which can be mislabeled as disordered eating behavior. Patients with type 1 diabetes also lose amylin production - a hormone responsible for gastric emptying and associated with feelings of fullness - that can also lead to increased feelings of hunger," Dr. Young-Hyman said.

Study findings could support a different treatment approach.

"We might come to understand that putting a child or adolescent on an insulin pump sooner rather than later and providing them with a more flexible nutrition regimen could decrease their insulin needs and prevent excess hunger," she said. "If we don't approach weight control as dieting, place less emphasis on food restriction and focus on healthy nutrition and usual eating patterns, we can help patients gain more control over their eating behaviors and their treatment without adoption of maladaptive weight management strategies. Studies indicate that feeling in control of your illness is one of the keys to successful treatment and good psychological adjustment."

Epidemics Of Both Type 1 Diabetes (Insulin Dependent) And Type 2 Diabetes (Obesity Related) Are Linked To Immunization – 11th December

Data by Dr. J. Bart Classen published this week in Diabetes & Metabolic Syndrome: Clinical Research & Reviews provides further evidence that epidemics of type 2 diabetes/obesity/metabolic syndrome, like type 1 diabetes, are linked to immunization. Classen previously published proof vaccines are causing an epidemic of type 1 diabetes in children.

The new data as well as Classen's recently published data demonstrate that the epidemics of type 1 diabetes and type 2 diabetes/obesity/metabolic syndrome in children are linked. Exposure to vaccines causes some individuals to develop an autoimmune disease such as type 1 diabetes. In other individuals vaccine induced inflammation is countered by release of cortisol and other factors to suppress the inflammation. The release in cortisol and other factors leads to a "cushingoid" like state and the development of type 2 diabetes/obesity/metabolic syndrome.

Classen's current paper shows that those races which have high cortisol activity, especially after immunization, have a low risk for developing type 1 diabetes but a high risk for developing type 2 diabetes. Classen has previously demonstrated vaccine induced type 1 diabetes has a strong genetic/familial risk and those who have a sibling with type 1 diabetes have a much greater risk of developing vaccine induced type 1 diabetes.

In a previous publication in The Open Endocrinology Journal, Dr. Bart Classen showed a 50% reduction of type 2 diabetes occurred in Japanese children following the discontinuation of a single vaccine, a vaccine to prevent tuberculosis. This decline occurred at a time when there is a global epidemic of type 2 diabetes and metabolic syndrome.

"The picture is becoming clear. Not only are vaccines causing an epidemic of autoimmunity including type 1 diabetes but they are causing an epidemic of metabolic syndrome as the immune system acts to suppress the inflammation and autoimmunity caused by the vaccines. The current practice of vaccinating diabetics as well as their close family members is a particularly risky practice" says Dr. Bart Classen.

Classen's research has become widely accepted. To view the published

papers and to find out the latest information on the effects of vaccines on autoimmune diseases including insulin dependent diabetes visit the Vaccine Safety Web site http://www.vaccines.net/newpage11.htm

Poor Areas, Poor Diabetes Control In Children, UK – 9th December

Children and young people with diabetes living in the most deprived areas may not manage their diabetes as well as those from the most affluent areasą warns leading health charity Diabetes UK. Poor diabetes control leads to a higher risk of developing diabetes-related complications such as blindness, kidney disease and amputation.

The findings are based on an audit of 1,742 children and young people with diabetes treated in paediatric units. The study looked at blood glucose control in the children and young people and factors that might explain any differences. These factors included how old children were at diagnosis, how long they had diabetes for, the type of area they lived in and the size of the clinic they were treated in.

The study, published recently in the journal 'Diabetic Medicine', found that on average blood glucose levels in children with diabetes from the most deprived areas were 0.5 per cent higher than those from the most affluent areas. Blood glucose levels were also higher in those who were diagnosed at an older age and those who had diabetes for longer. This is particularly worrying as reducing blood glucose levels by 1 per cent reduces the risk of diabetes-related deaths by 21 percent, heart attacks by 14 per cent and retinopathy and kidney disease by 37 per cent.˛

Good blood glucose control is essential for people with diabetes as it prevents potentially fatal complications such as heart disease and stroke developing in later life. Short term complications include hypos when blood glucose levels fall too low, which could lead to becoming unconscious or in extreme cases, death, and Diabetic Ketoacidosis when blood glucose levels are too high.

Bridget Turner, Head of Healthcare and Policy at Diabetes UK, said: "The results of this study are particularly worrying as children in the UK already have the worst diabetes control in Europe. It raises questions that need to be investigated further in respect of the stark differences in health outcomes between the deprived and the affluent in this country.

"Diabetes UK wants all children and young people with diabetes to receive the same level of care regardless of their economic or cultural background and regardless of where they live. Local services need to invest in local paediatric diabetes services to ensure that children and families are given the support they need to self-manage and prevent the onset of devastating complications."

The study was carried out by Professor Patricia McKinney and researchers at the Centre for Epidemiology and Biostatistics at the University of Leeds who manage the Yorkshire Register of Diabetes in Children and Young People.ł

Diabetes in children is rising in the UK and other developed countries. There are 20,000 young people with Type 1 diabetes under the age of 15 and about 1,400 with Type 2 diabetes in the UK. Between 2002 and 2007 the number of children under five with Type 1 diabetes increased five-fold and the number of under-15s with Type 1 diabetes almost doubled.

Notes

-- Research carried out by P.A. McKinney, R.G. Feltbower, C. R. Stephenson and C. Reynolds on behalf of the Yorkshire Paediatric Diabetes Special Interest Group at the Centre for Epidemiology and Biostatistics, University of Leeds. Published in . Diabetic Medicine Volume 25 Issue 11. The study looked at 1742 children and young people with diabetes in 16 paediatric units in Yorkshire between January 2005 and March 2006.

-- Stratton IM, Adler AI, Neil HAW, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405-412.

-- Diabetes UK is the charity for people with diabetes. We fund more than Ł7 million of medical research every year, provide information and support to people with diabetes and campaign on their behalf. For more information visit http://www.diabetes.org.uk.

-- In the UK, there are currently 2.5 million people diagnosed with diabetes and it is estimated that more than half a million people have the condition but do not know it.

-- The Diabetes UK Careline (0845 120 2960) offers information and support on any aspect of managing diabetes. The line is a lo-call number and opens Monday to Friday between 9am and 5pm (operates a translation service). Recorded information on a number of diabetes-related topics is also available on this number 24 hours a day.

-- Membership of Diabetes UK is from Ł23 a year with special rates available. In addition to our bi-monthly magazine Balance, members receive support and the latest information on diabetes care and treatments to help them live a healthy life.

-- The University of Leeds is one of the largest higher education institutions in the UK with more than 30,000 students from 130 countries. With a total annual income of Ł422m, Leeds is one of the top ten research universities in the UK, and a member of the Russell Group of research-intensive universities.

Diabetes UK

First Childhood Obesity Symposium – 8th December

The Obesity Institute at Children's National Medical Center recently gathered experts from many disciplines to share ideas, failures and successes, and the future promise of prevention and intervention strategies to fight childhood obesity.

Through the Obesity Institute, Children's National seeks to reduce childhood obesity using a multidisciplinary approach that draws upon our experts from throughout Children's National, as well as research, clinical, policy, and advocacy partners region.

"There is no single cause for the increase in childhood obesity, but certainly high fat diets and lack of exercise are contributing factors," said Denice Cora-Bramble, MD, MBA, executive director of the Goldberg Center for Community Pediatric Health at Children's National. "Likewise, there is no single answer to systematically solving the problem. But the upward trend, especially here in the District, demands that we develop effective interventions faster."

Children's Obesity Institute tackles these issues from all angles. The Institute's multidisciplinary approach allows for a better understanding of the causes and barriers around this disorder, analyzing them from the laboratories that study the genetics to the community interventions impacting family lifestyles. Scientists, pediatricians, psychologists, psychiatrists, and many others presented their most recent efforts to uncover the underlying risk factors for childhood obesity and the earlier onset of type 2 diabetes.

Presentations included: An overview of Children's General Clinical Research Center (GCRC), which provides special resources, including trained research nurses and high-tech equipment for more effectively investigating growth, body composition, nutritional status, and metabolism from Catherine Klein, PhD, RD, Director of the Bionutrition Research Program at Children's National.

# A successful community intervention program for inner-city Latino youth developed by pediatrician Nazrat Mirza, MD, director of Children's Obesity Clinic.

# A study of the role of emergency departments in targeted obesity interventions, especially for low-income communities where families frequently use the emergency department as a primary care resource as well as for urgent care, from Mohsen Saidinejad, MD, of the Division of Emergency Medicine and Trauma Services.

# Current research by post-doctoral researcher Eleanor Mackey, PhD, of the Division of Psychiatry and Behavioral Health, that focuses on the linkages between eating disorders and other maladaptive weight control measures in overweight teens.

# An overview of new genomic research from geneticist Eric Hoffman, PhD, director of the Center for Genetic Medicine Research, that identifies a single gene which may signal a greater likelihood for high LDLs, and therefore when present may also signal an increase in the chance of high cholesterol, other health factors related to arterial disease, and the onset of type 2 diabetes.

# An analysis by health policy expert and pediatrician Anjali Jain, MD, of the current state of play for regional and national policies aimed at reducing obesity, from state-by-state school lunch policies to the newest legislation on the national food stamp and WIC programs.

"This is the first of many such meetings that will bring together our best and brightest investigators on this issue," said Joseph Wright, MD, executive director of the Child Health Advocacy Institute at Children's National. "These collaborations allow our teams to develop effective strategies locally through multidisciplinary studies. Then, as a national research and education leader, we can help similar communities replicate our successes."

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Article adapted by Medical News Today from original press release.

----------------------------

Children's National Medical Center is a proven leader in the development of innovative new treatments for childhood illness and injury. Children's has been serving the nation's children for more than 135 years. Children's National is proudly ranked among the best pediatric hospitals. For more information, visit http://www.childrensnational.org. Children's Research Institute, the academic arm of Children's National Medical Center, encompasses the translational, clinical, and community research efforts of the institution. Learn more about our research programs at http://www.childrensnational.org/research.

Source: Jennifer Leischer

Children's National Medical Center

MannKind Reports Positive Results From Final Two Pivotal Phase 3 Clinical Studies In Type 1 And Type 2 Diabetes – 5th December

MannKind Corporation (Nasdaq: MNKD) announced that it has met the primary endpoints of its final two pivotal Phase 3 studies of AFRESATM, the company's ultra rapid acting, inhaled insulin product. The company expects to disclose more details of the top-line data from these studies in patients with type 1 and type 2 diabetes (studies 030 and 102) by mid-December.

"We are very pleased to announce the positive outcome of these, the last of our three pivotal Phase 3 studies. We look forward to presenting more complete data, including analyses of secondary endpoints, as soon as they are available, which are expected before the end of this year. AFRESA promises to be an important additional option for the treatment of patients with diabetes. Our next step is to finalize a new drug application for AFRESA, which we expect to submit to the FDA in early 2009," commented Dr. Peter Richardson, MannKind's chief scientific officer.

