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:: FURTHER NEWS
The NHS’s National Diabetes Audit has revealed that in some areas of England fewer than 10 per cent of diabetes patients are receiving the full complement of the recommended diabetes health checks. If the figures of the audit are representative of care across the country, it would mean that 1.3 million people with diabetes in England are missing out on one or more of the essential health checks.
Clinical guidelines set by NICE recommend nine different tests are performed once every 12 months for adults with diabetes. The tests include HbA1c, cholesterol, blood pressure, two kidney tests, foot and eye checks, measuring of BMI and a check whether support to quit smoking is needed.
The Mid-Essex Primary Care Trust came bottom of the table but weren’t the only PCT to provide all 9 tests to fewer than 10 per cent of patients with diabetes.
Screening tests are an important part of diabetes care and can help to detect the early signs of, and prevent, serious complications such as heart and kidney disease and lower leg amputations.
Chief Executive of Diabetes UK, Baroness Young points out that despite the large amount of NHS money that is spent on diabetes, too much is being used to treat the diabetic complications instead of preventing the complications from developing to begin with.
Source: http://www.diabetes.co.uk
Breakfast cereals are a popular choice of breakfast in the UK but many are unsuitable for people with diabetes because of how much and how quickly they affect blood sugar levels.
Consumer Watchdog has released its report on nutrition in breakfast cereal which records Kellogg’s Frosties as the worst offending cereal in terms of sugar content. Frosties is recorded as being 37 per cent sugar. Other cereals exceeding 35 per cent sugar included Coco Pops, Crunchy Nut Cornflakes and Sugar Puffs. Supermarket own brand versions of these cereals also recorded similarly high levels of sugar.
Under the ‘traffic light system’ of food labelling, products that are more than 12.5 per cent sugar are recorded as a ‘red light’ high sugar product. Other cereals which fell into this category included Special K, All Bran, Bran Flakes and a number of muesli brands.
As well as naming and shaming the most sugary cereals, the report also identifies the more healthy breakfast cereals which includes Shredded Wheat, Weetabix and Oat So Simple.
The report also highlighted the fact that on pack ‘low fat’ claims could mislead customers into believing highly sugary cereals are healthy. As well as being a poor choice for people with diabetes, sugary cereals could also present problems such as increased blood pressure and cholesterol for people without diabetes.
Source: http://www.diabetes.co.uk
A mapping study into areas where people are at most risk of developing type 2 diabetes has shown that parts of east London have been prone to poverty and ill health for the last hundred years or more. When the researchers from Queen Mary, University of London, compared their diabetes map with that produced by the Victorian reformist Charles Booth at the end of the 19th century, there were strong similarities found.
The study, set up to assist local authorities and NHS services in targeting their resources, mapped out the London boroughs of Hackney, Tower Hamlets and Newham, finding that type 2 diabetes – a condition closely associated with poverty and South Asian ethnicity – was still highly prevalent there.
The modern mapping system eschewed the Victorian method of observation in favour of using the electronic records from doctor surgeries in the area, involving over half a million people in these boroughs. Although around one in ten adults in the population can be classified as at high risk from diabetes, the survey revealed that up to 17 per cent were at risk in these areas.
Study leader Douglas Noble commented "It was no surprise to see that diabetes risk is high in areas where poverty was high. What was surprising was that some of these pockets of deprivation and ill health have persisted for over 100 years."
He added "But unlike in Booth's time, we now know how diseases like diabetes can be prevented."
Source: http://www.diabetes.co.uk
A questionnaire of diabetes treatment satisfaction in NHS hospitals shows that a significant number of patients felt their blood glucose levels were unacceptably high for most of their duration in hospital.
The questionnaire, carried out by the DIPSat group, took place across 58 UK care trusts. 74% of the patients were insulin users before admission and the average age, of those questioned, was 60 years old. The Diabetes Treatment Satisfaction Questionnaire for Inpatients invited patients to rate, on a scale of 0 to 6, how often their blood glucose levels were unacceptably high during their hospital stay.
The survey showed that about 1 in 8 patients gave a 6, indicating that their levels were unacceptably high for most their time in hospital. 1 in 20 gave a rating of 5 or more and 1 in 3 gave a rating of 4 or more out of 6.
It is common for diabetic patients on insulin to experience higher blood sugar levels than normal whilst in hospital to reduce instances of hypoglycemia. The number of patients reporting being unacceptably low whilst in hospital was notably smaller. 1 in 7 patients gave a rating of 4 or more out of 6 to indicate how often their levels were unacceptably low.
Source: http://www.diabetes.co.uk
Scientists at King's College London and the National Diabetes Centre (Sri Lanka) have found evidence of a high number of risk factors for type 2 diabetes among the young urban population in Sri Lanka. The study is the first large-scale investigation into diabetes risk among children and young people in South Asia, and provides further evidence that the region is rapidly becoming a hotspot in the growing international diabetes epidemic.
The study, published in the journal PLoS One, is part of a research programme aiming to develop methods to prevent diabetes in young people in Sri Lanka, as the disease is now having a major public health impact. The scientists suggest that urgent action is now required to raise awareness of diabetes and obesity in developing countries and encourage young people to make lifestyle changes to reduce their risk.
According to the World Health Organization (WHO), 346 million people worldwide have diabetes, with 80 percent of diabetes deaths occurring in low- and middle-income countries. Recent research has shown that urban populations in South Asia are increasingly at risk from developing type 2 diabetes, which develops largely as a result of excess body weight and physical inactivity. In Sri Lanka, studies have shown that one in five adults has either diabetes or pre-diabetes, but until now no research has been carried out into risk-factors among young people.
The DIABRISK-SL project is an international collaboration between scientists in Sri Lanka, led by Dr Mahen Wijesuriya and the UK, led by Dr Janaka Karalliedde from the Cardiovascular Division at King's College London. The team surveyed 22,507 people aged between 10 and 40 from cities in Sri Lanka to check for various early risk factors for type 2 diabetes - such as high body mass index (BMI), raised waist circumference and high levels of physical inactivity. They also checked for family history of the disease.
The survey revealed that 5,163 people (23 percent) had two or more risk factors for diabetes, with two or more risk factors found in 24 percent of children aged 10-14. Raised BMI was found in nearly 20 percent of children aged 10-14, and 15 percent of children aged 15-19. Most worryingly, the prevalence of physical inactivity and central obesity was nearly 40% in females aged under 16. The results also showed that physical inactivity was a lot higher among females in all age groups, with overall inactivity rising in both sexes with age.
'What we have found in this report really confirms that South Asia is becoming the centre of a worldwide diabetes epidemic,' said Dr Karalliedde. 'We were expecting the levels of risk factors to be high, but we were still surprised at just how high they were. The fact that we found such a high prevalence in children has not been shown Sri Lanka before, or anywhere else in South Asia, and is of great concern.
'This dramatic rise is clearly linked to a decline in physical activity and mirrors global trends of rising childhood obesity. Being overweight in childhood means people are much more likely to become obese as adults and will have a greater risk of developing type 2 diabetes and cardiovascular disease. Now that we know how widespread the problem is, we can take steps towards identifying high risk groups to evolving preventive strategies.'
Dr Mahen Wijesuriya, of the National Diabetes Centre, said: 'These data highlight the need for early intervention in younger people in Sri Lanka. A primary prevention intervention trial is now underway to evaluate the effects of intensive lifestyle intervention on improving diet and exercise. We will have the results of this in the next two years.'
Dr Wijesuriya emphasized the importance of public health education and awareness and stressed that these results have already contributed to the development of a National Non-Communicable Disease Strategy to combat type 2 diabetes in Sri Lanka.
Professor Jean Claude Mbanya, President of the International Diabetes Federation, said: 'These figures reflect the disturbing rise in risk factors for type 2 diabetes among young people being seen worldwide. This is an example of good-quality scientific research that will bring solutions to the global epidemic of diabetes and other chronic non-communicable disease.
'We hope that the DIABRISK-SL project in Sri Lanka will lead to effective and cost-effective interventions that work in the real world. This is a golden opportunity to make a very deep and very positive long-term impact on individuals, families and entire communities in Sri Lanka.'
Berries contain the same kind of properties that are found in red wine, tea and chocolate that can be protective against the risks of heart disease and type 2 diabetes. A one year trial run by the University of East Anglia showed that diets rich in biological properties, called flavonoids, were associated with a reduced risk of suffering a heart attack within the next decade.
The participants that ate a bar rich in flavonoids, as part of the study, experienced a 3.4% reduction in risk of heart attacks compared with participants which were given a placebo.
The study was comprised of 93 female participants, aged between 51 and 74, with type 2 diabetes. Women of this age group with type 2 diabetes have a notably higher risk of heart disease, with diabetes increasing the risk by three and a half.
Dr Ketan Dhatariya, one of the researchers at the University of East Anglia, adds: "Foods that are rich in flavonoids can potentially reduce the risk of heart attacks and strokes, which sadly remain the leading causes of premature death in this group of women."
Berries are known to be a healthy option and as they have relatively low GI (glycaemic index) values, compared with other fruits, they're a good choice of fruit for people with diabetes.
Source: http://www.diabetes.co.uk
Scientists from two UK universities and the Medical Research Council (MRC) have been awarded GBP1.9 million grant to help them carry out a large prevention programme for patients suffering from type 2 diabetes. The Prevention of Diabetes through Physical Activity Education with Different Levels of Ongoing Support (PROPELS) programme has been set up to offer information to the NHS to lessen the amount of people who develop diabetes in the future.
The grant to researchers, from the universities of Leicester and Cambridge, as well as the MRC, from the National Institute for Health Research (NIHR) Health Technology Assessment programme (HTA), is to assess the effectiveness of structured education in helping prevent diabetes in the long term.
They will monitor the benefits of encouraging people in a high-risk category of type 2 diabetes to take part in more physical activity to help them reduce their blood glucose levels over one to two years.
A spokesperson for the NIHR Health Technology Assessment programme commented "The NIHR HTA programme identifies the most important questions that the NHS needs answers to through wide consultation and have highlighted this area as being of national importance."
Researcher Kamlesh Khunti commented "Type 2 diabetes costs the NHS over GBP10 billion annually. Many cases of type 2 diabetes are preventable through changes to lifestyle, such as increasing physical activity."
Source: http://www.diabetes.co.uk
A study from the University of Leicester reveals that genes passed via Y chromosomes can increase risk of heart disease by 50%. The study looked at over 3,000 British men who were involved in other studies related to heart disease risks. The specific version of the Y chromosome linked to the risk was found to be present in 1 in 5 men.
The next step in the research is to determine which genes of this version of the Y chromosome are responsible for the increase in heart disease risk. It’s believed that the genes may lead to the increased risk by upsetting the body’s immune system .
Dr Maciej Tomaszewski, from the University of Leicester, said: "Doctors usually associated the Y chromosome with maleness and fertility but this shows it is also implicated in heart disease."
Men generally develop heart disease a decade before women. Amongst the population, Men over 40 years old have a 50% risk of developing heart disease in their lifetime. Diabetes, high cholesterol, high blood pressure and smoking are other known factors for increasing risks of developing cardiovascular disease .
Source: http://www.diabetes.co.uk
A renowned diabetes expert has been appointed Chief Scientist for Scotland. Professor Andrew Morris, who works at Dundee University and is co-director of the medical research institute at the university, is due to take up the position in March.
Professor Morris will advise government ministers and officials on issues concerning science and how research can contribute to improvements in healthcare, as well as work to enhance Scotland's reputation in science. He will carry out his duties for two days each week as part of the Scottish Government Health and Social Care Directorates, which promotes research targeted at improving services provided by NHS Scotland, as well as long-term improvements to public health.
Professor Morris has led a range of clinical studies on diabetes, and also published more than 200 research papers, and has been convener of the Scottish academic health science collaboration for the last couple of years.
He said "There are great opportunities to translate our outstanding NHS and university research capabilities into improved patient care and economic growth across Scotland."
John Connell, vice principal of Dundee University, also commented "This is a very important position that reflects the high regard in which Andrew is held in Scotland and I am sure that he will carry out his duties with distinction."
