|
:: FURTHER NEWS
100,0 00
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 h uman 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. Pac holczyk 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
– 17th 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 compare d
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
areas¹ 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.²
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.³
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 £7 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
£23 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 £422m, 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."
----------------------------
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
| 