About Study 030

Study 030 compared the pulmonary safety of meal-time inhalation of AFRESA versus usual care in over 2000 patients with type 1 and type 2 diabetes. The study met its primary endpoint: after two years of treatment, no adverse effects were observed on patients' lungs in the AFRESA-treated group.

About Study 102

Study 102 compared the efficacy of meal-time AFRESA in combination with a long-acting basal insulin versus twice daily injections of pre-mixed insulin (a mixture of a rapid-acting insulin analog and intermediate-acting insulin). Study 102 met its primary endpoint, showing comparable improvements in HbA1c levels over 52 weeks between the two treatment groups.

About AFRESA

Afresa is an ultra rapid acting inhaled insulin product that has completed Phase 3 trials. The pharmacokinetic profile of Afresa sets it apart from all other insulin products. The large surface area of the lung provides unique access to the circulatory system. The pH-sensitive Afresa particles immediately dissolve upon contact with the lung surface, releasing insulin monomers that rapidly enter the bloodstream. It achieves peak insulin levels within 12-14 minutes of administration, effectively mimicking the release of meal-time insulin observed in healthy individuals, but which is absent from patients with diabetes.

About MannKind Corporation

MannKind Corporation (Nasdaq: MNKD) focuses on the discovery, development and commercialization of therapeutic products for patients with diseases such as diabetes and cancer. Its pipeline includes AFRESA, which has completed Phase 3 clinical trials, and MKC253, which is currently in phase 1 clinical trials. Both of these investigational products are being evaluated for their safety and efficacy in the treatment of diabetes. MannKind maintains a website at http://www.mannkindcorp.com to which MannKind regularly posts copies of its press release as well as additional information about MannKind. Interested persons can subscribe on the MannKind website to email alerts that are sent automatically when MannKind issues press releases, files its reports with the SEC or posts certain other information to the website.

Forward Looking Statements

This press release contains forward-looking statements, including statements related to the promise for AFRESA, next steps in the Company's clinical trial program, plans and timing for the submission of a new drug application and expectations regarding potential position and use of AFRESA in the market. Words such as "believes", "anticipates", "plans", "expects", "intend", "will", "goal", "potential" and similar expressions are intended to identify forward-looking statements. These forward-looking statements are based upon MannKind's current expectations and involve risks and uncertainties. Actual results and the timing of events could differ materially from those anticipated in such forward-looking statements as a result of these risks and uncertainties, which include, without limitation, risks related to the progress, timing and results of clinical trials, difficulties or delays in seeking or obtaining regulatory approval, MannKind's ability to enter into any collaborations or strategic partnerships, MannKind's ability to raise additional financing and other risks detailed in MannKind's filings with the Securities and Exchange Commission, including the Annual Report on Form 10-K for the year ended December 31, 2007 and periodic reports on Form 10-Q and Form 8-K. You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this press release. All forward-looking statements are qualified in their entirety by this cautionary statement, and MannKind undertakes no obligation to revise or update any forward-looking statements to reflect events or circumstances after the date of this news release.

Coffee lowers risk of diabetes – 4th December

According to recent reports from Finland, those people that drink at least three cups of coffee per day could be lowering their risk of developing type 2 diabetes . The results were unveiled at a seminar on preventing disease.

A professor of Public Health at the University of Helsinki, Jaako Tuomilehto, reportedly said that Finnish studies found that those who consume more coffee faced lesser risks of developing type 2 diabetes .

The optimum level of coffee was also found to be high, with those drinking three or four cups per day lowering risk by 30 per cent whilst women drinking 10 cups a day took risks down by 79 per cent. Furthermore, those men that drank 10 cups per day lowered their risks by 55 per cent.

Secreted Protein Sends Signal That Fat Is On The Way – 4th December

After you eat a burger and fries or other fat-filled meal, a protein produced by the liver may send a signal that fat is on the way, suggests a report in the December issue of the journal Cell Metabolism, a Cell Press publication.

Researchers have found in mice that the liver produces a protein called adropin, which rises in response to high-fat foods and falls after fasting. The protein seems to play a role in governing the activity of other metabolic genes, particularly those involved in the production of lipids from carbohydrates. Studies of the protein in obese animals suggest that it also plays a role in insulin response and in preventing the buildup of fat in the liver (a condition known as nonalcoholic fatty liver disease), the researchers said.

"What is remarkable is that it appears that this factor is specifically regulated by the fat content of the diet," making it one of the first such factors ever discovered, said Andrew Butler of Pennington Biomedical Research Center. (The findings follow another report in the November 26th issue of the journal Cell of a phospholipid produced by the gut that rises after a fatty meal, signaling the brain to eat less.)

The new results suggest that treatments designed to deliver adropin or otherwise boost its levels may hold promise in the war against obesity and associated metabolic disorders, including fatty liver disease and type 2 diabetes.

Indeed, Butler's team found that animals that become obese after eating a high-fat diet for a period of 3 months or due to a genetic mutation don't produce adropin normally. However, obese animals that are manipulated to produce excess adropin or that are given the protein show less fat in their livers and become more responsive to insulin. The mice also ultimately eat less and lose weight, but the other metabolic improvements do not depend on the animals' shrinking waistlines, Butler said.

The good news is that when you provide a synthetic version of the peptide, it reverses some of the consequences of obesity," he said.

Butler noted, however, that there is still plenty left to learn. For instance, they would like to know whether mice that lack adropin become obese and show evidence of the metabolic syndrome, a cluster of diseases associated with obesity and insulin resistance. The protein is also produced in the brain, suggesting it may also affect behavior and metabolism in as-yet-undiscovered ways. The clinical promise of adropin will depend on whether the relationships between the protein, diet, and metabolism seen in mice will hold in human patients.

The researchers aren't yet certain exactly how adropin works its magic. Its benefits could involve effects within the liver and/or hormonal actions on other body tissues, they said. The answers to those questions will require further investigation.

"In summary," the researchers wrote, "adropin is a newly discovered secreted peptide that is involved in energy homeostasis and lipid metabolism … Adropin may form the basis for the development of new therapeutic targets for treating metabolic disorders associated with obesity."

Asian diabetes 'time-bomb' feared – 3th December

UK-based South Asians face a health "time-bomb" in the next 30 years due to the prevalence of diabetes within the community.

This stark warning is just one of the remarks made by campaigners behind a film aimed at raising awareness about the disease.

People from South Asia are six times more likely to develop Type 2 diabetes than the white members of the UK population, and they are likely to develop it ten years earlier.

It is feared that widespread ignorance about the disease threatens the lives of tens of thousands in the UK.

But the team behind a Bollywood-style comedy hope they can educate people and save lives while making people laugh.

Sweet Talk, which can be seen at religious and community centres, as well as on cable channels, is about 55-year-old Bobby. He eats excessively and takes no exercise.

DIABETES FACTS

There are 246m cases worldwide

By 2025, some 380m global cases expected

Diabetes caused 3.8m deaths worldwide in 2007

The 15-minute film follows his experiences after his sister, who has diabetes, suffers a heart attack, prompting the realisation that he is at risk and must take action.

Diabetes occurs when the body does not produce or use enough insulin.

Serious complications

The chronic disease leads to high blood sugar which, over time, can cause blindness, stroke, amputation, kidney failure and heart disease.

There is currently no cure for the disease. Treatment involves lowering blood glucose and other risk factors that damage that damage blood vessels. For example, giving up alcohol may help to avoid complications.

Type 2 diabetes tends to be associated with age, obesity, inactive lifestyle and genetic factors.

Dr Rumeena Gujral, of the South Asian Health Foundation (SAHF), is behind the film.

She pointed to research which shows that South Asians have a 50% risk of developing diabetes at some point in their life, and that one in four people from the community aged over 25 is a sufferer.

Dr Gujral said she found the figures "shocking".

She attributed the problem to a lack of exercise amongst members of the community, as well as a diet which is high in fat.

South Asians based in the UK are particularly vulnerable when they move from a simple diet on the subcontinent to a rich Western one, along with a more sedentary lifestyle.

And the phenomenon is not restricted to people based in the UK.

Global problem

Professor Anushka Patel, a cardiologist from Sydney, said: "We're seeing very high rates of South Asians with diabetes around the world."

"There has to be a greater awareness of how great a problem diabetes is.

Her sentiments were echoed by Dr Wasim Hanif, who chairs the SAHF's diabetes working group and is a consultant physician in Birmingham.

He said about 30% of patients receiving dialysis in Birmingham are from the community.

"The way to tackle this issue is to raise awareness in the South Asian community so that they're aware diabetes is a big problem," said Dr Hanif, who added that early treatment and diagnosis were the key to addressing the issue effectively.

When asked why there is a need to focus specifically on the health needs of a particular community within the UK's population, he insisted that the problem has ramifications which affect others in the UK.

"We are sitting on a time-bomb. We need to tackle it now and tackle it aggressively because if we don't in 20 or 30 years the same people will have heart disease, kidney failure at huge cost to the NHS."

He stressed that it would make "economic sense" to act now and reduce the future "burden" on the UK's health system.

Diamyd Medical: Diamyd(R) Diabetes Vaccine - Three Blockbuster Indications – 2th December

As reported in New England Journal of Medicine (Oct 30, 2008), Diamyd® preserves insulin producing beta cells best in patients recently diagnosed with the disease. Beta cell destruction is a consecutive process, eventually leading to the need for life-long treatment with insulin. Diamyd® given before clinical presentation could hence prevent the onset of the disease.

"This is good news for individuals at risk for type 1 diabetes", says Elisabeth Lindner, President and CEO of Diamyd Medical. Several large programs are in full operation around the world with the goal to screen thousands of small children for their risk to develop type 1 diabetes. These children could all benefit from vaccination with Diamyd®.

Beyond the vaccine application for type 1 diabetes, Diamyd® has shown effect in preventing insulin treatment in a study including GAD antibody positive patients with type 2 diabetes, representing 10% of all type 2 diabetes patients. The data were recently presented by Professor Carl-David Agardh, Lund University, Sweden.

The three applications; treatment and prevention of type 1 diabetes, as well as prevention of insulin treatment in autoimmune type 2 diabetes, are all believed to have blockbuster potential.

About Diamyd Medical: Diamyd Medical is a Swedish biopharmaceutical company focusing on development of pharmaceuticals for treatment of autoimmune diabetes and its complications. The company's most advanced project is the GAD-based drug Diamyd® for type 1 diabetes and for which Phase III trials are ongoing in both the US and Europe. Furthermore, the company has initiated clinical studies within chronic pain, using its Nerve Targeting Drug Delivery System (NTDDS). The company has also out-licensed the use of GAD for the treatment of Parkinson's disease.

Diamyd Medical has offices in Sweden and in the US. The share is quoted on the OMX Stockholm Nordic Exchange (ticker: DIAM B) and on OTCQX in the US (ticker: DMYDY) administered by the Pink Sheets and the Bank of New York (PAL). Further information is available on the company's web site: http://www.diamyd.com.