Source: http://www.diabetes.co.uk
Scientists at Oxford University have found that storing fat in your bottom, rather than stomach, cuts levels of ‘bad’ LDL cholesterol and raises the ‘good’ HDL cholesterol that protects against hardening of the arteries.
Their review, published in the International Journal of Obesity, showed the benefits of an ample derriere extend even to cutting the risk of diabetes.
Professor Jimmy Bell, head of metabolic and molecular imaging at Hammersmith Hospitals NHS Trust, explains: ‘Fat comes in “good” and “bad” forms.
'Gluteofemoral fat stored around the bottom seems to act as a buffer, mopping up inflammatory fats that could have a dangerous effect elsewhere. ‘Because fat around your backside breaks down more slowly than belly fat, it produces fewer inflammatory cytokines — chemicals which have been linked to diabetes, heart disease and obesity.
'Burning off too much of this healthier form of fat isn’t good for you.’ However, excess fat around the middle can have severe health implications, so getting rid of it is important.
Source: http://www.dailymail.co.uk
We all know of couples who piled on the pounds once they married and fat friends who seem to encourage each others bad eating habits.
But scientists have now claimed that chubbiness could be catching.
A study from Yale University found that both obesity and liver disease can be triggered by a family of proteins called inflammasomes that alter the balance of microbes in the stomach.
Amazingly, this altered intestinal environment can be passed on - making obesity an infectious condition.
The finding came to light during a study on stomach bacteria in mice.
The Yale team found that a deficiency in components of two particular inflammasomes in mice resulted in the development of an altered microbial community associated with increased bacteria.
This determined the severity of non-alcoholic fatty liver disease (NAFLD) and obesity in the mice.
Senior study author Professor Richard Flavell,said: 'When healthy mice were co-housed with mice that had altered gut microbes, the healthy mice also developed a susceptibility for development of liver disease and obesity.'
NAFLD is the result of metabolic syndrome, a collection of disorders that includes obesity and diabetes, and is the leading cause of chronic liver disease in the western world.
It is estimated that up to 30 million people suffer from NAFLD in the United States alone.
Professor Flavell said the next step will be to extend the research to see if the same effect can be seen in humans.
'We found, in mice, that targeted antibiotic treatment brought the microbial composition back to normal, and thus eased the liver disease. Our hope is that our findings may eventually lead to a treatment for humans.'
In the meantime, overweight adults should use the tried and tested formula of eating a healthy diet and performing half an hour of moderate exercise at least three times a week.
The study was published in the online version of Nature.
Source: http://www.dailymail.co.uk
A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health suggests that hyperglycemia (high blood sugar) injures the heart, even in patients without a history of heart disease or diabetes. Researchers found that elevated levels of glycated hemoglobin (HbA1c), a marker for chronic hyperglycemia and diabetes, were associated with minute levels of the protein troponin T (cTnT), a blood marker for heart damage. The high-sensitivity test they used detected levels of cTnT tenfold lower than those found in patients diagnosed with a heart attack. The findings, which are published in the latest issue of the Journal of the American College of Cardiology, suggest that hyperglycemia may be related to cardiac damage independent of atherosclerosis.
"Hyperglycemia and diabetes are known to be associated with an increased risk for heart attack and coronary disease and our study sheds some light on what may be happening," said Elizabeth Selvin, PhD, MPH, senior author of the study and associate professor in the Bloomberg School's Department of Epidemiology. "Our results suggest that chronically elevated glucose levels may contribute to heart damage."
For the study, the researchers followed 9,662 participants from the Atherosclerosis Risk in Communities (ARIC) study. None of the participants had coronary heart disease or history of heart failure. Higher levels of HbA1c were associated in a graded fashion with elevated levels of high-sensitivity cTnT. This relationship was present at HbA1c levels even below the threshold used to diagnose diabetes. Using conventional tests, troponin T can be detected in 0.7 percent of the population and is associated with heart attacks and death. With the high-sensitivity cTnT test, low levels of troponin were found in 66 percent of the study population.
"Our study hints at other potential pathways by which diabetes and elevated glucose are associated with heart disease. Mainly, glucose might not only be related to increased atherosclerosis, but potentially elevated glucose levels may directly damage cardiac muscle," said Jonathan Rubin, MD, general internal medicine fellow at the Johns Hopkins School of Medicine. He was lead author of the study while studying at the Johns Hopkins Bloomberg School of Public Health.
Source:http://www.diabetes.co.uk
Researchers from Mount Sinai School of Medicine have discovered that decaffeinated coffee may improve brain energy metabolism associated with type 2 diabetes. This brain dysfunction is a known risk factor for dementia and other neurodegenerative disorders like Alzheimer's disease. The research is published online in Nutritional Neuroscience.
A research group led by Giulio Maria Pasinetti, MD, PhD, Professor of Neurology, and Psychiatry, at Mount Sinai School of Medicine, explored whether dietary supplementation with a standardized decaffeinated coffee preparation prior to diabetes onset might improve insulin resistance and glucose utilization in mice with diet-induced type 2 diabetes. The researchers administered the supplement for five months, and evaluated the brain's genetic response in the mice. They found that the brain was able to more effectively metabolize glucose and use it for cellular energy in the brain. Glucose utilization in the brain is reduced in people with type 2 diabetes, which can often result in neurocognitive problems.
"Impaired energy metabolism in the brain is known to be tightly correlated with cognitive decline during aging and in subjects at high risk for developing neurodegenerative disorders," said Dr. Pasinetti. "This is the first evidence showing the potential benefits of decaffeinated coffee preparations for both preventing and treating cognitive decline caused by type 2 diabetes, aging, and/or neurodegenerative disorders."
Coffee intake is not recommended for everybody due to the fact that it is associated with cardiovascular health risks such as elevated blood cholesterol and blood pressure, both of which lead to an increased risk for heart disease, stroke, and premature death. These negative effects have primarily been attributed to the high caffeine content of coffee. Nonetheless, these novel findings are evidence that some of the non-caffeine components in coffee provide health benefits in mice. Dr. Pasinetti hopes to explore the preventive role of decaffeinated coffee delivered as a dietary supplement in humans.
Source:http://www.diabetes.co.uk
New research has claimed that the common diabetes treatments can effect the potential risk of developing pancreatic cancer. Common treatments, such as metformin, which is taken by some patients with type 2 diabetes, was linked to fewer cases of pancreatic cancer in women, although other diabetes drugs were seen to increase the risk of the disease.
The study, which was published in the American Journal of Gastroenterology, involved the review of primary care data on over eight million people in the UK, including around 2,800 of which had been diagnosed with pancreatic cancer between 1995 and 2009. Two percent of patients with pancreatic cancer had been using metformin on a long-term basis before they were diagnosed, as compared with 1.6 percent of those without cancer.
When gender was assessed, it was found that substantially fewer women with a new diagnosis of pancreatic cancer had been taking metformin for at least a few years, as compared with cancer-free women. It was also shown that one in nine pancreatic cancer patients had a prior diagnosis of diabetes, as compared with around one in twelve for those who were cancer-free.
Metformin performed well in the research, supporting previous studies showing that it was able to reduce the likelihood of multiple cancers, while some of the newer diabetes drugs performed less effectively. It was not conclusively shown why such treatments affect men and women differently.
Source:http://www.diabetes.co.uk
New research from scientists in Finland has identified parts of the human genome that are linked with levels of circulating metabolites involved in a range of chemical reactions in the body. Some of the metabolites were revealed as biomarkers for cardiovascular disease that could offer insight into biological processes that lead to conditions such as type 2 diabetes.
The study, carried out at the Institute for Molecular Medicine Finland, used nuclear magnetic resonance (NMR) to assess over a hundred different metabolic markers from a sample of 8,330 Finnish people in one assay, finding a total of 31 genetic regions linked to the blood levels of the metabolites, with 11 loci not having been previously associated with any metabolic measures.
Five of the new loci were found to affect levels of amino acids that are potential biomarkers for type 2 diabetes.
Study leader Samuli Ripatti, commented "Using this extensive analysis in thousands of people, we could identify a large number of genetic loci regulating the level of compounds circulating in the blood stream."
He added "the study provides further support for the use of detailed data on multitude of metabolites in genetic studies to provide novel biological insights and to help in elucidating the processes leading to common diseases."
Source:http://www.diabetes.co.uk
Most Britons have a "troubling" lack of understanding about the calorie content of everyday foods, a health charity has warned.
A survey, commissioned by the World Cancer Research Fund (WCRF), found two out of three adults underestimated the calorie level of foods such as houmous and light mayonnaise. Only 32 per cent said houmous was high in calories while only 29 per cent said the same about the mayonnaise.
Houmous contains an average 332 calories per 100g while reduced fat mayonnaise contains an average of 259 calories. The poll also found 20 per cent mistakenly believe bananas are high in calories. The WCRF said the findings are worrying because being overweight is linked to cancer, heart disease and diabetes.
Maya Monteiro, senior education manager, said: "This troubling lack of understanding is perhaps not helped by labels such as 'light' when applied to foods which still have a high calorie content. If people are unaware which foods contain lots of calories, it makes it more difficult to adopt a diet that helps maintain a healthy weight."
Source:http://www.independent.co.uk
A diet rich in green leafy vegetables may reduce the risk of developing diabetes, UK research says. In an analysis of six studies into fruit and vegetable intake, only food including spinach and cabbage was found to have a significant positive effect. A portion and a half a day was found to cut type 2 diabetes risk by 14%, the British Medical Journal (BMJ) reports.
The researchers from Leicester University reviewed data from the studies of 220,000 adults in total.They found that eating more fruit and vegetables in general was not strongly linked with a smaller chance of developing type 2 diabetes.
Yet when it came to green leafy vegetables, which the researchers said also includes broccoli and cauliflower, the risk reduction was significant. The team calculated that a daily dose of 106g reduced the risk of diabetes by 14% - a UK "portion" is classed as 80g.
It is not clear why green leafy vegetables may have a protective effect but one reason may be they are high in antioxidants, such as vitamin C and another theory is that they contain high levels of magnesium.
Study leader Professor Melanie Davies, professor of diabetic medicine at the University of Leicester, said the message to eat five portions of fruit and vegetables a day remains an important one.
But she added: "People like very specific health messages.
"We know that intake of fruit and vegetables is important, but this study suggests that green leafy vegetables seem to be particularly important in terms of preventing diabetes."
Source:http://www.diabetes.co.uk
Overweight patients in East Hertfordshire are being asked to lose weight before they can be listed for routine surgery. People with a body mass index (BMI) of over 40 that need any routine surgery under general, epidural or spinal anaesthetic are being told they first need to lose at least 10 per cent of their weight during the course of nine months before they can have the operation.
In addition, those people who have a BMI of between 30 and 40 and suffer from health problems including diabetes, high blood pressure and high cholesterol will also be required to lower their weight by the same amount.
Tony Kostick, chairman of the East and North Herts Clinical Commissioning Group, commented "There are a number of things that contribute to the success of a procedure carried out under anaesthetic. An important one of these is to be a healthy weight and another is to be a non-smoker." He added "There’s always a risk when patients are given an anaesthetic, but there is strong clinical evidence that proves that this risk is significantly higher when they are overweight and if they smoke."
The reason for the move is that overweight patients are at a higher risk from serious breathing problems, infections and heart, kidney and lung complications, as well as being more likely to die under anaesthetic. However, the restrictions are intended for patients requiring routine and planned surgery, and not for those who need emergency surgery.
Source:http://www.diabetes.co.uk
The number of people in Scotland that have developed diabetes has soared in recent years, and a new report has found that one person in the country is now diagnosed with the metabolic condition every 35 minutes.
Nearly five per cent of the population have diabetes, and the number of new patients is increasing by four per cent per year. There are now thought to be about 287,000 diabetics in Scotland, some 95,000 of whom use insulin on a daily basis to treat their condition.