Diamyd Medical

Genaera Begins Phase 1b Trial Of Trodusquemine (MSI-1436) In Overweight And Obese Type 2 Diabetics – 2th December

Genaera Corporation (Nasdaq: GENR) announced that dosing of subjects has begun in study MSI-1436C-102 (Study 102), the multiple ascending dose Phase 1b study of trodusquemine (MSI-1436) in overweight and obese type 2 diabetics. MSI-1436 is a novel therapeutic for the treatment of type 2 diabetes and obesity which works centrally and peripherally to regulate insulin and leptin pathways through the highly selective inhibition of its novel target enzyme, PTP-1B.

Study 102 will establish multiple dose pharmacokinetics (PK) and expand the safety database for MSI-1436 in a population of overweight and obese adult type 2 diabetic subjects who are poorly controlled on metformin. The study will also evaluate key secondary outcomes in this population, including oral glucose tolerance and insulin sensitivity, satiety and weight loss.

"We hope that Study 102 will help establish proof-of-concept for MSI-1436 as a highly competitive treatment for both type 2 diabetes and obesity with a single drug," said Jack Armstrong, President and Chief Executive Officer of Genaera. "In two previous Phase 1 studies, single doses of MSI-1436 administered to over 60 subjects were well-tolerated with an acceptable adverse event profile, exhibited linear PK, produced dose-dependent weight loss and improved insulin sensitivity. We expect the multiple dose data from Study 102 to verify the exciting potential and positive efficacy results of this drug."

Study 102 is a double-blind, randomized, placebo-controlled, safety and PK study being conducted at two U.S. sites. The study will initially enroll 21 subjects at three dose levels (3, 6, and 10 mg/m2) of MSI-1436 with treatment occurring every three days over a 23 day period. Five subjects in each dosing group will receive MSI-1436 and two subjects in each dosing group will receive placebo. The multiple ascending dose protocol has an adaptive design permitting the enrollment of additional subjects in each cohort. Data from the study is expected in the first half of 2009.

MSI-1436 is also being evaluated in preclinical studies using a once-weekly subcutaneously administered formulation which Genaera expects to utilize in Phase 2 clinical trials in the second half of 2009.

About Trodusquemine (MSI-1436)

Trodusquemine is a centrally and peripherally-acting appetite suppressant and the first highly selective inhibitor of protein tyrosine phosphatase 1B (PTP1B), an enzyme central to controlling the function of both the leptin and insulin pathways. By inhibiting PTP1B, MSI-1436 is expected to decrease appetite and normalize blood sugar. Trodusquemine has produced consistent, sustainable weight loss in a variety of animal models and appears to overcome metabolic readjustment, which often limits sustained weight loss during caloric restriction. In addition, trodusquemine has shown the ability to reverse co-morbidities associated with obesity such as abnormal glucose metabolism and cholesterol elevation.

About Genaera

Genaera Corporation is developing trodusquemine (MSI-1436), for type 2 diabetes and obesity currently in Phase 1 clinical testing and has a fully out-licensed partnership with MedImmune, Inc. that is in Phase 2 clinical testing in asthma. For further information, please see our website at http://www.genaera.com.

This announcement contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 that are subject to risks and uncertainties, known and unknown. Forward-looking statements reflect management's current views and are based on certain expectations and assumptions. You may identify some of these forward-looking statements by the use of words in the statements such as "anticipate," "believe," "continue," "develop," "expect," "plan" and "potential" or other words of similar meaning. Genaera's actual results and performance could differ materially from those currently anticipated and expressed in these and other forward-looking statements as a result of a number of risk factors, including, but not limited to the risks and uncertainties discussed in Genaera's filings with the U.S. Securities and Exchange Commission, all of which are available from the Commission in its EDGAR database at www.sec.gov as well as other sources. You are encouraged to read these reports. Given the uncertainties affecting development stage pharmaceutical companies, you are cautioned not to place undue reliance on any such forward-looking statements, any of which may turn out to be wrong due to inaccurate assumptions, unknown risks, uncertainties or other factors. Genaera does not intend (and it is not obligated) to publicly update, revise or correct these forward-looking statements or the risk factors that may relate thereto.

Genaera Corporation

http://www.genaera.com

EMIS Web Improves Diabetes Care In Cheshire And Hertfordshire, UK – 1th December

Diabetes and endocrinology specialists at Leighton Hospital in Crewe and Victoria Infirmary, Northwich, can access a summary of the patient's primary care record, enabling them to make more informed decisions at the point of care and helping them to advise a greater number of patients.

The patient information, which is accessed on the spot by doctors, consultants, registrars, specialist nurses and a dietician contains medication details, and a summary of allergies and previous diagnoses. Consent to view the information is given by the patient in hospital and audited in the system.

Dr Adrian Heald, consultant physician at Leighton Hospital's diabetes and endocrinology clinics, explains: "Accessing primary care information gives us a different perspective on the patient's condition and the way we manage chronic diseases, giving us important extra information about patient care at the GP end.

"By having a fuller picture of the patient's health, we are able to produce a more focused and tailored health management plan for each patient.

"We have received positive feedback from patients. Significantly, none of the patients we have seen have refused the specialist team access to their primary care record."

The first phase of the project gives clinicians a 'read-only' view. The next stage of the project will enable hospital clinicians to record consultation details into a clinical record template that will be added to the patient's primary care record. The patient's GP will be able to view this back at the practice.

Two practices in Nantwich and Middlewich, covering approximately 10 per cent of patients in Central and Eastern Cheshire Primary Care Trust are streaming information from their EMIS LV systems into EMIS Web, so that the secondary care clinicians can access it. In the near future, the project will be extended to cover all EMIS practices in the PCT.

Sean Riddell, EMIS' Managing Director, says: "The mobility of information not only gives secondary care clinicians a more complete picture of a patient's health, but it aids continuity of care, as easily accessible records are vital for monitoring long-term conditions such as diabetes."

EMIS is working with InPractice Systems (INPS) to facilitate the streaming of patient data from their GP systems into EMIS Web. The project team also hopes to extend the shared record system to other specialist clinics and to the provider arms of the PCT.

Dr Heald continues: "In addition to enhancing the quality of the individual patient experience, we can potentially adapt the search and report facility in EMIS Web to take a longitudinal view of trends in management of cohorts of patients. This ultimately could result in changes to care pathways."

In a similar project, diabetes clinics at two branches of the West Hertfordshire Hospitals NHS Trust - Hemel Hempstead Hospital and St Albans Hospital - can also view a summary of the patient's primary care details using EMIS Web.

Manor Street Surgery in Berkhamsted, Hertfordshire, is leading the project, which involves two other practices at the pilot stage, streaming patient record data from EMIS LV into EMIS Web.

The project is being phased, as in Cheshire, with clinicians currently only able to view summary information. The next phase is for clinicians to be able to record into a consultation template so that the patient's GP can view the information added by the hospital. The patient gives implied consent at the referral stage, and an audit trail is recorded.

Dr Elizabeth Ponsonby, a GP at Manor Street Surgery, says: "A clear display of historical data is crucial for managing diabetes. Our vision for the future is for diabetes clinics to be brought out of hospitals into the community. This will make it even more essential for clinicians to be able to access information, wherever they are located."

EMIS and the Trust are also working with INPS to extend interoperability to non-EMIS practices.

EMIS is the UK's leading supplier of IT systems to GPs, providing the software that holds the medical records for 39 million NHS patients nationwide. Around 56 per cent of GPs in the UK currently use EMIS software. www.emis-online.com

EMIS Web is a web-based system that will ultimately replace popular EMIS systems such as EMIS LV and EMIS PCS. It offers greatly improved functionality for clinicians, including the ability for GPs and community practitioners to contribute to a single patient record and access for secondary care and out-of-hours providers too. http://www.emis-online.com/primary-care-systems/emis-web/

EMIS is responsible for a number of innovatory products and services for GPs and patients, including EMIS Access - the first online appointment bookings service; a groundbreaking electronic prescription management service and a shared data system that enables secure GP-to-GP exchange of patient records.

EMIS

UAE Walks Against Diabetes In The Lead Up To National Day

Celebrations – 28th November

Abu Dhabi readies for the second annual Diabetes walkathon, dubbed WALK UAE 2008 (on National Day weekend, November 28 at 3pm along the Corniche). This is the latest activity in the award winning Diabetes public awareness campaign under the patronage of HH Sheikha Fatima bint Mubarak.

As many as 10,000 participants are expected to walk the five kilometre route, according to the event organisers, Imperial College London Diabetes Centre (ICLDC).

"The numbers could easily double from our inaugural walk last year when 5,000 people joined us. We see this as a clear indication of the community uniting to fight of the disease," said Dr Maha Taysir Barakat, Medical & Research Director and Consultant Endocrinologist, ICLDC. WALK UAE 2008 is organised by ICLDC, in partnership with the Emirates Foundation and with the exclusive sponsorship of The National Insurance Company - Daman.

Daman's CEO Dr Michael Bitzer said: "The overriding message of WALK UAE to the nation is very simple. We need to make changes to our lifestyles in order to bring about swift and profound changes to the state of our country's health.

"WALK UAE 2008 is a sterling initiative to promote regular walking as a way of helping to prevent several ailments, and more specifically, Diabetes," Dr Bitzer added.

Maytha Al Habsi, Communications Director, Emirates Foundation commented:

"The UAE population requires much more information about Diabetes and its implications on health. The community needs to learn clearly what measures it can take to prevent and manage Diabetes, and related complications, such as cardio-vascular disease."

She added: "Our Takatof volunteers will be on hand at the Walkathon to coordinate walkers and to encourage them along the route."

Reasons you should be walking with Walk UAE 2008

- Regular exercise can lower the risk of developing Diabetes by 58 per cent.

- Walking briskly for 30-minutes each day is proven to be effective in Diabetes prevention.

- Slim people are not exempt from developing Diabetes and should also exercise regularly.

- Though many people think that a reasonable weight equates to good health, visceral fat can build up around the organs even in people who are visibly thin, and it is this that predisposes you to developing type 2 diabetes.

About Imperial College London Diabetes Centre

The Imperial College London Diabetes Centre is a state-of-the-art specialised out-patient one-stop facility that specialises in Diabetes Treatment, Research, Training and Public Health. Located in Abu Dhabi (next to the Zayed Military Hospital), ICLDC allows the highest level of specialised patient care, from first diagnosis to the continued management of all complications associated with Diabetes.

Imperial College London holds a renowned history and expertise in the study of Diabetes, bringing one of the leading medical academic institutions in the world to Abu Dhabi as a core working partner. Under ICLDC practices, one of the Centre's primary objectives will be to provide continuing education for health professionals and the general public. For more details visit: http://www.icldc.ae

About the Emirates Foundation

The Emirates Foundation is a United Arab Emirates philanthropic organisation, established by the Government of the Emirate of Abu Dhabi in 2005 to facilitate new public-private initiatives for social betterment. The Foundation represents a unique multi-sector effort that offers a channel for individuals and organisations to give back to the community through six major programme areas. It manages an independent capital fund with donations from the private sector, the government and private individuals interested in philanthropy.

The Emirates Foundation contributes to UAE society by supporting people, institutions and community organisations that contribute to the nation's long-term progress and sustainability. It addresses important educational, cultural, environmental and social issues affecting people's lives and aspirations. Its philanthropy helps to groom socially responsible individuals and to empower them to achieve their full personal and intellectual potential.

The Foundation focuses on six core areas: Education, Science & Technology, Arts & Culture, Social Development, Environment, and Public Awareness. In each area, the Foundation supports programmes that aim to achieve social balance and individual fulfillment. As a national initiative, the Foundation uses a variety of mechanisms to identify and support qualified individuals, organisations, and community projects in every region of the United Arab Emirates.

The Foundation also administers key strategic projects directly - such as Takatof, which promotes volunteerism among young Emiratis - and Tawteen, which helps to improve occupational qualifications of young Emirati professionals.

The UAE is a country with a great legacy of social and cultural values. The Emirates Foundation strives to promote these, as well as other traditions that can combine with today's prosperity to engender a highly motivated, informed and goal-oriented nation. The Foundation also actively encourages the spirit and practice of volunteerism, while working to promote and build a commitment to service, particularly among young men and women.

Through institutional grants, fellowships, research awards, and philanthropy-led initiatives in various key areas, the Emirates Foundation aspires to raise the profile of UAE peoples and their institutions, as well as the reputation of its corporate citizens. Its mission is consistent with the ideals of the nation's founding father, the late Sheikh Zayed bin Sultan Al Nahyan. http://www.emiratesfoundation.ae/english/index.aspx

About National Health Insurance Company - Daman

The National Health Insurance Company - Daman, was established on 01 May 2006. Today it is the region's leading health insurance company, providing comprehensive healthcare solutions to over 1.1 Million customers in the UAE via the largest network of private hospitals and pharmacies available.

With affordable health insurance for people of all income levels, Daman offers international standard healthcare insurance cover for both individuals and companies.

A 24-hour dedicated Medical Authorisation Center, staffed by a team of doctors and nurses, ensures that patient enquiries are dealt with speedily and efficiently using the most sophisticated technology available. A second customer hotline, also open 24/7 and manned by multilingual staff, guarantees that UAE residents can access information about plans and their insurance cover whenever and wherever they want.

With an international network, Daman's customers have access to healthcare provision in 35 countries across the world, depending on the terms of their personal cover.

The National Health Insurance Company - Daman

Fear Of Hypoglycemia A Barrier To Exercise For Type 1

Diabetics – 27th November

According to a new study, published in the November issue of Diabetes Care, a majority of diabetics avoid physical activity because they worry about exercise-induced hypoglycemia (low blood sugar) and severe consequences including loss of consciousness. Despite the well-known benefits of exercise, this new study builds on previous investigations that found more than 60 percent of adult diabetics aren't physically active.

"Our findings confirmed our clinical suspicion," say Dr. Rémi Rabasa-Lhoret, co-author of the study. "Exercise has been proven to improve health and one would assume diabetics would remain active. Yet our findings indicate that type 1 diabetics, much like the general public, are not completely comfortable with exercise."

Lack of understanding of insulin metabolism

One hundred adults, 50 women and 50 men, with type 1 diabetes answered questionnaires to assess their barriers to physical activity. The biggest fear was hypoglycaemia and other barriers included interference with work schedule, loss of control over diabetes and low levels of fitness.

When questioned further, only 52 of the participants demonstrated appropriate knowledge of how insulin is metabolized and processed. Those individuals who best understood how insulin works in their body were shown to be less fearful of physical activity. Such knowledge is essential in order to adapt insulin and/or food intake to prevent hypoglycaemia induced by exercise.

"Our study was launched to find ways to make diabetics healthier and suggests there is a major gap in information and support required by these patients," says Anne-Sophie Brazeau, lead author and doctoral student. "Programs aimed an increasing physical activity among type 1 adult diabetics need to incorporate specific actions to prevent hypoglycemia."

"We also found that individuals with the greatest fear of physical activity had the poorest control of their diabetes," says Dr. Hortensia Mircescu, co-author of the study. "Education is particularly relevant for this group."

About type I diabetes

Type 1 diabetes occurs when specialized cells of the pancreas, islet cells, no longer produce insulin. Insulin helps regulate the body's glucose levels and is necessary for its proper function. Type 1 diabetes usually develops in childhood or adolescence.

About the study

The article "Barriers to Physical Activity Among Patients With Type 1 Diabetes" published in Diabetes Care , was authored by Anne-Sophie Brazeu, Rémi Rabasa-Lhoret, Irene Strychar, Hortensia Mircescu.

Molecular Partnership Controls Daily Rhythms, Body

Metabolism – 27th November

A research team led by Mitchell Lazar, MD, PhD, Director of the Institute for Diabetes, Obesity, and Metabolism, has discovered a key molecular partnership that coordinates body rhythms and metabolism.

Lazar and his colleagues, including the study's first author Penn Veterinary Medicine doctoral student Theresa Alenghat, studied a protein called NCoR that modulates the body's responses to metabolic hormones. They engineered a mutation into mice that prevents NCoR from working with an enzyme that is normally its partner, HDAC3. These animals showed changes in the expression of clock and metabolic genes, and were leaner, more sensitive to insulin, and on different sleep-wake cycles than controls.

The role of the NCoR-HDAC3 partnership in regulating the body's internal clock was previously unknown. HDAC3 is an enzyme that affects gene expression by binding to receptors in the cell nucleus to affect gene activity, but not by directly changing DNA. The findings suggest that HDAC via NCoR controls the body's internal clock, and therefore metabolism, through this epigenetic change. Their findings are reported in this week's issue of Nature.

"In the fight against the obesity and diabetes epidemics, disruption of NCoR and its enzyme partner, might be a valuable new weapon," says Lazar.

Most physiological processes cycle every day and night, and the most well-known of these circadian rhythms is the sleep-wake cycle. Abnormal sleep patterns, such as those of shift-workers, can be risk factors for metabolic disorders such as obesity and diabetes. "These diseases have reached epidemic proportions, so scientists are urgently seeking to understand the connections between biological rhythms and metabolism," notes Lazar.

The daily rhythm of mice with the disrupted molecular partnership was shortened by almost half an hour. Over time, this added up to a shifted daily rhythm.

The mice were also leaner (not gaining as much weight when put on a high-fat diet), and they were protected from developing resistance to the action of insulin, which is a hallmark of the most common form of diabetes in people. Expression of several metabolic genes was also altered in the engineered mice.

"The molecular partnership regulates hormone action as well as clock genes that coordinate circadian rhythms," says Lazar. "It's extraordinary that, despite their abnormal sleep-wake cycle, which might have been predicted to cause metabolic problems, the mice were actually healthier metabolically.

"However this finding doesn't mean people should start changing their sleep patterns because this is really evidence that there is coordination between metabolism and circadian activities, including sleep," cautions Lazar. "It's not that the mice are sleeping less, it's that their sleep cycle is shifted, when compared to mice maintained on a normal sleep-wake cycle."

Companies are currently targeting enzymes like HDAC with drugs called histone deacetylase (HDAC) inhibitors. "However there are dozens of HDACs, which do not all have the same molecular target," says Lazar. "If we target all of them we will get unwanted side effects related to the other HDACs. Our results suggest that HDAC3, and especially its partnership with NCoR, could be a specific target for diabetes and obesity."

In addition to Lazar and Alenghat, Penn co-authors are Katherine Meyers, Shannon Mullican, Kirstin Leitner, Adetoun Adeniji-Adele, Jacqueline Avila, Maja Bućan, Rex Ahima, and Klaus Kaestner. The National Institute of Diabetes and Digestive and Kidney Diseases provided funding for this research.

Study Details Annual Medical Cost Increases For People With Diabetes – 26th November

People diagnosed with diabetes spend over $4,100 more each year on medical costs than people who don't have diabetes, a gap that increases substantially each year following the initial diagnosis, according to a study published online today in the journal Diabetes Care.

In the first study to examine medical cost increases for individuals living with diabetes on a year-by-year basis, calculated that a 50-year-old newly diagnosed with diabetes spends $4,174 more on medical care per year than a person the same age who doesn't have diabetes. For the person with diabetes, medical costs go up an additional $158 per year every year thereafter, over and above the amount they would increase due to aging-related increases in medical expenses.

Most of the increase can be attributed to the cost of diabetes-related complications, such as heart and kidney disease, the researchers found. Once they controlled for complications, the remaining annual increase in medical costs was $75 per year the bulk of which could be attributed to the increasing need for diabetes medications the longer a person lives with the disease.

"The good news is that many of these costs could be contained through proper diabetes management and lifestyle changes," said lead researcher Justin Trogdon, Research Economist. "Numerous studies show that losing weight and increasing physical activity, along with maintaining proper blood glucose levels, can substantially delay or reduce the risk for diabetes-related complications. What our study does is to point out that there is also a cumulative, financial impact to the progression of this disease."

Preventing the onset of diabetes would also help to reduce cumulative costs, since medical expenditures grow along with the duration of the disease, the researchers concluded. "Delaying the development of diabetes will delay the steady rise in medical expenditures that accompanies it," they wrote.

The study was funded by a grant from the Centers for Disease Control and Prevention.

Diabetes Prevention Through Healthy Weight Management - CalorieKing And Joslin Team Up For Diabetes Awareness Month

- 26th November

On the occasion of Diabetes Awareness Month, CalorieKing, the leading provider of calorie-centric education tools for food awareness, and Joslin Diabetes Center, the world's preeminent diabetes research and clinical care organization, have joined once again to remind people about the importance of knowing about diabetes and how to manage it, as well as how to prevent type 2 diabetes. Through their collaboratively-developed food and physical activity awareness resources and tools, CalorieKing and Joslin are enabling people with, or at risk for diabetes, to make more informed choices that can lead to lifelong weight management and better diabetes control.

Joslin experts have reviewed the diabetes section of the 2009 edition of The CalorieKing® Calorie, Fat & Carb Counter and provided additional diabetes-related content to the book. The Carb Counter contains information and tips to prevent or delay the onset of diabetes. Joslin clinicians have also reviewed the educational and nutritional information provided by the CalorieKing Club (http://www.calorieking.com/benefits.php), an online membership community where people can set goals and track progress toward healthier eating, physical activity and weight loss.

The two organizations intend to collaborate on additional online diabetes resources in the future, including a program specifically developed to help individuals with type 2 diabetes better manage their weight and help control their diabetes.

"There are millions of overweight or obese people that have diabetes and don't know it," said Amy Campbell, MS, RD, LDN, CDE, Manager, Clinical Education Programs for Strategic Initiatives at Joslin Diabetes Center and a member of CalorieKing's Advisory Board. "Our work with CalorieKing provides individuals with tools and resources needed to learn about and manage diabetes."

Joslin resources are presently available through the CalorieKing Web site at http://www.calorieking.com/joslin. These include information on diabetes management, weight management, programs for kids and teens and diabetes discussion boards. Other Joslin-authored materials can be accessed through the CalorieKing nutrition toolbar at http://www.calorieking.com/toolbar. This innovative toolbar operates like a search engine browser toolbar, but is specifically for foods. It is designed to promote daily food awareness in order to help those seeking to bridge the gap between weight loss and lifelong weight control. The toolbar can also be downloaded through a link from the Joslin Web site at http://www.joslin.org/calorieking.