Before insulin, someone diagnosed with type 1 diabetes did not have much hope of surviving beyond a few weeks. With the 90th anniversary of the development of the hormone being on Monday, Jane-Claire Judson, national director of the charity Diabetes Scotland, pointed out "Everyone living with diabetes owes a debt to those scientists who made the breakthrough."
Before insulin, someone diagnosed with type 1 diabetes did not have much hope of surviving beyond a few weeks. With the 90th anniversary of the development of the hormone being on Monday, Jane-Claire Judson, national director of the charity Diabetes Scotland, pointed out "Everyone living with diabetes owes a debt to those scientists who made the breakthrough."
Source:http://www.diabetes.co.uk
A new device developed by scientists in the United States measures blood sugar levels in saliva, so that diabetics do not have to draw blood when checking their levels.
The study, published in the journal Nano Letters, involved thousands of plasmonic interferometers being etched onto a biochip that was then able to measure the concentration of glucose molecules in water. Small alterations in the intensity of the light passing through the slit of each plasmonic interferometer provides data on the concentration of glucose molecules in solution.
The slits that capture incoming light photons and confine them are only around 100 nanometers wide, with a couple of 200 nanometer-wide grooves on either side. The grooves scatter the photons so that they interact with the free electrons moving on the metal surface of the sensor. It was found that the biochip could detect glucose levels similar to the levels found in human saliva, which is usually around 100 times less concentrated than in the blood. It is hoped the breakthrough will also offer measurements of a variety of biological, chemical and environmental substances.
Lead author Domenico Pacifici commented "This is proof of concept that plasmonic interferometers can be used to detect molecules in low concentrations, using a footprint that is ten times smaller than a human hair." The researchers now hope to build sensors specifically for glucose and other substances and carry out more tests on the device.
Source:http://www.diabetes.co.uk
With China having the most adult diabetes patients in the world, the drug giant Novartis have announced the launch of its oral diabetes treatment Galvus (also known as vildagliptin) in the country, as well as receiving approval for Lucentis by the State Food and Drug Administration (SFDA).
Galvus is an oral treatment for patients with type 2 diabetes, and is taken as either a monotherapy or in combination with metformin, a sulphonylurea, a thiazolidinedione or insulin, while Lucentis is used to treat wet age-related macular degeneration (AMD), the main reason for blindness and severe vision loss in the over 50s.
Lucentis has become the standard therapy for treating wet AMD, a disease that affects the macula, the part of the eye that lets us see fine detail, identify faces and carry out regular activities such as reading and driving. David Epstein, head of the pharmaceuticals division of Novartis, commented "We are proud to bring Lucentis and Galvus to patients and physicians in China and support the achievement of the Chinese government's public health goals."
There are thought to be up to 75 million people in China who suffer from type 2 diabetes . Ning Guang, an endocrinologist at Ruijing Hospital, said "Uncontrolled diabetes is threatening to overwhelm our healthcare system. It is important that new treatments continue to be made available to help physicians address the growing healthcare need."
Source:http://www.diabetes.co.uk
A new survey has revealed that the rate of pre-diabetes and diabetes in Ireland for men is double that for Irish women, findings coincide with National Type 2 Diabetes Screening Day in the country.
The screening project into diabetes and cardiac disease, which has been carried out by VHI Healthcare since early 2009, showed that of the 2,500 patients receiving a diabetes diagnosis, 1,600 were for men, while just 900 were for women. The figures were also based on a higher number of women attending the screening, so these numbers represent 18.5 per cent of the men and 8.4 per cent of the women screened.
The study also highlighted risk factors for diabetes, with 76 per cent of men being shown to be overweight or obese as compared with 54 per cent of the women, while 23 per cent of the women and 27 per cent of the men suffered high blood pressure when screened, independent of a previous diagnosis for raised levels of blood pressure.
Bernadette Carr, who is medical director at VHI Healthcare, commented "Early detection and lifestyle changes can improve outcomes, and in the case of pre-diabetes can even delay or prevent progression to diabetes." She also argued that the results of the survey show how important it is for both men and women to be aware of the risk factors for diabetes.
Source:http://www.diabetes.co.uk
Tesco today found itself under siege from both sweet-toothed shoppers and horrified anti-obesity experts after slashing the price of chocolate bars to 20p. In a move to win back customers following a Christmas slump, the supermarket chain has slashed the price of five-packs of Snickers, KitKat Chunky, Twix, Mars and Bounty to just £1. The deal means each bar costs just 20p - while bars sold individually in the shop can cost up to 54p.
Shoppers have been seen leaving Tesco stores across the country with armfuls of the chocolate. However, health experts have criticised the move as promoting poor eating habits. ‘To have this kind of promotion at this time when obesity is such as problem is frankly totally irresponsible,’ said National Obesity Forum spokesman Tam Fry. But consumers seemed more concerned with snapping up a bargain. One woman was spotted leaving a Tesco Extra in Southampton, Hants, with ten packs of Mars, which are normally on sale for 1.89 per pack. Helen Taylor, 42, said: 'My family and I are chocoholics so when I spotted this deal I couldn't resist. These will keep us going for the next few months. 'I saved nearly nine pounds on all of this.'
The deal, which lasts until the end of January, could be a spirited attempt to turn around a Christmas slump when takings fell by as much as 2.3 per cent. Share prices plummeted and nearly £5billion pounds wiped of the value of the company as a result. Financial expert Jasmine Birtles, who runs website moneymagpie.com, added: 'Potentially, this deal is a good thing.
'In this day and age thrift is the new bling - and this country is going to be bargain crazy for the next two years as we recover. 'Bargains are the way to go but Tesco can't make it a one off. 'They should do deals like this regularly and the deals have to be real to keep customers' trust.' Tesco has meanwhile defended their price-drop, saying they had also reduced the prices of ‘bread, meat, fish, fruit and vegetables.’
Source:http://www.dailymail.co.uk
Drinking coffee can help reduce the risk of diabetes, say scientists. A study found three compounds contained in the beverage can block the toxic build up of a protein, which is known to trigger the long-term condition. Type 2 diabetes occurs when the body doesn't prevent enough insulin for it to function properly but the coffee extracts were also shown to prevent insulin-producing cells from being destroyed.
Researchers now believe the coffee extracts - caffeine, caffeic acid, and chlorogenic acid - could help develop more effective treatment. Lead researcher Kun Huang from Huazhong University of Science and Technology said: 'We found three major coffee compounds can reverse this toxic process and may explain why coffee drinking is associated with a lower risk of type 2 diabetes.' All of the compounds were shown to have a positive effect during laboratory tests, however caffeine was the least effective of the three.
As a result Huang states that decaffeinated coffee could be more beneficial than regular options. Huang added: 'In decaffeinated coffee, the percentage contents of caffeic acid and chlorogenic acid are even higher [than in regular coffee], whereas the level of caffeine is greatly reduced. 'We expect that decaffeinated coffee has at least equal or even higher beneficial effect compared to the regular caffeinated types.' The new study, published in the Journal of Agricultural and Food Chemistry, supports previous studies which have found people who drink four or more cups of coffee a day have a 50 per cent lower risk of getting type 2 diabetes.
Despite the findings Joe Vinson from the University of Scranton, highlights that the concentrations of coffee compounds used in the Chinese study are much higher than those found in a typical coffee consumption. Researchers now plan on carrying out further studies in animals and humans to better understand the link between coffee consumption and reduced risk of diabetes. Diabetes affects 2.8 million people in the UK and it is thought that a further one million people have the condition but are unaware of it. Type 2 diabetes is often associated with obesity and can often be controlled by following a healthy diet and monitoring blood glucose levels.
Source:http://www.dailymail.co.uk
A class of drugs taken to treat type 2 diabetes could also help patients to keep their weight down, according to a new study. The research, by scientists in Denmark, found that newer diabetes medicines such as exenatide ( Byetta, Bydureon ) could also reduce a patient’s weight.
The benefits come from both weight loss and a reduction in cholesterol often being side effects of this type of drugs, glucagon-like peptide-1 receptor agonists (GLP-1), and which suppress appetite, so could be useful in the treatment of obesity.
The study, published in the British Medical Journal, carried out a meta-analysis on the data from 25 different studies with over 6,000 patients. The patients that took GLP-1R agonists for at least 20 weeks were seen to lose more weight than those not taking the drugs, with weight loss being experienced by both diabetics and non-diabetics.
As lead researcher Tina Vilsboll, from the Gentofte Hospital of the University of Copenhagen, pointed out "If you use this treatment for 20 weeks, you have a positive effect on body weight. The hope is that we have a new class of treatment for obesity, and not just for type 2 diabetes." However, the researchers admit that more study is needed, and that GLP-1 drugs are not recommended only as a standalone treatment for weight loss.
Source:http://www.diabetes.co.uk
Eating one sausage a day or two rashers of bacon raises the risk of pancreatic cancer by a fifth, according to research. Scientists have found that even relatively small amounts of processed meat increase the chance of developing this deadly illness. Pancreatic cancer is called ‘the silent killer’ because it often does not produce symptoms in early stages.
Even when it does, the symptoms are often vague – such as back pain, loss of appetite and weight loss. By the time the disease is diagnosed it is often too late and, because of this, it has one of the worst survival rates of all cancers and only 3 per cent of patients live beyond five years. Little is known about its causes other than that smoking, excess alcohol and being overweight all seem to contribute.
Now scientists in Sweden have found that eating just 50g of processed meat a day raises the likelihood by 19 per cent. This is equivalent to a few slices of ham or salami, a hot dog or sausage or two slices of bacon. Eating 100g a day – a small burger – increases the risk by 38 per cent while 150g a day raises it by 57 per cent. Ordinary red meat such as joints or steaks increases a man’s chance of getting the cancer, but not a woman’s. But the risk posed by eating meat was substantially lower than for smoking, which was found to increase the likelihood of pancreatic cancer by 74 per cent.
The research, published in the British Journal of Cancer, analysed the results of 11 other studies involving 6,000 patients with pancreatic cancer. There is already widespread evidence that red and processed meat may trigger bowel cancer. For this reason the Government last year published guidelines advising the public to limit their consumption to 500g of red and processed meat a week. Professor Susanna Larsson, of the Karolinska Institutet in Stockholm said: ‘Pancreatic cancer has poor survival rates. ‘So it’s important to understand what can increase the risk of this disease.’ Just over 8,000 Britons are diagnosed with pancreatic cancer every year.
Source:http://www.dailymail.co.uk
With global number of diabetes patients increasing dramatically, the news from China is that almost 10 per cent of adults in the country now suffer from the metabolic condition. The Chinese Health Education Center have stated that around 9.7 percent of Chinese who are 18 or over have developed diabetes, with the amount of patients now coming to around 97 million.
The study found that men were more likely to develop the disease than women, as 10.2 per cent of men have it as compared with only 9 per cent of women, and also that 19.6 per cent of the total are aged 60 or more. In addition, it was found that 12.3 per cent of people in urban areas have diabetes, as compared with 8.4 per cent of rural residents.
The research claimed that just over a third of diabetic adults in China were actually aware they suffered from the disease, and that only a third of people who had been treated for diabetes had successfully managed to control their blood sugar.
The number of Chinese adults with type 2 diabetes was also revealed to be on the rise, and that there was a general lack of knowledge in the country about the most effective ways of preventing and treating the condition, which was blamed on risk factors such as excessive alcohol consumption, smoking, not enough exercise and a bad diet.
Source:http://www.diabetes.co.uk
A new study by scientists at Imperial College London and Imperial College Healthcare NHS Trust has found that patients who have weight loss surgery as a way of treating their type 2 diabetes may not be hitting the same levels of remission as previously thought.
However, the research project, which was funded by the National Institute for Health Research (NIHR) Biomedical Research Centre and published in the British Journal of Surgery, showed that weight loss surgery, also known as bariatric surgery, can also help people control their blood sugar levels.
The research re-examined data concerning over 200 people with type 2 diabetes to identify how useful the three types of weight loss surgery are with the new criteria, finding that the remission rate was 41 per cent for gastric bypass, and that this was the most effective type of surgery. The previous, less-stringent, criteria used by previous studies had claimed that there was an 80 per cent remission rate.