New Survey Shows Majority Of Americans Need To Take Proper Steps To Manage Diabetes Risk – 25th November

According to a new survey released, the vast majority of Americans at risk for type 2 diabetes -- a whopping 83 percent -- are not taking the most basic steps of determining if they are at risk for the disease: getting a blood glucose test if they are at risk or taking the appropriate actions as a result of their test. The survey sought to determine a baseline among Americans on their level of awareness and knowledge regarding type 2 diabetes.

The survey showed those individuals are not meeting elements of an important diabetes target -- the National Diabetes Goal (NDG). The NDG was established in May 2008, by leading advocacy, health and business organizations and is the following: by 2015, 45 percent of Americans who are at-risk for type 2 diabetes will know their blood glucose level and what actions to take. Currently more than 40 professional organizations have joined forces and have committed to helping the nation achieve the goal by becoming a goal champion.

Reaching the Goal is critical when you consider that nearly 24 million Americans suffer from diabetes, a number that is expected to double by 2025, and 57 million have pre-diabetes. Further, according to the American Diabetes Association, the total annual economic cost of diagnosed diabetes in 2007 was estimated to be $174 billion. In factoring in other associated costs, such as the expenses associated with people with undiagnosed diabetes, pre-diabetes, and gestational diabetes, the economic cost is as much as $218 billion each year according to a study conducted by a NDG Champion, the Novo Nordisk's National Changing Diabetes(R) Program, and released earlier this month.

The survey on awareness and understanding of diabetes, also commissioned by the National Changing Diabetes(R) Program and NDG Champion Fleishman-Hillard, Inc., determined that 131 million Americans are at risk for type 2 diabetes and should be tested -- based on American Diabetes Association (ADA) guidelines. According to the ADA, people 45 years and older, and those who are younger than 45, are overweight and have one additional risk factor, such as high blood pressure or a history of heart disease, are considered at risk and should be tested.

Additional survey results show that minority populations, who often have a higher risk of diabetes, are among those groups in most need of support to meet the National Diabetes Goal. Findings show:

-- 42 percent of at risk Hispanics do not meet any element of the National Diabetes Goal while 44 percent of at risk African Americans did not meet any element.

-- 56 percent of Hispanics should be tested and 59 percent of African Americans are at risk for diabetes and should talk to their doctor about being tested.

-- Only 6 out of 10 at risk Hispanics recall being tested. And only 3 out of 10 at risk Hispanics claim to know their number.

"It is important for Americans, particularly the Hispanic and African American communities in our country, to get tested for diabetes," said Stewart Perry, Chair of the Board for the American Diabetes Association, another leading National Diabetes Goal Champion. "We also encourage people older than 45, and those who are younger than 45 but overweight or have additional risk factors to get tested. It's a simple step that can have profound positive benefits."

The National Diabetes Goal is supported by many of the nation's leading advocacy and business organizations, including the American Diabetes Association, American Association of Diabetes Educators, American Association of Clinical Endocrinologists, American Optometric Association, Entertainment Industry Foundation, Food Marketing Institute, National Association of Chain Drug Stores, National Business Coalition on Health, and Revolution Health.

"This study clearly demonstrates the need for greater education and awareness, especially among people who are at risk. When a person knows they are at risk, is tested and knows the appropriate actions to take, they are armed with the information they need to live a happier and healthier life," said Dana Haza, senior director, National Changing Diabetes Program.

"In working with our National Diabetes Goal partners to release this information and help create awareness about type 2 diabetes, we hope it will serve as a call to action for at-risk Americans to get tested and respond accordingly," said Martha Boudreau, president Mid-Atlantic, Fleishman-Hillard.

For more information, please visit the National Diabetes Goal at http://www.nationaldiabetesgoal.com

About the National Changing Diabetes(R) Program

The National Changing Diabetes(R) Program (NCDP) is a multi-faceted initiative that brings together innovators in diabetes education, treatment and policy to improve the lives of people with diabetes. NCDP strives to create change in the U.S. health care system to provide dramatic improvement in the prevention and care of diabetes. Launched in 2005, NCDP is a program of Novo Nordisk. For more information, please visit http://www.ncdp.com.

About Fleishman-Hillard

Fleishman-Hillard Inc., one of the world's leading public relations firms, has built its reputation by using strategic communications to deliver what its clients value most: meaningful, positive, and measurable impact on the performance of their organizations. The firm is widely recognized for excellent client service and a strong company culture founded on teamwork, integrity, and personal commitment. Based in St. Louis, the firm operates throughout North America, Europe, Asia Pacific, Middle East, South Africa, and Latin America through its 80 owned offices. For more information, visit the Fleishman-Hillard Web site at http://www.fleishman.com.

Survey methodology

Opinion Research Corporation (ORC) conducted nationally representative survey of U.S. (continental 48 states) adults (18 years of age and older) using random digit dial (RDD) methodology, which assures inclusion of listed and unlisted telephone households. 3,269 telephone interviews were conducted on April 11 and 20, 2008. Three waves of a national omnibus survey were administered with supplemental sample from geographic areas that have a high incidence of Hispanic households (including 433 Hispanic adults). +/- 2 percentage points for the overall sample and +/- 5 percentage points for the Hispanic portion of the sample (both at a 95% confidence level). Data were weighted to population based on age, race, region, and gender to ensure the overall results accurately reflect the profile of U.S. adults based on Census data.

National Changing Diabetes(R) Program

http://www.ncdp.com

Real-Life Stories Of Diabetes Success - American Diabetes Association – 24^th November

How do you measure success? The December issue of Diabetes Forecast, the consumer magazine of the American Diabetes Association, features the personal triumphs of people with diabetes -- some of their stories may surprise you. Here are just a few:

With a glucose meter tucked in his pocket, Jerry Nairn, 49, of Chandler, Arizona, completed his first marathon in 1998. Since then he has run a total of 44 marathons and two ultra-marathons despite having type 1 diabetes. A runner since junior high school, Nairn's passion for long distances has grown so much so that he runs between 30 and 50 miles per week and travels across the country to participate in marathons. "I'm more or less always training for a race," he says. "I think in general it helps keep me healthy."

Morris Older, 60, of Orinda, California, noticed his legs were numb and tingly a few years before he was diagnosed with type 2 diabetes and neuropathy. He enrolled in a four-week diabetes education course and was amazed by the things he learned both about diabetes and himself. "We went over my diet and I was shocked," he tells Diabetes Forecast. "I was somebody who thought I was eating really well. I was into natural foods." In six months, with the help of a diabetes-focused meal plan, exercise, and oral medications, Older's A1C dropped from 12.4% to 4.8%. For him, being successful is being able to live a normal, physically active, life -- like going out for a 23-mile hike. "If I wasn't successful in managing my diabetes, I couldn't do that."

Naomi Kingery of Simi Valley, California, was diagnosed with diabetes just as she was entering her teenage years. Today, at 19 years old, she has written and published a book about growing up with diabetes and its emotional ups and downs. Her book was inspired by a hospital stay where she met another person with diabetes. "He was negative, and he hated his life," says Kingery. "I said, 'I'm not going to be like that. I need to stay positive.'" Her positive attitude toward coping with diabetes has become an inspiration to others -- the role diabetes has played in her life was her topic when speaking at her college. "You need to say, 'I love my body not despite diabetes, but with diabetes.'"

Also in the December 2008 issue:

Blindness, amputations, and heart attack. These are only a few of the grave complications that can result from diabetes, but how does diabetes increase the risk of these complications and how can they be avoided? Covering both microvascular (small vessel) and macrovascular (large vessel) complications, this article explains the connection between diabetes and diabetes-related complications, examines symptoms, and provides advice for prevention. There is also information on other complications such as depression, skin disease, and gum problems.

In addition, this issue of Diabetes Forecast brings you information about:

-- Staying healthy during cold & flu season: 5 ways to boost your immunity

-- Surviving the Holidays: how your emotions can trigger your appetite and ways to avoid this emotional eating

-- Learning to relax: what stress can do to you emotionally and physically, the effects it can have, and what you can do to minimize stress

Diabetes Forecast has been America's leading diabetes magazine for 60 years, offering the latest news on diabetes research and treatment to provide information, inspiration, and support to people with diabetes.

The American Diabetes Association is leading the fight against the deadly consequences of diabetes and fighting for those affected by diabetes. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. Founded in 1940, its mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. For more information, please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit http://www.diabetes.org. Information from both these sources is available in English and Spanish.

American Diabetes Association

India battles diabetes 'epidemic' : watch the video Online on BBC

Successfull Completion Of Phase I Development Of In Vivo Glucose Sensing RFID Microchip - 20th November 2008

VeriChip Corporation ("VeriChip") (NASDAQ:CHIP), a provider of RFID systems for healthcare and patient-related needs, and its development partner RECEPTORS LLC, a technology company whose AFFINITY by DESIGN™ chemistry platform can be applied to the development of selective binding products, announced today that a significant milestone has been achieved toward the development of an in vivo glucose-sensing RFID microchip. Upon successful completion of the in vivo glucose-sensing RFID development program, this self-contained, implantable bio-sensing device will, for the first time, have the ability to measure glucose levels in the human body through an external scanner, thereby eliminating the need for diabetics to prick their fingers multiple times per day.

The key to the development of the implantable glucose sensor is the self-contained, in vivo capable glucose-sensing system. RECEPTORS' sensing system design is discussed by RECEPTORS' President and Chief Science Officer, Dr. Carlson, in the "Self-Contained Implantable RFID Glucose-Sensing Microchip" white paper that is available on RECEPTORS' and VeriChip's websites. The design of the glucose-sensing system incorporates two critical components. RECEPTORS recently completed Phase I proof-of-concept program successfully prepared prototype examples for both the glucose-selective binding environment and the glucose-competitive signaling component. These critical components were used to demonstrate the bench top format application of the glucose-sensing system to the detection of glucose levels. This demonstration is the proof-of-concept foundation of the glucose-sensing system.

Scott R. Silverman, Chairman of VeriChip, said, "We are not only focused on current opportunities for patient identification within our VeriMed Health Link business, but also on the future applications of RFID in healthcare. The glucose sensor is a promising example, combining a unique application of the technology and an extremely valuable market. While there is much more to do, development of the binding environment was a big step towards reaching that future."

In December 2007, VeriChip and RECEPTORS unveiled plans to build a prototype self-contained implantable bio-sensing device included in an RFID microchip. Following VeriChip's purchase of all intellectual property related to the human implantable RFID glucose-sensing microchip from Digital Angel Corporation in November 2008, VeriChip is now RECEPTORS' exclusive partner.

In the next phase of this program, the optimization of the sensing system components, development of the sensing to electronics signal transduction system and incorporation of the devices biocompatible shield will be developed.

About RECEPTORS LLC

RECEPTORS LLC is a private company based in Chaska, Minnesota. RECEPTORS' mission is to advance the diagnosis and treatment of disease and to enhance the health, safety, and quality of the global environment through the development and application of artificial receptor products for both research and industry. To achieve this mission, RECEPTORS' focuses its individual and collective efforts, its commitment to excellence, and the power of its technology to develop innovative solutions that meet the unique needs of its customers and stakeholders. For further information please visit http://www.receptorsllc.com.

About VeriChip

VeriChip Corporation, headquartered in Delray Beach, Florida, markets its VeriMed™ Health Link System for rapidly and accurately identifying people who arrive in an emergency room and are unable to communicate. This system uses the first human-implantable passive RFID microchip, cleared for medical use in October 2004 by the United States Food and Drug Administration.

For more information on VeriChip, please call 1-800-970-2447, or e-mail info@verichipcorp.com. Additional information can be found online at http://www.verichipcorp.com.

Statements about VeriChip's future expectations, including its ability to develop and market a glucose-sensing microchip in conjunction with its development partner RECEPTORS LLC, and all other statements in this press release other than historical facts are "forward-looking statements" within the meaning of Section 27A of the Securities Act of 1933, Section 21E of the Securities Exchange Act of 1934, and as that term is defined in the Private Litigation Reform Act of 1995. Such forward-looking statements involve risks and uncertainties and are subject to change at any time, and VeriChip's actual results could differ materially from expected results. Additional information about these and other factors that could affect the Company's business is set forth in the Company's various filings with the Securities and Exchange Commission, including those set forth in the Company's 10-K filed on March 28, 2008, as amended, under the caption "Risk Factors." The Company undertakes no obligation to update or release any revisions to these forward-looking statements to reflect events or circumstances after the date of this statement or to reflect the occurrence of unanticipated events, except as required by law.

World Diabetes Day: Eyes Save Diabetics' Lives - Queensland University Of Technology - 12th November

QUT researchers are developing a simple eye test to help save the lives and limbs of diabetics from a debiliting condition that affects up to half of people with diabetes.

Professor Nathan Efron is using a breakthrough technique to develop the use of an optical instrument capable of looking at the cornea - the clear window at the front of the eye - under high magnification to assess a painful nerve condition known as diabetic neuropathy.

The eye test will replace the current test for assessing the state of the nerves in diabetic neuropathy which involves taking a skin biopsy from the patient's foot and then running tests which can take up to three days.

Professor Efron and his team from QUT's Institute of Health and Biomedical Innovation (IHBI), are using a corneal confocal microscope, one of only a handful in the country, to further research and validate the diagnostic technique with the help of $5 million funding from the Juvenile Diabetes Foundation International.

The international study will track 400 people with diabetes in Australia and the UK over five years.

"Diabetic neuropathy is a nerve disorder caused by diabetes," Professor Efron said.

"It is a significant clinical problem which affects up to 50 per cent of diabetic patients and which currently has no effective therapy.

"It can be very painful and can also result in numbness and tingling to the hands, feet, or legs and in advanced cases is a major cause of morbidity and mortality worldwide."

He said that by using a corneal confocal microscope diabetic neuropathy could now be diagnosed in a couple of minutes.

"By looking closely at the nerve fibres in the eye we can see whether there is damage to the nerves and thus pinpoint whether or not a patient is suffering diabetic neuropathy," he said.

"The benefit of this new technology is that it's instant, non-invasive and painless, and it appears that it can diagnose this condition much earlier than is currently being done."

Professor Efron has also received $0.52 million in funding from the National Health and Medical Research Council.

Patients With Type 2 Diabetes in Japan, Taking Low-Dose Aspirin Does Not Significantly Reduce Cardiovascular Risk

In patients with type 2 diabetes, low-dose aspirin does not appear to significantly reduce the risk of endpoints including coronary, cerebrovascular, and peripheral vascular events, according to a report released on November 9, 2008 in JAMA, to coincide with the results' presentation at the American Heart Association (AHA) meeting.

Diabetes is a disease which carries with it risk factors for many diseases and co-morbidities. "Diabetes mellitus is a powerful risk factor for cardiovascular events," write the authors. "Individuals with diabetes have a two- to four-fold increased risk of developing cardiovascular events than those without diabetes." While aspirin is often recommended for non-diabetic patients, the authors point out that the "American Diabetes Association recommends use of aspirin as a primary prevention strategy in patients with diabetes who are at increased cardiovascular risk." This group of patients includes those older than 40 years, or with additional risk factors including family history, hypertension, or smoking. One specific endpoint that indicates cardiovascular disease is atherosclerosis, in which arteries narrow or harden due to the buildup of plaques.

To investigate the potential benefits of aspirin use for diabetics in the prevention or heart disease, Hisao Ogawa, M.D., Ph.D., from the Graduate School of Medical Sciences, Kumamoto University, Japan and colleagues from the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) Trial Investigators performed a randomized controlled study. They enrolled 2,539 patients with type 2 diabetes and no previous history of atherosclerosis from 163 institutions throughout Japan between December 2002 to April 2008. The average age of the subjects was 65, and 55% of all subjects were men.

Subjects were randomized to either a low-dose aspirin group (1,262 subjects) receiving 81 or 100mg per day, or a non-aspirin group (1,277 subjects) without aspirin. Follow-up was performed through clinical visits in either two- or four-week intervals for a median 4.37 years, evaluating for the following main outcome measures: atherosclerotic events, fatal or nonfatal ischemic heart disease, fatal or nonfatal stroke, and peripheral arterial disease.

The researchers summarized the results: "A total of 154 atherosclerotic events occurred: 68 in the aspirin group and 86 in the nonaspirin group." They continue: "In the 1,363 patients aged 65 years or older (719 in the aspirin group and 644 in the nonaspirin group), the incidence of atherosclerotic events was significantly lower in the aspirin group (45 events, 6.3 percent) than in the nonaspirin group (59 events, 9.2 percent)." The differences in events for the two groups was not significant in patients under age 65 years (1,176 subjects.)

When examining adverse outcomes, aspirin was tolerated well. A total 13 hemorrhagic strokes were reported, with no statistical significance between aspirin and non-aspirin takers. This was also true in comparing all serious hemorrhagic events, which include hemorrhagic strokes and major gastrointestinal bleeding.

While failing to find a significant effect of aspirin in the risk of atherosclerotic events in patients with type 2 diabetes, the authors note the importance of this issue:
"Myocardial infarction [heart attack] and ischemic stroke are leading causes of mortality and morbidity in patients with type 2 diabetes. Given the rapid increase in the number of patients with type 2 diabetes worldwide and especially in Asia, establishing effective means of primary prevention of coronary andcerebrovascular events is an important public health priority." They continue, noting the need for further research in this area in diverse populations: "These findings should be interpreted in context with the low incidence of atherosclerotic disease in Japan and the current management practice for cardiovascular risk factors and suggest the need to conduct additional studies of aspirin for primary prevention of cardiovascular disease in diabetic patients."

In an accompanying editorial Antonio Nicolucci, M.D., from Consorzio Mario Negri Sud, Italy, noted the lack of conclusive results regarding the recommendation of aspirin in the primary prevention of cardiovascular events. "The use of aspirin for primary prevention of cardiovascular events in individuals with diabetes is widely recommended by existing guidelines, but the evidence supporting its efficacy is surprisingly scarce," he says.

He continues, noting the relative risk of the specific group used in the above study. "The lack of precision and the low statistical power in the JPAD trial are the consequence of the substantially lower than expected event rate in the trial population." Because the study population had a very low baseline risk of cardiovascular events, it may be difficult to generalize these results to other populations.

He concludes: "The issue of aspirin therapy for patients with diabetes is an example of how, in the presence of a long-lasting uncertainty, scientific organizations or governmental bodies should provide the foundation for answering this question by promoting pragmatic, large-scale clinical trials.  Considering all diabetic patients with no history of cardiovascular disease (except those with documented contraindications or perceived indications) as candidates for randomized clinical trials would represent a major contribution to the credibility of scientific methods in guiding practice."

Depression Increases Mortality Rate In People With Diabetes - Nov 6

A new study of Medicare beneficiaries with diabetes discovered individuals who were depressed experienced a higher death rate than diabetics who were not depressed. The findings are published in the October 2008 Journal of General Internal Medicine.

Lead author Dr. Wayne Katon, professor of psychiatry and behavioral sciences at the University of Washington (UW), noted that previous research indicates that depression and diabetes is a potentially lethal mix among young to middle-aged patients. Depression also puts patients at greater risk of complications from their diabetes. This more recent study suggests that depression is also a risk factor for mortality in older patients with diabetes. Most Medicare beneficiaries, like the ones in this study, are over age 65. The mean age of the participants was 75.6 years. The study tracked 10,704 Medicare beneficiaries with diabetes who were enrolled in a disease management program in Florida.

They were surveyed at the start of the study with a health assessment questionnaire. Evidence of depression among members of the group came from physician diagnosis, patient reports of having a prescription for an antidepressant in the year before the survey, or patient answers to a brief screening test. For the next two years, the research team recorded the death and cause of death of participants through bi-monthly checks of Medicare claims and eligibility files, or from phone calls with the participants’ families. The research team found that patients with both diabetes and depression had an increased risk of about 36 percent to 38 percent of dying from any cause during the two-year follow-up. Participants with a physician diagnosis of depression were significantly younger than their cohorts, more likely to be female, had more severe medical illness, were less likely to be African-American, and more likely to be Hispanic.

These variables were controlled for in the analysis of increased risk. A total of 12.1 percent of participants who had both disorders died during that period. Among those without depression, 10.4 percent died. Participants who had been treated with one or more antidepressant medications in the year before the study had a 24 percent increased risk of mortality, compared to non-depressed participants. According to the study authors, those patients may have been treated with antidepressants because their depressive symptoms were more severe and persistent than those of more mildly depressed patients who weren’t prescribed antidepressants. There was no difference in the rate of cardiovascular or cerebrovascular events between those treated with antidepressants and those who had no indication of depression.

“Rates of mortality from vascular disease may be decreasing in recent years among patients with diabetes due to more aggressive treatment of high blood pressure, cholesterol, and glucose levels,” the researchers surmised, “as well as widespread use of preventative medications such as aspirin and beta blockers.” According to the authors, there may be several reasons why depression worsens chronic diseases such as diabetes. Depression has been associated with inadequate self-care and harmful habits like smoking or overeating. Depression is also associated with nervous system and endocrine system problems, and with inflammatory markers. The authors noted their study’s limitations: the participants were from one geographic region of the United States, and the follow-up period was relatively short. Defining depression in part by physician diagnosis and treatment, they added, may have selected for participants with more severe illness. The study was also not able to obtain information on education, income, weight, smoking habits, physical activity, or compliance in taking medication.

Source: University of Washington

Derma Sciences Enrolls First Patient In DSC127 Phase II Study - 04th November

Derma Sciences, Inc. (OTC Bulletin Board: DSCI) announced the first study patient has been entered into the company's Phase II study of its drug candidate, DSC127. Enrollment of the 75-patient study, looking into the drug's ability to accelerate healing in diabetic foot ulcers, is expected to be completed within 12 months. Currently, 4 US facilities have signed on as clinical study sites, with an additional 15 sites pending contract negotiations and internal review board approvals. All sites are based in the United States and include top-tier academic institutions and large, highly regarded wound care clinics. Derma Sciences acquired the global rights to the product and to the patent portfolio surrounding it - for wound care and scar prevention applications - in November, 2007.