Carel le Roux, who led the study, commented "Using the new criteria, we don't get such eye-catching figures as some that have been quoted in recent years. But it's clear that weight loss surgery, particularly gastric bypass, has a significant beneficial effect on glucose control." He added "Diabetes is a chronic, multisystem disease. Stomach surgery may not mean that patients can stop taking diabetes medication, but surgery and medication together achieve better results than either treatment on its own."
Source:http://www.diabetes.co.uk
A new study has claimed that the longer people have an excessive body mass index (BMI) that classified them as obese, the more chance they have of developing type 2 diabetes. The study, which involved assessing 8,446 participants, revealed that a higher level of excess BMI years was generally linked with a greater chance of developing diabetes.
The research, which was published in the Archives of Pediatrics aand Adolescent Medicine, showed that white men that are aged 40 with 200 cumulative excess BMI years experienced nearly three times the risk of developing diabetes than men of the same age and race with only 100 excess BMI years. For men those with 200 excess BMI years, there was a greater risk of diabetes for 30-year-olds as compared to those between the ages of 35 and 40 years.
The report recommended that "public health interventions" should be targeted at young people in the United States due to the findings. It was noted that "Understanding the impact of both degree and duration of obesity on incident type 2 diabetes is critical, given the childhood obesity epidemic." Both ethnic background and being of a young age were identified as risk factors.
It was also noted there was rising obesity levels in among adolescents, which could result in "steeper increases in diabetes for younger compared with older adults."
Source:http://www.diabetes.co.uk
Forget that punishing exercise regime or elaborate diet. The key to losing weight could be as simple as putting your feet up and relaxing.Scientists have found a gene that makes us crave sweet and fatty foods and pile on the pounds when under stress. The 'comfort eating gene' has also been linked to type 2 diabetes - the form of the disease that usually occurs in middle-age and is related to obesity.
It is hoped that studying the gene will lead to new diabetes drugs as well as weight loss pills. But it seems finding time to relax could also do us the power of good. Researcher Dr Alon Chen set out to find out why so many people reach for the biscuit tin when under pressure at home or at work. In studies on mice, he pinpointed a gene that pumps out a protein called Ucn3 at times of stress.
Produced in the brain, the protein has profound effects throughout the body, affecting organs including the heart, muscles, liver and pancreas. It increases appetite and affects how full we feel as well as the way the body uses insulin, a hormone crucial in the processing of sugar into energy. Mice that were made to make more Ucn3 than usual began to show the first signs of diabetes, the journal Proceedings of the National Academy of Sciences reports. Ucn3 also seems to trigger a taste for sugary and fatty foods - providing the body and brain with extra fuel when under extreme stress. But when the system is constantly activated by everyday stresses and strains, we can become fat and ill. Dr Chen, of the Weizmann Institute-in Israel, said: 'Stress is good when you have to cope with an event, like when you meet a lion. 'Your metabolism is changing, you consume more sugars and more glucose goes to the muscles to help you escape the lion.
'Your metabolism is changing, you consume more sugars and more glucose goes to the muscles to help you escape the lion. 'But the stress response needs to be a tightly-regulated system. The genes need to kick in at the right time. If they are not working properly it can lead to psychiatric and metabolic disorders.' Drugs that target the 'comfort eating gene' or the Ucn3 protein could help prevent diabetes and keep weight down. Previous work by British researchers has shown that almost two-thirds of people in the UK carry other 'junk food genes' that cause them to crave fatty and sugary foods. Those with the genetic flaw eat 100 calories more at each meal - the equivalent of a Kit Kat or a bag of Wotsits.
Over the course of a week, that amounts to an extra 2,100 calories - or an extra day's food. The findings, by researchers at Dundee University, help explain why some people find it hard to resist fast food - and why some diets are doomed to fail. Britons are also the world's worst junk food addicts, beating even the Americans in their appetite for fat and sugar-laden snacks. Figures show the average adult in this country eats just over three portions of fruit and vegetables a day and will get through 22,000 ready-meals, sandwiches and sweet snacks in a lifetime - little short of one a day.
Source:http://www.dailymail.co.uk
A new study has claimed that people who drink at least three cups of black tea each day could be lowering their risk of developing conditions such as diabetes and heart attacks.
It already believed that regularly drinking tea helps to prevent the blood from clotting and manages blood pressure. However, this research, based on analysis of 40 research papers and published in the UK Nutrition Bulletin, found that three cups of tea per day could reduce the risk of heart attack by up to 60 per cent and substantially lower the chances of people getting type 2 diabetes.
The study, which assessed data potentially linking the consumption of black tea with disease prevention, revealed that tea helped to produce a significant protective association in the majority of cases, with benefits coming from a range of positive factors in black tea, including antioxidant flavonoids and theanine, which work to control levels of blood pressure and maintain the production of nitric oxide production and therefore the health of arteries, as well as inhibiting platelet aggregation, a main cause of blood clots.
Co-leader of the research, Carrie Ruxton, commented "Given the available evidence, regular black tea intake is linked with a reduced risk of cardiovascular disease and type 2 diabetes."
She added "Three to six cups of black tea a day appears to contribute to cardiovascular health."
Source:http://www.diabetes.co.uk
Slapping a 10 per cent ‘fat tax’ on soft drinks such as cola would cut consumption and help curb rising levels of obesity in this country, experts say. The price hike would drive down sales of sugary drinks and encourage consumers to buy healthier alternatives, a study suggests.
A similar rise in the price of full-fat milk would make people drink reduced fat milks instead, researchers told the British Journal of Nutrition. Four co-authors, including Professor Susan Jebb – who has been the Government’s main adviser on obesity since 2007 – claim the change in policy would result in people making healthier choices. Denmark became the first country to introduce a fat tax in October, with a surcharge on foods high in saturated fat.
Within days, David Cameron said the Coalition would consider following its example as a way of tackling Britain’s growing obesity levels. The latest study analyses trends in consumption of drinks by both children and adults in Britain between 1986 and 2009. ‘In testing taxation as an option for shifting beverage purchase patterns, we calculate that a 10 per cent increase in the price of sugar sweetened beverages could potentially result in a decrease of 7.5ml per capita per day,’ the researchers stated.
A similar increase in the cost of full-fat milk would also reduce consumption of it by 5ml per person per day and increase intake of reduced fat milk by 7ml per head every day, their report added. However, Professor Jack Winkler, a professor of nutrition policy, said the tax would be ‘ineffective’.
Consumers will simply buy larger bottles, use cheaper shops, drink cheaper brands or buy soft drinks on ‘special offer’, he warned. The soft drinks industry branded the idea ‘ineffective, intrusive and unfair’. A Department of Health spokesman said: ‘This is one of a number of independent academic papers that looks at the likely impact of taxes on food products. We keep all international evidence under review.’
Source:http://www.dailymail.co.uk
A new study has argued that people who have developed type 2 diabetes and are taking the oral drug metformin to treat it should take more than the recommended daily allowance of vitamin B12.
The research, which was published in Diabetes Care, assessed data from the National Health and Nutritional Examination Survey (NHANES) in the United States between 1999 and 2006. The NHANES data showed that the prevalence of biochemical B12 deficiency was greatest for people with type 2 diabetes taking metformin compared with those with type 2 diabetes but not taking metformin and those without diabetes.
Biochemical B12 deficiency was revealed in 5.8 per cent of patients with diabetes that took metformin as compared to 2.4 per cent of those who did not take metformin and 3.3 per cent of people that did not have diabetes.
In the US, it is currently believed that adults with type 2 diabetes that are over 50 should take 2.4 µg of synthetic vitamin B12 daily either in supplement form or in fortified food.
Researcher Godfrey Oakley commented "It is important to conduct further research to learn how much B12 is needed to correct the deficiency and to determine whether or not raising serum B12 levels improves the clinical picture for persons taking metformin who have low serum B12 concentrations."
Source:http://www.diabetes.co.uk
News that NHS figures show an increase in obesity levels among children aged 10 and 11 in England raises concern about the effect of this diabetes risk factor will have on future numbers of people suffering from the metabolic condition.
The NHS reported that there are now 19 per cent of children who will leave primary school in 2012 that are classified as obese, a slight rise from 18.7 per cent level recorded in last year. It also revealed that obesity levels were greatest in London and the lowest in the home counties in the south of England, and was more prevalent in deprived and urban areas. However, it was shown that obesity was down to 9.4 per cent for children entering reception, a reduction from the 9.8 per cent recorded last year.
Information on about one million pupils was compiled by the National Child Measurement Programme, which examines the height and weight of primary school children in England by measuring them when in reception and again in their last year of primary.
Tim Straughan, chief executive of the NHS Information Centre, commented that the findings show that "while the proportion of four-to-five year olds who are obese has fallen, the opposite has happened among 10 and 11-year-olds."
He added "This means that while fewer than one in 10 children in Reception Year are obese; for children in their final year of primary school this prevalence is nearly one in every five."
Source:http://www.diabetes.co.uk
A new study has found that doing short cycle sprints three times per week could help to prevent the development of type 2 diabetes.
Scientists at the University of Bath, who work was published in the European Journal of Applied Physiology, assessed the effects of two 20-second cycle sprints three times a week, finding that there was a 28 per cent improvement in the insulin function of participants. Although the short sprints in the study are not suitable for weight loss, as they don’t burn off sufficient calories, they do also offer other health benefits and help general fitness.
It is known that regular exercise can help to maintain low levels of blood sugar but that two thirds of the population are not managing to achieve the recommended five 30-minute sessions of moderate exercise each week. The short sprints are a great way for the muscles to use glycogen, as they can break down as much glycogen in 20 seconds as carrying out moderate endurance exercise for an hour.
Study leader, Niels Vollaard, commented "Our muscles have sugar stores, called glycogen, for use during exercise. To restock these after exercise the muscle needs to take up sugar from the blood. In inactive people there is less need for the muscles to do this, which can lead to poor sensitivity to insulin, high blood sugar levels, and eventually type 2 diabetes."
He added "We already knew that very intense sprint training can improve insulin sensitivity but we wanted to see if the exercise sessions could be made easier and shorter."
Source:http://www.diabetes.co.uk
In women, there is a positive association between rotating night shift work and the risk of developing type 2 diabetes and, furthermore, long duration of shift work may be associated with greater weight gain. These findings from a study by Frank Hu and colleagues from Harvard School of Public Health in Boston, USA, published in this week's PLoS Medicine, are of potential public health significance as a large proportion of the working population is involved in some kind of permanent night and rotating night shift work.
The authors used data from the Nurses' Health Study I (NHS I - established in 1976, and which included 121704 women) and the Nurses' Health Study II (NHS II - established in 1989, and which included 116677 women), and found that in NHS I, 6,165 women developed type 2 diabetes and in NHS II 3,961 women developed type 2 diabetes. Using statistical models, the authors found that the duration of rotating night shift work was strongly associated with an increased risk of type 2 diabetes in both cohorts and that the risks of women developing type 2 diabetes, increased with the numbers of years working rotating shifts. However, these associations were slightly weaker after the authors took other factors into consideration.
Although these findings need to be confirmed in men and other ethnic groups, these findings show that additional preventative strategies in rotating night shift workers should therefore be considered. The authors say: "Recognizing that rotating night shift workers are at a higher risk of type 2 diabetes should prompt additional research into preventive strategies in this group."
In an accompanying Perspective article, Mika Kivimäki from University College London, David Batty from the University of Edinburgh, and Christer Hublin from the Finnish Institute of Occupational Health in Helsinki, Finland (uninvolved in the research study) say: "We are increasingly residing in a '24/7' society, thus the option to eradicate shift working is not realistic. If the observed association between rotating shift work and [type 2 diabetes] is causal, as it may be, additional efforts to prevent [type 2 diabetes] among shift workers through promotion of healthy life styles, weight control and early identification and treatment of prediabetic and diabetic employees are needed."