Extensive pre-clinical studies have shown that DSC127 - a biologically active angiotensin analog - significantly increases wound healing rates, notably in reliable and validated diabetic animal models. Diabetic ulcerations represent a large and growing portion of the overall chronic wound care market. More than simply a blister on a patient's foot, non-healing diabetic foot ulcerations can lead to a cascade of events including infection, amputation of the patient's limb, and even death. In the United States alone, there are an estimated 2.4 million diabetic foot ulcers and over 60,000 diabetes-related amputations each year. Depending on the study, 5-year mortality rates following a diabetic ulcer related amputation have been shown to range from 39% to 68%. Ulcers are present in 3% to 6% of all hospital stays in which diabetes is listed on the discharge record. The average length of these hospital stays is 59% greater than stays in which diabetes is listed on the discharge record but when an ulceration is not present. In 2001, the financial costs to US healthcare payers for the management of diabetic ulcers and associated amputations were over $10 billion.

Not merely a problem in the United States, the World Health Organization has recognized that there is a "global epidemic of obesity", with a sharp rise in the incidence of diabetes around the world as part of that epidemic. The International Diabetes Federation has stated that in 2006 there were 246 million people living with diabetes, and that this number is expected to increase to 380 million within 20 years.

Speaking about the first patient entered into this Phase II study, CEO Ed Quilty stated, "I am excited to say that, based on the exceptional results of multiple pre-clinical studies, some of the top wound care researchers in the US have signed on as investigators for this trial. Diabetic foot ulcerations are a major problem in the US and worldwide, as the incidence of diabetes continues to grow rapidly. A significant portion of diabetic ulcerations leads to lower limb amputation, which itself is associated with a high long-term mortality rate." Quilty continued, "Our recent launch of MedEfficiency's EZ-Cast and the investment we are making into DSC127 for diabetic ulcers speaks volumes to our commitment to help reduce the number of these amputations. We are confident that taking a leadership position in this area will help us reach our goal as a leader in advanced wound care, which in turn will drive shareholder value. A drug that is as effective in humans as DSC127 has been shown to be in validated animal models could have blockbuster potential."

DSC127, a topically applied pharmaceutical, has been shown to promote healing in a variety of ways; by increasing keratinocyte proliferation, extracellular matrix production, and vascularization.

Peer reviewed articles on the technology as applied to wound healing and scar reduction have appeared in such journals as the Journal of Peptide Research, Wound Repair and Regeneration, Experimental Dermatology, Plastic and Reconstructive Surgery, the Annals of Plastic Surgery, and the Journal of Burn Care and Rehabilitation.

Derma Sciences Chief Scientific Advisor, Laura Bolton, Ph.D, whose involvement in wound care began in 1974 as a Johnson & Johnson Scientist and continued in Wound Care R&D before retiring in 2006 as Global Director of Scientific Affairs at ConvaTec, a Bristol-Myers Squibb company, said, "This is the most rigorously researched, most promising active wound healing agent I have seen. The clinical studies are well-designed to test the promise of this unusually versatile and effective molecule in diabetic foot ulcers. If results match the pre-clinical findings, surpassing moisture-retentive dressing and growth factor effects, diabetic patients will have a sterling option they can count on to help them heal their foot ulcers..."

About DSC127

The skin represents one of the few human tissues with a high turnover rate. Upon injury, the expression of receptors in injuried skin is upregulated and down regulates as the skin heals. In human skin, angiotensin II type 1 (AT1) and angiotensin II type 2 (AT2) receptors are found in the epidermis and in dermal vessel walls. DSC127, a novel angiotensin analog, has been shown to accelerate skin healing in a variety of animal models including wound repair after full-thickness excision in normal rats, in adriamycin or steroid-treated rats, in diabetic mice, after partial thickness thermal injuries in guinea pigs, and after random flap injuries in rats.

DSC127 upregulates a cassette of genes at the site of skin healing. These genes are involved in energy metabolism (glycolysis and electron transport), oxidative stress, and production of cytoskeletal proteins, all of which could be involved in the growth of new skin during wound healing. This finding suggests that DSC127 produces different actions at the wound site during various stages of healing. DSC127 appears to stimulate production of dermal progenitor cells following injury.

Acute and chronic administration of DSC127 in rodents and dogs failed to demonstrate any meaningful toxicity to major organ systems. No mutagenic effects of DSC127 were observed in standard test panels. Pre-clinical and human Phase 1 studies of DSC127 have demonstrated safety in FDA monitored studies.

About Derma Sciences

Derma Sciences is a global manufacturer and marketer of advanced wound-care products. Its key product, MEDIHONEY(TM), is sold throughout the world by Derma Sciences and Comvita New Zealand -- the licensor of the patented honey- based technology -- and is the leading brand of honey-based dressings for the management of wounds and burns. The product has been shown to be effective in a variety of wounds and burns, and was recently the focus of a large-scale randomized controlled trial on leg ulcers. Derma has two products in development: the BIOGUARD(TM) line of barrier gauze dressings, and DSC127, the company's novel angiotensin analog for accelerated wound healing and scar reduction. The barrier technology was licensed from Quick-Med in Q1 of 2007 and is pending its initial FDA marketing clearance. DSC127 was licensed from the University of Southern California in Q4 of 2007. For more information about Derma Sciences, Inc., visit its home page on the Internet at http://www.dermasciences.com.

Forward looking Statements

Statements contained in this release that are not statements of historical fact may be deemed to be forward-looking statements. Without limiting the generality of the foregoing, words such as "may," "will," "expect," "believe," "anticipate," "intend," "could," "estimate" or "continue" are intended to identify forward-looking statements. Readers are cautioned that certain important factors may affect the Company's actual results and could cause such results to differ materially from any forward-looking statements which may be made in this release or which are otherwise made by or on behalf of the Company. Factors which may affect the Company's results include, but are not limited to, product demand, market acceptance, impact of competitive products and prices, product development, completion of an acquisition, commercialization or technological difficulties, the success or failure of negotiations and trade, legal, social and economic risks. Additional factors that could cause or contribute to differences between the Company's actual results and forward-looking statements Include but are not limited to, those discussed in the Company's filings with the Securities and Exchange Commission.

Derma Sciences, Inc.
http://www.dermasciences.com

Number of American Kids Medicated For Chronic Conditions Increasing - 3 November

The number of children on medication for chronic illnesses in the United States went up between 2002 and 2005 across a range of diseases, with a doubling of medication for type 2 diabetes, according to a new study.

The study was the work of lead author Dr Emily Cox of Express Scripts, Inc, St Louis, Missouri, and colleagues from other research centres in the US, and was published online on 31 October in the journal Pediatrics.

The researchers investigated commercial medical insurance claims made between 2002 and 2005 for a nationally representative sample of more than 3.5 million children aged from 5 to 19 years.

For each quarter of the three years covered by the study the researchers noted use of medication for the following chronic conditions: high blood pressure (antihypertensives), high blood fats (antihyperlipidemics), type 2 diabetes, antidepressants, asthma, attention deficit disorder and attention- deficit/hyperactivity disorder.

The results showed that:

• The figures for medication use in the first quarter of the study period (first three monts of 2002, the baseline quarter) ranged from 29.5 per 1,000 child patients for asthma medication to 0.27 per 1,000 for antihyperlipidemics.
   

• Except for asthma medication, the prevalence for older children, aged 15 to 19, was higher than for those who were younger than this.
   

• The prevalence for type 2 diabetes medication doubled over the three years of the investigation.
   

• This was driven mostly by a 166 per cent rise among females aged 10 to 14 and 135 per cent among females aged 15 to 19.
   

• The highest rates of prevalence increase (in the double digits) were in medications for: asthma (46.5 per cent), attention-deficit disorder and attention-deficit/hyperactivity disorder medications (40.4 per cent), and antihyperlipidemics (15 per cent).
   

• This compared with a more moderate growth in the use of antihypertensives and antidepressants (1.8 per cent).
   

• The increase in prevalence rates for type 2 diabetes medication was far more dramatic for girls than for boys (147 versus 39 per cent).
   

• There was a similar pattern for attention-deficit disorder and attention-deficit/hyperactivity disorder medications (63 versus 33 per cent), and antidepressants (7 versus 4 per cent).

In reporting their findings the authors commented that:

"Varying patterns were noted between males and females and across age groups. Particularly noteworthy are growing rates of use among female children, at times rates twice as great as among males."

"These findings hold important implications for children's health and health care costs in the United States," they added.

And they concluded that:

"Prevalence of chronic medication use in children increased across all therapy classes evaluated. "

Cox and colleagues suggested more research was needed to look into the reasons behind this increase, including factors like growth in risk of chronic diseases among children, greater awareness of these conditions and more successful screening of them, and perhaps also a greater tendency to intervene earlier with drugs.

They also said more needs to be known about why the prevalence is growing faster for girls than for boys and also what this growing trend for both boys and girls means for overall child health..

Finally they wrote that:

"As chronic prescription use grows, so too do the risks of drug-related adverse effects and drug-drug interactions.".

Although research is already going ahead to understand more about chronic diseases in childhood, "addressing the appropriateness of current treatment patterns must not be ignored," they added.

DOES DIABETES HAVE  A DIRECT CARCINOGENETIC EFFECT?  - October 30

The association of DM2 with solid tumors, and particularly with HCC, has been long suspected and several studies have reported increased mortality rates for neoplastic diseases in patients with DM2. However, the temporal relationship between the onset of diabetes and development of HCC, and the clinical and metabolic characteristics of patients with DM2 and HCC have not been well examined.

A research article published on October 7, 2008 in the World Journal of Gastroenterology addresses this. The research team led by Dr. Valter Donadon from Pordenone Hospital of Italy investigated the relationships between DM2 and risk of HCC in a large population based case-control study. They enrolled 465 consecutive patients with HCC compared with an age and sex matched control group of 490 subjects.

Their results confirm that patients with DM2 have a significantly increased risk of HCC, independent of cofactors such as HBV and HCV infection and alcohol intake, and demonstrate that DM2 pre-exists to the development of HCC in most cases, suggesting that DM2 is more likely a concourse rather than merely a consequence of the liver tumor. This conclusion is also supported by the finding of a similar frequency and severity of DM2 in patients with small HCC detected during follow-up of cirrhosis and in those with more advanced and diffuse cancers detected outside of a surveillance program. The observation that patients with DM2, particularly males, treated with insulin had an increased frequency of HCC is intriguing and clinically relevant. These patients are those often showing the highest insulin blood levels, and this might contribute to facilitate the development of HCC.

It is well known that patients with DM2 treated with insulin are those with more severe hyperinsulinaemia and more diabetic complications. Their results indicate the need for close surveillance for HCC in patients with chronic liver disease and DM2, particularly when males and treated with insulin. They also suggest that in these patients strategies to improve the metabolic control should be directed primarily against hyperinsulinaemia by avoiding as much as possible the use of oral secretogogue drugs and of insulin treatment, giving preference to insulin-sensitizers such as metformin and glitazones. Because diabetes may be secondary to HCC or to the underlying cirrhosis, and the liver cirrhosis may be caused by diabetes, further studies, including cirrhotic patients, must be performed to evaluate these complex relationships and particularly whether the diabetes itself has a direct carcinogenetic effect.