These authors continue: "Some modifications to shift work itself might also be feasible. Rotating shift work comprises a range of alternative schedule patterns, such as backward- and forward-rotating shift systems, and the proportion of night and early morning shifts varies. Future studies should address these variations and identify patterns that minimize [type 2 diabetes] risk, ideally through large-scale randomized trials that would provide insights into causality."
Source: http://www.medicalnewstoday.com
The European Commission has given approval to saxagliptin, to be marketed under the brand name Onglyza, for use as a combination therapy by adult patients with type 2 diabetes to help improve their control of blood sugar levels.
Onglyza, which has been developed by pharma giants Bristol-Myers Squibb and AstraZeneca, was approved from Phase 3b 24-week data that showed Onglyza 5 mg added to insulin, with or without metformin, could substantially lower blood sugar levels as compared with a placebo added to insulin, with or without metformin.
It was also found that during the 28-week extension period of the study, Onglyza 5 mg added to insulin, with or without metformin, maintained a lowering of HbA1c levels from 24 to 52 weeks as compared with a placebo.
Onglyza is to be used in combination with drugs such as metformin, thiazolidinedione, sulphonylurea or insulin, if each of these is insufficient on their own to offer sufficient glycaemic control to patients. The approval of Onglyza in Europe provides another option for treating type 2 diabetes, particularly as a large number of patients will eventually have to use insulin to treat their condition.
However, it is advised that Onglyza should not be taken by people with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis, and should not be seen just as an alternative to insulin.
Source: http://www.diabetes.co.uk
It is hoped that the forthcoming World Diabetes Congress in Dubai will help build momentum regarding global diabetes awareness in what has been termed a landmark year by its organisers. The congress, which starts on December 4, follows the recent United Nations summit on the prevention and control of non-communicable diseases.
The event is taking place at an important juncture for diabetes, which organisers, the International Diabetes Federation (IDF) also hopes will be a catalyst to kick-start a greater understanding of the metabolic condition.
The congress is intended as a way of educating governments around the world concerning the most cost-effective ways of dealing with diabetes, especially as there are now an estimated 366 million people worldwide who have the condition, with a further 280 million at a high risk of developing it. IDF are also expecting over 550 million to be affected by the disease and another nearly 400 million to be at high risk by 2030 if the current increase in prevalence continues.
Jean Claude Mbanya, president of the IDF has stated that "Progressive urbanization, increased life expectancy, and economic development associated with a shift to unhealthy lifestyles have resulted in a huge explosion in type 2 diabetes in the region over the last 30 years."
Jean Claude Mbanya, president of the IDF has stated that "Progressive urbanization, increased life expectancy, and economic development associated with a shift to unhealthy lifestyles have resulted in a huge explosion in type 2 diabetes in the region over the last 30 years."
Source: http://www.diabetes.co.uk
New research from Queen Mary, University of London suggests that many cases of diabetes could be prevented by making use of existing prediction tools. The study, published in the British Medical Journal, shows that there are dozens of different techniques for predicting with reasonable accuracy who will develop diabetes but almost none are currently being used. The researchers say that if these tools were used by GPs and members of the public, many cases of diabetes could be prevented.
The team led by Dr Douglas Noble reviewed 145 different 'risk scores' for type 2 diabetes. While none were 100 per cent accurate, many gave a reasonable prediction of whether someone will develop diabetes over the next decade.Research suggests that up to half of all cases of diabetes can be prevented by lifestyle measures, such as diet and exercise, or medication.
Dr Noble said: "The big take home message was that despite there being vast numbers of risk prediction models, hardly any of them were in use in clinical practice or by members of the public. The best ones, of which we identified seven, represent a big opportunity for people to spot whether they are at high risk of developing diabetes and if so to take urgent action to reduce their risk. Importantly, for most people that means increasing physical exercise and losing weight If we stop people from developing diabetes in the first place we will prevent a great deal of ill health, save money, reduce use of NHS resources and, crucially, save lives."
Many diabetes risk scores included: increasing age, obesity, high blood pressure, high cholesterol and ethnicity. People with all these risk factors may be at particularly high risk. Some risk scores also included a family history of diabetes, lack of physical exercise and low socio-economic status, since diabetes is more common in deprived populations. Professor Trisha Greenhalgh, who was also part of the research team, said "This study has confirmed what many doctors already suspected: that risk scores are good at detecting people at high risk of developing diabetes but very few people have actually had their risk estimated. "
"My father died of the complications of diabetes, which makes me at increased risk of developing it myself. I try to stay thin, keep active and get my blood pressure and cholesterol checked regularly."
Source: http://www.medicalnewstoday.com
The National Institute for Health and Clinical Excellence (NICE) says ranibizumab, sold under the brand name Lucentis, is too expensive to use in people with diabetic macular oedema. Charities say they will continue to campaign for the drug to be used. At least 50,000 people in the UK are affected by this eye condition.
Macular oedema occurs when fluid leaks from the small blood vessels in the eye.
The fluid collects in the central part of the retina at the back of the eye, called the macular area, which can lead to severe visual impairment.
Straight lines may appear wavy and people can have blurred central vision or sensitivity to light. Sight can become so impaired that the person can no longer read, work or drive. Laser treatment has been the standard treatment for diabetic macular oedema on the NHS, but this only stops vision from deteriorating further. An injection of Lucentis in the eye, however, can improve vision.NICE already recommends Lucentis to the NHS for a different eye condition called wet age-related macular degeneration.
Diabetes Research Foundation, the Macular Disease Society and the Royal National Institute of Blind People (RNIB) - are urging government to rapidly agree a Patient Access Scheme with the manufacturer of Lucentis, Novartis, in order to bring down the cost of the drug to the NHS for treating diabetic macular oedema.
Currently, the drug costs £742.17 per injection.
Steve Winyard from the RNIB said: "We now hope that a patient access scheme can be agreed swiftly, so that patients with diabetic macular oedema are not left to needlessly lose their sight." A spokeswoman for Novartis said the company would continue to work with NICE and the Department of Health to "ensure appropriate patients are able to receive this very important treatment, which in clinical trials has been shown to double the likelihood of gaining vision and reduce the chance of losing vision by up to three-fold compared to laser treatment".
Novartis believes that NICE did not consult sufficiently with clinical and patient experts on the data it submitted to the appraisal committee. But Sir Andrew Dillon, Chief Executive at NICE, said the manufacturer significantly underestimated the cost of treatment.
Source: http://www.bbc.co.uk
A new study has offered further evidence that the consumption of low-fat dairy products can help reduce the risk of developing type 2 diabetes.
The research, which was published in The Journal of Nutrition, found that eating a diet that was high in low-fat dairy products is linked with lower diabetes risk in postmenopausal women, especially in women who are also obese. The study monitored over 82,000 postmenopausal women that took part in an observational study and who had not reported their diabetes when enrolling.
When assessing their health eight years later, it was found that there were nearly 4,000 cases of diabetes among the women participants. It was also revealed that low-fat dairy consumption was inversely associated with the risk of type 2 diabetes, and that higher consumption was linked with a lower risk.
The study pointed out "The inverse relationship was more pronounced in women with a higher (body mass index). Higher yogurt consumption was associated with a significant decrease in diabetes risk."
The findings follow an earlier study from the American Journal of Clinical Nutrition that showed that women who consumed the most dairy products as teenagers experienced a reduced risk from type 2 diabetes when they were adults.
Source: http://www.diabetes.co.uk
New research has revealed that high levels of air pollution from traffic could raise the risk of people developing diabetes. It was shown that those who live in places with bad traffic-related air pollution face a somewhat higher likelihood of developing the metabolic condition because of high levels of nitrogen dioxide from traffic exhausts, although it does not confirm if just the air pollution was causing the greater diabetes risk.
The study, involving data from almost 52,000 urban Danish citizens and which was published in the journal Diabetes Care, showed that people living in areas of heavy traffic are at a four per cent higher risk of being diagnosed with diabetes than those who live where there is cleaner air.
Within a 10-year period, nearly 5.5 per cent of those aged between 50 and 65 at the start of the study received their first diabetes diagnosis. As well as being exposed to air pollution for longer, the people that were diagnosed with diabetes tended to be older, heavier men who were either previous or current smokers.
The scientists also claimed that healthier people were more at risk from air pollution, being at a 10 per cent greater risk, while non-smokers also faced a 12 per cent higher risk. These findings follow a previous study that revealed diabetics appeared to be more vulnerable to the effects of exposure to air pollution than non-diabetics
Source: http://www.diabetes.co.uk
It's the one leader board that the UK doesn't want to top. But British women have been named the fattest in Europe. Almost one in four (23.9 per cent) women in Britain are classed as obese, far worse than the rest of Western Europe. In Germany, 15.6 per cent were found to be obese, while just 12.7 per cent of French women and 9.3 per cent of Italian women have piled on the pounds.
Former Soviet states including Lativa and Estonia were among those who came closest to matching Britain's obesity rate. The European Union's statistics agency Eurostat, which collated data from 2008 to 2009, said the percentage of obese younger women was particularly notable in the UK.The figures revealed 16.6 per cent of 18 to 24-year-olds were severely overweight, nearly four times as many as our gallic neighbour.
British men hardly fared any better, with 22.1 per cent classed as obese. They came second overall only to Malta, where 24.7 per cent are obese. Men aged between 45 to 64 in the UK had the highest proportion of overweight men with 33.2 per cent classes as obese. The study also revealed that the proportion of European women who are obese falls as the educational level rises, although figures for the UK were unavailable.
Tam Fry, spokesman for the National Obesity Forum, said education is key to fighting obesity. Mr Fry said: 'For a significant number of UK women knowing what food to buy and how to cook it is foreign territory. Mainland Europe doesn't have this problem.'Until the UK puts domestic science properly back into the school curriculum, many women will continue to rely on cheap, ready meals and fast, processed food for their families and themselves.' He said many UK women struggled to regain a normal weight after childbirth - a situation exacerbated by the shortfall in midwives and health visitors. The findings were based on the Body Mass Index, where the weight in kilos is divided by the square of the height in metres. A body mass index of between 18.5 and 24.9 is classed as healthy, while a measurement above 25 is overweight and one more than 30 indicates obesity.
While the BMI measure can give a fairly accurate population snapshot, it has been criticised by some doctors because it cannot take into account how much weight is carried as body fat compared to muscle. Britain’s obesity crisis has led to a massive increase in the amount of money spent on treatments, such as drugs to treat diabetes. Diabetes drugs now account for 8.4 per cent of the NHS medicines bill, costing taxpayers £725 million a year. The amount spent in 2010/11 was up 41 per cent on the £513 million spent in 2005/06. Most of the rise is down to the treatment of Type 2 diabetes, which is linked to obesity and unhealthy lifestyles. Obesity also increases the risk of heart disease, stroke, liver disease, and certain types of cancer.
Source: http://www.diabetes.co.uk
Scientists at the University of Massachusetts in the United States have found that people who are taking second-generation antipsychotic drugs are at a four times greater risk of developing diabetes than those who do not take any psychotropic medications.
Although the study, which was published in Pediatrics, did not prove conclusive due to the small amount of diabetes cases involved, it does raise issues about the use of these drug treatments. The new types of antipsychotic drugs are known to bring about both metabolic problems and weight gain for children and adults, as well as diabetes and insulin resistance in adults.
The research involved monitoring the data on 57 diabetes cases from a group of over 9,000 children between the ages of 5 and 18 who began to take second-generation antipsychotic medication between 2001 and 2008. Their health was assessed going forward, finding that the ratio for diabetes with second-generation antipsychotic use was 4.24-fold as compared to that of children not on psychotropics.
However, it was admitted that the diabetes cases were not split into type 1 or type 2 diagnoses, although it would be expected that the effects of antipsychotic drug would be on the incidence of type 2 diabetes. Also, it was observed that looking at children taking antidepressants could improve the analysis, as would be more similar in terms of healthcare with the potential diagnosis of diabetes.
Source: http://www.diabetes.co.uk
Worrying about the recession? Anxious about a big work meeting? Fretting over the performance of your football team? If these concerns keep you awake at night, you're not alone.