Diabetes Becoming More Expensive To Treat  - October 29

A new study published in the October 27 issue of Archives of Internal Medicine finds that more adults with type 2 diabetes are receiving progressively more complex and expensive arrays of treatments.

Type 2 diabetes - a metabolic disorder where the body becomes unable to control blood sugar levels - affected more than 11 million Americans in 2000. "By 2050, the number of Americans with diabetes is expected to soar to 29 million, a prevalence of 7 percent," write G. Caleb Alexander, M.D., M.S. (University of Chicago Hospitals) and colleagues. "The annual economic burden of diabetes is estimated at $132 billion and increasing. In 2002, more than one-tenth of U.S. health care expenditures were attributable to diabetes." Physicians have been prescribing more medications and combining drugs from different therapeutic classes, factors that come with increasing costs as they become more prevalent and more complex.

The researchers collected diabetes prescription information and costs from national databases in order to evaluate the national trends. The data consisted of prescription data from U.S. patients with type 2 diabetes who were age 35 and older. The patients all visited a physician's office between 1994 and 2007, and information was available about medication costs from 2001 to 2007.

A summary of some of the researchers' findings on diabetes care between 1994 and 2007 is presented below:
 

• The number of yearly patient visits to treat diabetes increased by 11 million

• Diabetes patients received on average 1.14 medication prescriptions in 19994 and 1.63 in 2007

• In 1994, 82% of visits resulted in only one drug prescription (when treatment was given) compared to 47% in 2007.

• Insulin use for type 2 diabetes patients was at 38% in 1994, 25% in 2000, and 28% in 2007

• The frequency of prescribing sulfonylurea drugs went from 67% to 34% of treatment visits

• The frequency of prescribing new drugs such as biguanides and glitazones incresed to 54% and 28% of treatment visits, respectively
   

Much of the increase in the average cost per prescription was attributed to the increasing use of glitazones and other new forms of insulin and new classes of drugs. Glitazone increased in price from $56 in 2001 to $76 in 2007. Similarly, overall medication expenditures for those with diabetes increased from $6.7 billion in 2001 to $12.5 billion in 2007.

"We document large shifts in patterns of diabetes treatment and pharmaceutical expenditures across treatment classes," conclude Alexander and colleagues. "Whether increased treatment costs are balanced by improved outcomes associated with these changes cannot be evaluated in the absence of data comparing effectiveness and cost-effectiveness across treatment classes. Our findings suggest the importance of generating new comparative data and coupling this information with clinical and formulary guidelines that contribute to constraining costs, maximizing glycemic control and minimizing diabetes-related morbidity and mortality."

Artificial Pancreas Could Revolutionize Treatment Of Type 1 Diabetes (October 2008)

Researchers at the University of Virginia and sites across the globe are testing a computerized, subcutaneous system that could one day transform the way Type 1 diabetics manage their disease.

UVA investigators have completed the first of several international artificial pancreas clinical trials to test an individually-"prescribed" control algorithm, which regulates blood glucose levels in Type 1 diabetics. UVA is one of seven centers worldwide funded by the Juvenile Diabetes Research Foundation to perform the novel closed-loop computer simulation of the human metabolic system.

Since late June, researchers have successfully tested the new system on five patients at the UVA Health System. An additional three patients have participated in a parallel study at the University of Padova, Italy.

"Our initial results are very encouraging," says Boris Kovatchev, Ph.D., associate professor of psychiatry and neurobehavioral sciences & systems and information engineering who is leading UVA's research team. "The system entirely maintained the patients' blood glucose levels, and the algorithm achieved excellent overnight control without any incidence of hypoglycemia."

Kovatchev, internationally known for his expertise in applying advanced computational methods to diabetes research, was one of the scientists who developed the system's novel algorithm, which allows for personalized treatment for each patient. By linking patients' glucose monitors with their insulin pumps, the "smart" program automatically regulates the amount of insulin a patient needs.

Researchers were granted FDA approval, based solely on in silico computer simulation experiments, to test the artificial pancreas in humans, without any prior in vivo animal trials. Such a rare distinction by the FDA cut research development time from several years to six months.

"This artificial pancreas could one day greatly improve the current methods of self treatment for Type 1 diabetes," Kovatchev says. "Instead of a patient having to measure his or her blood sugar with a glucose meter several times a day and self-administer insulin injections, this system would continuously regulate the patient's blood glucose, much like the way a non-diabetic's pancreas functions."

Complete results from the initial clinical trials at the UVA Health System, the University of Padova and the University of Montpellier, France are expected by the end of 2008.

The international collaboration is a result of the establishment of the Artificial Pancreas Consortium by the Juvenile Diabetes Research Foundation. Other centers involved in the consortium include Cambridge University, England, the University of Colorado, Sansum Diabetes Research Institute, Stanford University, Boston University, and Yale University.

University of Virginia Health System
PO Box 800795
Charlottesville
VA 22908-0795
United States
http://www.healthsystem.virginia.edu


FOOT PAIN? YOU MAY HAVE DIABETES...(October 2008)

Do you ever feel burning, tingling or numbness in your feet and toes? The American College of Foot and Ankle Surgeons (ACFAS) warns against ignoring these symptoms. They could be a warning sign of diabetes.

Foot and ankle surgeons say those symptoms may be caused by a condition called diabetic peripheral neuropathy, or nerve damage. Neuropathy in the feet can lead to permanent numbness, deformities such as bunions and hammertoes, and dry skin that cracks open and won't heal.

"Diabetic peripheral neuropathy is not only painful but dangerous," says Boston foot and ankle surgeon John M. Giurini, DPM, FACFAS, president of the 6,000-member surgeons' association. "It's a leading contributor to foot ulcers in people with diabetes."

Burning, tingling and numbness in the toes can also be symptoms of thyroid problems, nutritional deficiencies, back problems and pinched nerves in the ankles. In the United States, diabetes is the leading cause of peripheral neuropathy and can lead to further foot complications.

Out of the 23 million Americans with diabetes, one in four hasn't been diagnosed. Some people learn they have diabetes only after seeing a doctor for burning, tingling and numbness in their toes and feet. Many people already diagnosed with diabetes aren't familiar with neuropathy's symptoms. According to FootPhysicians.com, even diabetic patients who have excellent blood sugar control can develop diabetic neuropathy.

Medications can treat neuropathy pain. But nerve damage cannot be reversed.

"When you have diabetes, and especially diabetic neuropathy, a minor cut on your foot can turn into a catastrophe," says Giurini. "The statistics on diabetic ulcers are sobering."

Twenty percent of diabetes patients who develop ulcers will require an amputation. Patients who are black, Hispanic and Native American are twice as likely as whites to need a diabetes-related amputation. Half of all people with diabetes who have a toe or foot amputation die within three years. The annual cost for diabetic ulcer care in the U.S. is estimated at $5 billion.

For more information on diabetic peripheral neuropathy, visit FootPhysicians.com and click on Foot & Ankle Information.

The American College of Foot and Ankle Surgeons is a professional society of more than 6,000 foot and ankle surgeons. Founded in 1942, the College's mission is to promote research and provide continuing education for the foot and ankle surgical specialty, and to educate the general public on foot health and conditions of the foot and ankle through its consumer Web site, http://www.footphysicians.com.


DIABETES GROWTH DOUBLES IN A YEAR, UK (October 2008)

Leading health charity Diabetes UK warns that the number of people diagnosed with diabetes in the UK has risen by more than 167,000 since last year, bringing the total diabetes population to almost 2.5 million according to new data1 from GP practices. This rise is more than double the 2006 to 2007 increase of 83,000.

In England, a 6.4 per cent increase means the number of people diagnosed with diabetes has broken two million for the first time. In Northern Ireland and Wales, the increase was 6.8 per cent and 6 per cent respectively, with diabetes prevalence now standing at 60,822 and 138,988. Improved recording in Scotland2 contributed to the biggest rise (16.9 per cent) with the recorded diabetes population now standing at 200,669 compared to 171,513.

Around 90 per cent of people with diabetes have Type 2 diabetes, which is strongly linked to lifestyle factors such as being overweight or obese, leading a sedentary lifestyle and eating an unhealthy diet. The figures also show that there are now five million people registered obese in the UK compared to almost 4.8 million last year. The largest increase in obesity was again seen in Scotland2 with a 16.7 per cent (57,000 people) increase, with almost 400,000 Scots now included on the obesity register.

Douglas Smallwood, Chief Executive of Diabetes UK, said: "These are truly alarming figures. Part of why we have seen such a huge increase can be attributed to improved screening from healthcare services and greater awareness amongst those at high risk of Type 2 diabetes. However, there is no getting away from the fact that this large increase is linked to the obesity crisis.

"Diabetes is one of the biggest health challenges facing the UK today. It causes heart disease, stroke, amputations, kidney failure and blindness, and more deaths than breast and prostate cancer combined. The NHS already spends one million pounds an hour on diabetes. The soaring diabetes prevalence will continue to put a massive strain on an already struggling NHS and unless it can respond, people's health could spiral downwards. We need to do all we can to raise awareness of the seriousness of diabetes and help people understand how a healthy lifestyle can help reduce their risk of developing Type 2 diabetes."

In addition to the 2.5 million people diagnosed with diabetes, there are still more than half a million people who have Type 2 diabetes in the UK and don't know it. Diabetes UK warns that the condition can go undiagnosed for up to ten years and 50 per cent of people already have signs of complications by the time they are diagnosed.

Diabetes UK has recently launched its Silent Assassin awareness campaign to highlight the seriousness of the diabetes and improve awareness of its devastating complications to people diagnosed with diabetes, the undiagnosed and those at risk of Type 2 diabetes.

Learn how to beat the Silent Assassin at http://www.diabetes.org.uk/SilentAssassin

1. The new figures are from the 2007-2008 Quality and Outcomes framework (QOF) for England by The Information Centre for Health and Social Care (http://www.ic.nhs.uk), for Scotland by The Information Services Division (http://www.isdscotland.org), for Northern Ireland by The Department of Health, Social Services Public Safety (http://www.dhsspsni.gov.uk).

2. The high increase in Scotland can be attributed to underestimating in previous years and improved recording.

3. Diabetes UK is the charity for people with diabetes. We fund more than L7 million of medical research every year, provide information and support to people with diabetes and campaign on their behalf. For more information visit http://www.diabetes.org.uk

4. In the UK, there are currently 2.5 million people diagnosed with diabetes and it is estimated that more than half a million people have the condition but do not know it.

5. The Diabetes UK Careline (0845 120 2960) offers information and support on any aspect of managing diabetes. The line is a lo-call number and opens Monday to Friday between 9am and 5pm (operates a translation service). Recorded information on a number of diabetes-related topics is also available on this number 24 hours a day.

6. Membership of Diabetes UK is from L23 a year with special rates available. In addition to our bi-monthly magazine Balance, members receive support and the latest information on diabetes care and treatments to help them live a healthy life.
 

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