Getting a good night's sleep has never been so tricky in Britain, it seems, as 51.3% of us struggle to nod off. And women are three times more likely than men to suffer – 75% of women report problems, compared with 25% of men, say new statistics from the Great British Sleep Survey, which suggests the nation's health is suffering as a result of insomnia.
Professor Colin Espie of Glasgow University, the co-founder of sleep organisation Sleepio, which commissoned the survey, said the results pointed to a "real medical issue that should be taken seriously". A quarter of those with insomnia had suffered for more than 11 years.
"Insomnia affects people's quality of life during the day, not just their sleep at night," he said. "Indeed, the survey data show significant effects across different aspects of personal functioning. Living with poor sleep and its consequences is not only very common, but it is in all likelihood degrading Britain's health. This is not a trivial matter. It's time for the NHS to pay attention to the scientific evidence that persistent poor sleep elevates the risk of developing new illnesses. This has been shown in disorders such as diabetes, but also very convincingly in depression."
The Great British Sleep Survey interviewed 11,129 adults earlier this year. It found that, of those who had trouble sleeping, 55% reported having relationship difficulties as a result, while 77% reported issues of concentration, 64% said they were less productive at work, 83% reported problems with their mood and 93% with energy levels.
"The evidence is that cognitive behavioural therapy (CBT) is very effective and CBT for insomnia really must be provided on the NHS," said Espie. "It is available if you're anxious or depressed; why not for insomnia?"
A two-year study by a team from the Tokyo Medical University published last week found that people who do not get a good night's sleep are twice as likely to suffer from depression.
Source: http://www.guardian.co.uk
In the UK individuals with diabetes are being reassured by doctors that new changes to the way driving licenses are issued will not end their days behind the wheel.
Adults diagnosed with diabetes are being urged by The Association of British Clinical Diabetologists (ABCD) to "steer clear" of alarmists who state that as a result of a new European directive, up to one million motorists could be forced off the roads.
ABCD national committee member Dr Ian Gallen, a consultant diabetologist at Buckinghamshire Healthcare NHS Trust and an advisor of diabetes driving issues, explains:
"The changes are not as far-reaching as many people had feared and focus in the main on people who have two episodes of hypoglycemia, and required medical intervention as a result, withing a 12 month period.
So far relatively few licenses have been revoked because of the change in definition of severe hypoglycemia.
However, what is deemed to be a hypoglycemia episode can be confusing and open to misinterpretation. As a result it is absolutely vital that the exact nature of each episode is closely explored by a specialist in diabetes as part of the medical assessment.
This approach will protect the safety of all road users, including the patient, while at the same time ensuring that the driver with diabetes is not disadvantaged by confusion over what is, and what is not, a hypoglycemic episode."
In addition the novel European directive includes positive news for insulin-treated diabetics who want to drive large minibuses or lorries as they will be able to apply for the appropriate license for the first time.
At present the ABCD, which represents over 500 consultant physicians and registrars specializing in diabetes, is collaborating with the DVLA in order to establish a network of assessors, and create a set of safety standards, to assist with the introduction of this novel initiative as smoothly as possible.
Dr. Gallen said: "With our support and guidance, we look forward to the first member of the insulin-treated diabetes community driving these vehicles safely on the nation's roads. This is an important development and a new era for them. It adds on extra dimension to their employment opportunities, which we strongly support."
Source: http://www.medicalnewstoday.com
A series of papers published by the Lancet medical journal today urge action to combat chronic diseases like cancer, diabetes and heart disease which are spreading in low and middle-income countries, fuelled by obesity, alcohol and tobacco.
"What will it take to get chronic diseases on the international health agenda?", the Lancet medical journal asks today. Globalisation is taking our bad habits to every corner of the world able to afford a chocolate bar or a packet of chips. As populations become just a bit wealthier, cheap junk food and less physical work ensure that they get unhealthier. Obesity looms large in every sense. The old foes - tobacco and alcohol - are out there, too. And the result is the rapid spread of diabetes, heart disease, cancers and respiratory diseases.
These chronic diseases have already become the big killers of our time in the affluent parts of the planet and are now taking an ever-bigger toll of the low- and middle-income populations. Out of every 10 deaths globally, six are the result of these chronic diseases.
A Lancet series of five papers published today is another attempt to make the world sit up and take notice. The same experts, led by Professor Robert Beaglehole from the University of Auckland in New Zealand, have tried it before. This is the third series on chronic diseases that the Lancet has published. But maybe it's like giving up smoking - each time you make the effort, you are a bit closer to succeeding even if you fail (or so they say).
While the rich countries are hardly doing brilliantly, the big worry for the Lancet authors is the failure of global health and development experts to pay attention to what is happening in the low- and middle-income countries. Less than 15% of the World Health Organisation's budget and less than 2% of the World Bank and Gates Foundation total health budgets are spent on efforts to prevent and control chronic diseases, they say.
Yet there are cheap and effective things that can be done. The 2007 series proposed salt reduction, tobacco control and the use of cheap generic drugs for those at risk of heart problems. This time, a paper from the Organisation for Economic Co-operation and Development (OECD) points to the cost-effectiveness of governments taking a grip on the food industry. Taxing unhealthy food (or reducing taxes on healthy fruit and vegetables, which is politically more acceptable), restricting junk food advertising and better food labelling are value for money, the authors say. They would add nearly 7 million "life years in good health" over the next two decades in the seven countries they analysed - Brazil, China, India, Mexico, Russia, South Africa and (for comparison, they say) England. It would cost less than $1 per head per year.
Another interesting paper points out that there is a downside to the economies of some low- and middle-income countries from a drive to better health. A big move to eat less saturated fat across Europe would have a massive impact on major meat exporters such as Brazil and China - damaging their economies and causing widespread job losses, says the paper from Professor Richard Smith of the London School of Hygiene and Tropical Medicine.
But, he said at the press conference, you need to know your enemy as well as your ally. And one assumes nothing will happen in a hurry - it certainly hasn't yet. Economies evolve as markets change to suit the needs and desires of consumers.
Doing nothing, as the burden of disease spreads across the poorer parts of the globe, should surely not be an option.
Source: www.guardian.co.uk
A study analyses the dietary patterns of the adult Spanish population with high cardiovascular risk. The results reveal a high consumption of both red meat and fish. However, whilst eating lots of cured meats is associated with greater weight gain and a higher obesity rate, the consumption of fish is linked to lower glucose concentrations and a smaller risk of developing diabetes.
Mercedes Sotos Prieto, lead author of the study which forms part of the Predimed study (Prevention with a Mediterranean Diet) and researcher at the University of Valencia explains how "in Mediterranean countries, consumption of foods that typically form part of the diet here has decreased in recent decades. The consumption of saturated fats mainly from red meats and industrial baking has increased and this is really worrying."
Conducted in the Valencian Community on 945 people (340 men and 605 women) between 55 and 80 years of age and with a high cardiovascular risk, the aim of the study was to understand dietary patterns in terms of meat and fish consumption. It also sought to understand the correlation between the Mediterranean diet and its association with cardiovascular risk factors. The results were published in the Nutrición Hospitalaria journal and show that the studied Mediterranean population eat a large amount of red meat and fish. However, the consumption of fish is associated with a decreased prevalence of diabetes and lower glucose concentrations whereas the consumption of red meat, especially cured meats is related to increased weight gain and obesity.
The researcher points out that "the red meat consumption of the sample population reaches an average of once a day, which is high in comparison to dietary recommendations. This could be influenced by many weight-loss diets which recommend eating grilled veal."
Eating red meat in excess is linked to higher cardiovascular risk, higher blood pressure, diabetes and a moderate decrease in life expectancy mainly due to cancer or heart disease. In contrast, fish appears in the Mediterranean diet and has health benefits for the heart.
Despite being a cross-sectional study that does not determine a causal effect, its authors confirm that there are many similar studies where the consumption of fish, both white and, even more so oily fish, is associated with a lower risk of developing diabetes type 2. "Various hypotheses have been put forward that attempt to explain why the consumption of fish can be related to diabetes," they explain. "The increase of omega-3 in the cells of the skeletal muscles improves insulin sensitivity."
"It is important to understand the dietary patterns of the Spanish population in order to learn whether dietary habits are changing. We should therefore strengthen dietary education," outlines Mercedes Sotos Prieto, who goes on to say that "we ought to establish dietary intervention programmes so that we do not stray from the Mediterranean diet. In other words, such a diet involves decreasing the amount of red meat that we eat and maintaining equal levels of fish consumption."
Gender Differences
The high intake of saturated fats from red and cured meat consumption (7.4 +/- 4.7 times a week) was more frequent in men. Women proved to eat more white meat, especially chicken and turkey.
As for fish consumption (4.5 +/- 2.6 times a week), no significant differences were found between men and women. In general, women scored higher for "healthy dietary patterns" or "healthy diets" compared to men.
Source: www.medicalnewstoday.com
For World Diabetes Day (14 November), the research charity Juvenile Diabetes Research Foundation (JDRF) is organising a competition to allow 60 supporters with type 1 diabetes to visit parliament to lobby for greater awareness about the condition. The "Type 1 Parliament" will take place next year on April 25, and will provide an opportunity for the winners to discuss the condition with MPs and government officials.
The competition is being judged by chief executive of JDRF, Karen Addington, MP Adrian Sanders and Caroline Horwood from the French pharma company, Sanofi, a sponsor. The judges are assessing more than 200 applications for the event, and aim to pick adults and children that have shown dedication to raising awareness about the condition, as well as a passion for encouraging more investment into research into type 1 diabetes.
George Dove from Mansfield, who is 13, has been chosen as co-chair for the event, along with Amy Wilton from Fareham, Hampshire, who is 16. Both suffer from type 1 diabetes, and are active in spreading awareness concerning the metabolic condition.
George admitted "This is such a fantastic opportunity; to have a voice at this kind of event is amazing. I just hope Parliament listens and together, hopefully, we can make a difference." Amy also said ". I hope that in doing so we can prove to the Government that more money needs to be put aside for research into finding a cure for type 1 diabetes, as well as raising awareness of the condition."
Source: www.medicalnewstoday.com
Monday, 14th November 2011 - Diabetes charity Silver Star illuminated the headquarters of the Leicester Mercury newspaper in blue, the internationally recognised colour for diabetes. This building joined an impressive list of landmark monuments such as the London Eye and Table Mountain in South Africa, which have also been lit in blue in celebration of World Diabetes Day on November 14th. Silver Star's campaign has received financial and communications support from MSD Diabetes.
‘Diabetes Education and Prevention’ was the World Diabetes Day theme for this year and Silver Star’s campaign called on all those responsible for diabetes care to help increase awareness and management of the condition. In aid of this, Silver Star and the Leicester Mercury screened around 400 people for diabetes in London and Leicester to raise awareness of the prevalence of diabetes.
There are currently 2.9 million people with diabetes in the UK1, of which 2.6 million have type two diabetes. People of South Asian descent are at greater risk – up to six times more likely to develop diabetes than the white population.
In addition to the screening event, Silver Star hosted a radio programme on Sabras Radio to highlight the importance of the occasion to listeners who may have an increased risk. The broadcast included appearances from the Rt Hon Keith Vaz, MP, and TV star Nina Wadia, who plays Zainab Masood on EastEnders. Topics of discussion included the scale of the problem diabetes poses and the importance of prevention and early diagnosis.
Silver Star will also be monitoring the progress of more than 50 MPs who have agreed to take part in this year’s Health Challenge. Each MP will wear a pedometer to measure the number of steps they take on a day in parliament. The health challenge is designed to demonstrate the importance of an active lifestyle in the prevention of type 2 diabetes.
Keith Vaz MP said: “I am delighted that we are able to take part in so many fantastic events. Diabetes affects 208,197 people in the East Midlands alone, and in Leicestershire an estimated 66,000 people are still unaware they have the condition. Figures like this clearly demonstrate the importance of days like World Diabetes Day and we are grateful to the support of our partners which allows events like this to happen.”
Professor Kamlesh Khunti, Professor of Primary Care Diabetes and Vascular Medicine at Leicester University, who was involved in the Sabras Radio programme, commented: “There are a number of diabetes complications that people are aware of, such as feet & eye problems and heart disease. However, many people are not aware that we can reduce the risk of these complications with good diabetes, blood pressure and cholesterol. South Asians also need to be screened for diabetes early so we can help minimise these complications.”
Silver Star’s campaign was particularly timely as World Diabetes Day fell on the eve of announcements from the DVLA, relating to diabetes and changes in their medical standards that people who hold a UK driving licence for heavy goods vehicles or passenger service vehicles must meet. This further highlights the need to raise awareness of diabetes and what people can do to reduce their risk by seeking advice from their GP.
Scientists are reporting development and successful laboratory testing of an electrochemical sensor device that has the potential to measure blood sugar levels from tears instead of blood - an advance that could save the world's 350 million diabetes patients the discomfort of pricking their fingers for droplets of blood used in traditional blood sugar tests. Their report appears in ACS' journal Analytical Chemistry.
Mark Meyerhoff and colleagues explain that about 5 percent of the world's population (and about 26 million people in the U.S. alone) have diabetes. The disease is a fast-growing public health problem because of a sharp global increase in obesity, which makes people susceptible to developing type 2 diabetes. People with diabetes must monitor their blood glucose levels several times a day to make sure they are within a safe range. Current handheld glucose meters require a drop of blood, which patients draw by pricking their fingers with a small pin or lancet. However, some patients regard that pinprick as painful enough to discourage regular testing. That's why Meyerhoff's team is working to develop a new, pain-free device that can use tear glucose levels as an accurate reflection of blood sugar levels.
Tests of their approach in laboratory rabbits, used as surrogates for humans in such experiments, showed that levels of glucose in tears track the amounts of glucose in the blood. "Thus, it may be possible to measure tear glucose levels multiple times per day to monitor blood glucose changes without the potential pain from the repeated invasive blood drawing method," say the researchers.
Source: www.medicalnewstoday.com
A new study by scientists in Leicester has claimed that a new lower limit should be set for obesity levels for migrant South Asians in the UK. The research, carried out at the University of Leicester and published in the journal PLoS One, found that there is a need for obesity levels to be recalibrated for South Asians so that there are substantially lower BMI and waist circumference cut points for defining obesity in South Asians.
In the first research project into reassessing the definition of obesity in a migrant UK south Asian population, the study involved monitoring data from more than 6,000 participants from Leicester that were screened for type 2 diabetes. With South Asians known to be at a heightened risk of developing type 2 diabetes and heart problems, as well as other chronic conditions at an earlier age, the research could have major implications for screening strategies.
Kamlesh Khunti, Professor of Primary Care Diabetes and Vascular Medicine at the University of Leicester and one of the leaders of the research, pointed out "Our study shows that the conventional definition of obesity (BMI 30 kg/m2) needs to be lowered in migrant South Asians to detect equivalent levels of cardiovascular risk, based on levels of glucose, blood pressure and cholesterol."
He added "Our study suggests that migrant South Asians should be classed as obese and therefore at high risk of developing diabetes based on a BMI of between 23-28 kg/m2." The team also categorised similar lower cut points for waist circumference.
Source: www.diabetes.co.uk
Members of the charity Diabetes UK and the chair of the all-party parliamentary group for diabetes Adrian Sanders MP have met with Transport Minister Mike Penning to discuss worries about forthcoming changes to rules on driving with diabetes. The rule change comes from a European directive that diabetes patients who have suffered two severe hypos within the period of a year could have their Group 1 licence revoked.
Penning admitted he would be worried if the number of diabetics who lose their licence increased drastically as a result of the changes, and agreed that there needed to be greater clarity regarding the criteria for assessing fitness to drive for people with diabetes. Since some hypos can occur when you are asleep, and the definition of severe is open to debate, the rule changes are being criticised as open to misunderstanding.
It was agreed that a working group would be instigated to review the definitions of severe hypoglycaemia and examine the statistics of diabetics having their licences revoked, as well offering improved guidance on the driving licence application and renewal process.
Simon O'Neill, director of care, information and advocacy at Diabetes UK, commented "We now have a real opportunity to take forward our concerns and resolve these issues, and we will continue working with the DVLA to try and ensure the process for people with diabetes who are applying and re-applying for licences is fair, consistent, transparent and safe."
Source: www.diabetes.co.uk
A new study has claimed that programmes such as the Weight Watchers are more effective at helping people lose weight than the programmes offered by the NHS. The research, which was published in the British Medical Journal, also showed that the WeightWatchers programme, and other diets such as those of Rosemary Conley and Slimming World, were cheaper than that of Size Down, the health service’s programme run by advisers and dieticians.
The scientists monitored 740 obese or overweight people recruited from an NHS trust in Birmingham, with participants being separated into six groups and attending different types of weight loss class, including counselling sessions carried out at GP surgeries, one-to-one counselling in pharmacies and receiving vouchers for the local health club.
It was shown that people were able to lose more weight and stayed thinner for longer if they attended a slimming club as compared to having counselling at a doctor’s surgery or pharmacy.
Although participants in all groups experienced weight loss by 12 weeks, those in the NHS programmes were seen to have no more improvement than the group that went to their local fitness centre. After a year, those on all the programmes had experienced significant weight loss, apart from participants on the GP and pharmacy programmes. The Weight Watchers programme was the only one that saw significantly more weight loss than the control group, and also was the best attended.
The report stated "Commercially provided weight management services are more effective and cheaper than primary care based services led by specially trained staff, which are ineffective."
Source: www.diabetes.co.uk
A new study by scientists at Oxford University has claimed that the wider adoption of the average English diet could improver overall health, as well as saving many lives.
The research, which investigated mortality rates involving cardiovascular disease, stroke and a range of cancers throughout the UK between 2007 and 2009, showed that almost 22,000 more people died from heart disease and diet-related cancers in Scotland, Wales and Northern Ireland in those years than would be expected if death rates were as low as in England.
The study, published in BMJ Open and which estimated the average intake of 10 dietary components for the four UK countries, also revealed that those in Scotland and Northern Ireland consistently consumed more saturated fat and salt and less fruits and vegetables than people in England. It is already known that the death rates for heart disease, cancer and stroke are higher in Scotland, Wales and Northern Ireland and than that in England.
The scientists also said that about 4,000 deaths could have been prevented or delayed annually for the rest of the UK if all people in those countries had stuck to the average diet in England. The team commented "Diet has a substantial impact on geographical variations in mortality from coronary heart disease, stroke and various cancers within the UK."
Source: www.diabetes.co.uk
A new UK study has claimed that body mass index (BMI) and a person’s age are able to predict the risk of gestational diabetes, especially for African and South Asian women. Gestational diabetes, where women exhibit high levels of blood sugar during their pregnancy prior to receiving any diagnosis of diabetes, results from the patient not secreting the excess insulin needed during pregnancy.
The study, which was published in An International Journal of Obstetrics and Gynaecology, examined the relationship between age, BMI and racial origin with the development of gestational diabetes, as well as how they interact with each other.
The data from 585,291 pregnancies between 1988 and 2000 was assessed, including 1,688 women who developed gestational diabetes mellitus and 172,632 who did not have the condition. A close link was found between the development of gestational diabetes and advancing maternal age, a result that changes depending on the racial group involved.
The risk of developing gestational diabetes was substantially greater for black African women older than 25 years of age, and older than 20 years for women of South Asian origin. For Europeans, on the other hand, the chances were higher for women older than 30 years. In addition, the rate of gestational diabetes increases quicker with age.
Researcher Makrina Savvidou commented "It is important that clinicians are aware of all the contributing factors as gestational diabetes can result in adverse perinatal outcomes."
Source: www.diabetes.co.uk
The charity Diabetes UK Scotland is calling for more insulin pumps to be made available, as the lack of their availability in Scotland is worrying health experts. The charity has demanded an urgent review to assess the growing need to boost the number of diabetes patients who are able to benefit from using an insulin pumps.
They are lobbying MSPs on the Public Petitions Committee at Holyrood to increase the amount of pumps available, especially as just 2 per cent of people in Scotland with type 1 diabetes are thought to have an insulin pump, as compared to 3.9 per cent in England and Wales and around 35 per cent in the US.
he National Institute for Clinical Excellence (NICE) has already claimed that about 2–15 per cent of type 1 diabetes patients could benefit from using the pumps, which would benefit more than 4,000 people with type 1 diabetes in Scotland.
Stephen Fyfe, communications officer at Diabetes UK Scotland, commented that the the pumps are "one of the most significant advances in the treatment of diabetes, freeing people from the daily challenges of multiple daily injections, helping to reduce the risks of complications, raising quality of life and freeing up NHS time and resources."
However, the Health Secretary Nicola Sturgeon has stated that more patients would receive insulin pumps by 2013, as the rise in diabetes numbers was "one of the biggest challenges in the health service."
Source: www.diabetes.co.uk
A new study has revealed that offering a so-called "muffin test" to people at risk of developing type 2 diabetes could help doctors in their diagnosis of the metabolic condition. The usual diabetes checks, such as the oral glucose tolerance test, involve monitoring levels of blood sugar in the body, but with this test eating a muffin rather than a glucose drink could make the test easier for patients.
The oral glucose tolerance test means people have to fast overnight before drinking a sugary solution to see how the body reacts and the quantity of sugar that stays in the bloodstream. It is claimed that the muffin test, however, could offer GPs a better idea of how the body is able to deal with real food for their diagnosis.
The study of 73 women in their 40s and 50s showed that the muffin test could provide a diagnosis of women that had impaired glucose tolerance, and that it was also less expensive than the regular sugar drink used. With the muffin test used in the research, over half of those found to have impaired glucose tolerance would have been missed using a regular blood test carried out after fasting.
However, there are concerns about standardisation and shelf life when using muffins instead of a glucose drink to test for diabetes, as the former is better in both respects.
Source: www.diabetes.co.uk
The new Scottish Health Survey has found that over a quarter of Scottish adults are now obese, a health issue that is costing the NHS more than GBP450 million every year. The survey showed that 27 per cent of Scots aged between 16 and 64 were obese last year, a dramatic increase from the 17 per cent level found in 1995.
With about 65 per cent of Scottish adults now being classified as either overweight or obese, it is thought that the numbers of obese adults in the country could amount to 40 per cent by the year 2030, adding up to a GBP3 million cost for the health service, especially as obesity pushes up the risk of people developing type 2 diabetes, cancer, cardiovascular disease, stroke and hypertension.
A spokesperson for the Scottish government, which commissioned the report, commented "Our action plan published earlier this year sets out actions being taken to change the environment in which we live to make it easier for everyone to make healthy choices, including eating more fruit and vegetables and less salt, fat and added sugar and becoming more active."
They added "We have introduced a range of measures to improve diet and are spending over GBP7.5 million in the next three years on projects to encourage healthy eating."
Source: www.diabetes.co.uk
Total of 2.9 million people in the UK now diagnosed with disease. Diabetes cases in the UK have soared to nearly three million, according to a charity.
The number of people diagnosed with the disease has risen by nearly 130,000 in the past year to 2.9 million, said Diabetes UK. There are now 50% more Britons with diabetes than when GP data on the disease was first published in 2005.
The rise is mainly due to a surge in type-2 diabetes, which accounts for 90% of all cases and is most common in people who are overweight.
Barbara Young, the charity's chief executive, said: "The rate of increase of diabetes is growing, with huge human cost and cost to the NHS. The time for action is now.
"Simple things can make a huge impact. The vascular screening NHS health check is critical in detecting early signs of type-2 diabetes. Losing 10% of your weight reduces your chances of developing type-2 diabetes by 50%. We must reverse this trend if more people are not going to suffer unnecessarily and if diabetes is not going to bankrupt the NHS."
The charity said about 10% of NHS spending, or £9bn a year, goes on diabetes and its complications. It is trying to raise awareness of lesser-known risk factorssuch as having a large waist, being aged over 40, having relatives with the disease, or being from a black, Asian, or other minority ethnic community.
At-risk waist measurements, irrespective of weight, are 37 inches or more for men, except those of South Asian origin for whom the threshold is 35 inches, and 31.5 inches or more for women.
Symptoms of diabetes include frequent urination, especially at night, increased thirst, extreme tiredness, unexplained weight loss, genital itching or regular episodes of thrush, slow healing of cuts and wounds, and blurred vision.
People with type-2 diabetes may have the condition for up to 10 years without realising it. About half of sufferers already show signs of complications by the time they are diagnosed.
Type-1 diabetes is an autoimmune disease not linked to lifestyle or weight, which results in the destruction of insulin-producing cells. It affects about 10% of diabetes sufferers.
Source: www.guardian.co.uk
A new study from France has found that people who drink less than a couple of glasses of water every day could be at a greater risk of developing extremely high levels of blood sugar. It was found that adults who consume about only half a litre of water or less a day were more likely to develop blood sugar levels in the pre-diabetes range, as compared to those who drank more water.
However, although the results of the research on over 3,000 French adults between the ages of 30 and 65 with normal blood sugar levels showed a link between water intake and blood sugar, it did not fully prove cause-and-effect.
Around 19 per cent of the participants drank less than half a litre of water per day, while the rest consumed up to a litre or more. During the following nine years, 565 of the participants developed abnormally high levels of blood sugar, while 202 developed type 2 diabetes.
On assessing the risk related to the amount of water consumed, the study showed that those who drank at least half a litre of water per day were 28 per cent less likely to develop high blood sugar than people who drank less.
It seems that a hormone called vasopressin could be the missing link, as it helps regulate water retention. If the body is dehydrated, levels of vasopressin rise, resulting in the kidneys conserving water. In addition, it is thought that higher vasopressin levels could also increase blood sugar levels, as there are vasopressin receptors in the liver, which is responsible for producing glucose in the body.
Source: www.diabetes.co.uk
A Canadian scientist has claimed that following a series of simple changes to your lifestyle could help you live to be 100 and free from disease.
Cardiologist Clyde Yancy stated that making seven lifestyle changes, involving being more active, managing cholesterol levels, having a healthy diet, managing your blood pressure, keeping at a healthy weight, managing diabetes and blood sugar levels, and avoiding tobacco can all help you become a centenarian.
Yancy said that 90 per cent of us could live to at least 90 and even reach 100 if they followed his guidance, which could also save the NHS billions of pounds by reducing the impact of heart disease and type 2 diabetes on the UK population.
He commented "Achieving these seven simple lifestyle factors gives people a 90 per cent chance of living to the age of 90 or 100, free of not only heart disease and stroke but from a number of other chronic illnesses including cancer."
He added "By following these steps, we can compress life-threatening disease into the final stages of life and maintain quality of life for the longest possible time."
Yancy is also lobbying governments to help improve people’s health through initiatives that include pressuring food companies to reduce salt levels, more health education and imposing a smoking ban in schools.
Source: www.diabetes.co.uk
A new study has claimed that black women who suffer from gestational diabetes are at substantially higher risk of later developing type 2 diabetes. It was found that black women with gestational diabetes were at the highest risk, even though they had a lower prevalence than Asian/Pacific Islanders and Hispanics, according to the research.
The researchers from the United States, whose work was published in Diabetologia, examined data from nearly 140,000 women who underwent a singleton pregnancy between 1995 and 2008. For black women who had glucose intolerance during their pregnancy, the rate for later diabetes was 29 per 1,000 person-years, as compared to that of 3.2 per 1,000 for those with normal glucose levels during their pregnancies, a 9.2-fold higher rate of diabetes.
Of the patients, just over 10 per cent had gestational diabetes, and the highest prevalence was found to be for people from the Asian/Pacific islands, followed by those of Hispanic origin. The prevalence was around the same for white and black women. It was recommended that ethnicity should be a consideration when looking at the screening and counselling of women who develop gestational diabetes, especially it they are black.
The report stated that "Whether this difference is due to genetics, environment, lifestyle, or other differences among ethnic groups will require further investigation."
Source: www.diabetes.co.uk
New figures for the rate of diabetes in Northern Ireland have shown that the province is facing increasing problems with the metabolic condition. With around 73,000 people suffering from diabetes in Northern Ireland, about another 300 people newly diagnosed each month and a further 10,000 unaware they have the condition, the charity Diabetes UK Northern Ireland has warned that this number will grow unless steps are taken to address the problem.
The majority of those diagnosed have type 2 diabetes, usually linked to lifestyle factors, and in some cases it can be prevented through a healthy diet, regular physical exercise and maintaining normal weight levels.
Iain Foster, director of Diabetes UK Northern Ireland, commented "We are in the middle of a diabetes epidemic. An extra 21,000 people are now living with diabetes since figures began to be collected, less than a decade ago."
He added "With the numbers rapidly increasing it is now more important than ever that everything is done to prevent serious complications which cost the NHS millions and are absolutely devastating for the individuals and families involved."
In addition, the Northern Ireland Childhood Diabetes Register has said there are 1,000 children and youths below the age of 17 that have been diagnosed with type 1 diabetes.
Source: www.diabetes.co.uk
A new weekly injection treatment has been approved for the NHS as a replacement for carrying out injections twice daily for people with type 2 diabetes. The National Institute for Clinical Excellence (NICE) has provisionally approved the jab, which costs GBP19 a week, for use on the NHS.
With an estimated 2.5 million people suffering from type 2 diabetes in the UK, and around 850,000 undiagnosed, the decision means that Bydureon can be prescribed to patients, which could mean an end to people having to inject exenatide two times every day.
Primary Care Trusts (PCTs) will be able to begin prescribing the weekly Bydureon straight away, with a wider availability being delayed until once final guidance has been issued, expected to be in February 2012.
Cathy Moulton, clinical adviser at the charity Diabetes UK, commented "For people currently using exenatide, a twice-daily injection, the possibility of being able to administer this treatment once a week could hugely improve their quality of life."
Bydureon, which induces the pancreas to produce more insulin, is released a lot more slowly into the body than exenatide, meaning less injections are necessary. The drug recreates a hormone existing in the Gila Monster lizard, limiting the amount of sugar in the blood.
Source: www.diabetes.co.uk
An overweight man has lost 100lb in weight due to taking part in a bet. Peter Heeks, a 26-year-old call centre worker from Darwen, Lancashire, won a bet with bookmakers William Hill for GBP10,000 that has left him both thinner and wealthier. His healthier lifestyle also means he is at less risk of developing chronic conditions such as diabetes.
Heeks, who admits losing a few pounds to the bookies over the years, said his latest attempt to lose weight by betting that he could offload 100lb of extra weight within a year has proved a big success.
The bet, of GBP100 at odds of 100-1 that he could lose 100lb in a year, saw him drop to 13st 5lb from 21st 1lb, and in the process reduce his waistline to only 36 inches from a previous 50 inches. His successful diet centred on giving up alcohol and pizzas, and eating more chicken and fish with vegetables .
Heeks commented "I don’t think they’ll give anyone else 100-1 to lose 100lb but it worked wonders for me."
He added "They hadn’t had anyone wanting a bet on themselves to lose so much, so they gave me a big price. If they kept the odds out there they’d be doing the nation a favour. It would be a great incentive to beat the obesity time bomb."
Source: www.diabetes.co.uk
The health charity Diabetes UK has warned that the government plans to reform the NHS could put the health of millions of patients across the country at risk. It is lobbying for a raft of changes to the Health and Social Care Bill so that people with diabetes do not lose out on important treatment and care.
They would like the new NHS Commissioning Board and clinical commissioning groups to be forced to report every year on how it is achieving their remit of ensuring integration of services for healthcare professionals to cooperate in the best interests of patients.
As well as that statutory requirement, Diabetes UK is also asking for Monitor, the new economic regulator, to be required to focus on integration of services ahead of competitive aspects of the service, and for patient groups to be involved in how healthcare services are organised.
Barbara Young, chief executive of the charity, commented "What matters in this debate is how these changes affect the patient. The issue is ensuring people have access to the care they need and services designed in a way that best suits them."
She added "People with diabetes already need at least 14 different NHS services. Getting it right means they can lead long and healthy lives. Getting it wrong could mean amputation, kidney failure, blindness and a shorter life.
Source: www.diabetes.co.uk
A diabetes expert in Ireland has warned that levels of the metabolic condition in the country are a national crisis, as new research reports that one in three people in Ireland have a family member with diabetes.
The study, from a survey of over 700 people, also reported that one in five people have a family member that have developed type 2 diabetes, while 77 per cent of Irish people know somebody who have the metabolic condition.
The research has been issued to coincide with changes to the HbA1C clinical measurements for diabetes in Ireland from the start of next year. The new measurement for reporting HbA1C is intended to stop any confusion between glucose and HbA1C results. There is also a campaign, called Know Your Numbers!, which helps diabetics reduce the risk of developing a complicationcomplication relating to their condition.
Séamus Sreenan, who is a consultant endocrinologist and medical director of the Diabetes Federation of Ireland, commented "We have been saying it for years, but these figures really bring the message home – diabetes is everywhere in Ireland."
Professor Sreenan also stated that it takes an average of about 12 years from the onset of type 2 diabetes and its diagnosis, a delay that often means it is too late to properly treat many sufferers.
Source: www.diabetes.co.uk
Scientists at the Helmholtz Zentrum München have shown that people with a good vitamin D supply are at lower risk of developing Type 2 diabetes mellitus. The study, which was conducted in cooperation with the German Diabetes Center and the University of Ulm, will be published in the October edition of the renowned scientific journal Diabetes Care.
New tests performed on participants of the KORA study have shown that people with a good supply of vitamin D have a lower risk of developing Typ 2 diabetes mellitus, while individuals with lower concentrations of vitamin D in their blood have a higher risk. This effect could be attributable, amongst other things, to the anti-inflammatory effect of vitamin D. The result of the study, which was conducted at the Helmholtz Zentrum München in cooperation with Dr. Christian Herder of the German Diabetes Center in Düsseldorf and Dr. Wolfgang König, Professor of Medicine/Cardiology at the University of Ulm, could have direct consequences for the prevention of this common disease.
"Vitamin D deficiency is relatively widespread due to our modern way of life and the geographical latitude of Germany. In the winter months, in particular, people often do not receive adequate supplies of the vitamin because of the lack of sunlight," explains Dr. Barbara Thorand of the Institute for Epidemiology II at the Helmholtz Zentrum München. "If follow-up studies confirm our results, a targeted improvement in the supply of vitamin D to the general public could at the same time reduce the risk of developing diabetes." The human body can produce vitamin D itself if it has sufficient exposure to sunlight. The UVB radiation in natural daylight splits the precursor of vitamin D, 7-dehydrocholesterol, in the skin and forms provitamin D3. Further vitamin D synthesis occurs in the liver and kidneys. In addition, the supply can be improved by eating specific foods, such as oily fish, eggs and milk products, or by taking vitamin D supplements.
More than six million people in Germany suffer from Type 2 diabetes mellitus, and the number of undiagnosed cases could be equally high. Up to now, there has been no cure for this common disease. Type 2 diabetes is a disorder of glucose metabolism. It is characterized by a loss of insulin action and a drop in the levels of the hormone produced by the body. The mechanisms that trigger the disease have not yet been fully clarified. However, it is known that diabetes is caused by a combination of genetic and lifestyle factors. The objective of the Helmholtz Zentrum München is to understand the mechanisms that cause common diseases and to develop new approaches with regard to their diagnosis, therapy and prevention
Source: www.medicalnewstoday.com
Scientists at Glasgow University have found that men are at a greater risk of type 2 diabetes than women, as they have to gain less weight to develop the metabolic condition.
The study, which involved data from 51,920 men and 43,137 women in Scotland with diabetes, showed that men developed diabetes at a lower body mass index (BMI) than women, which was claimed to be behind the higher rates of diabetes in men in many places around the world. It also shown that being above standard weight was a major risk factor for developing type 2 diabetes, as well as genetics, age and ethnicity.
The findings from the study highlighted that the average BMI at diabetes diagnosis in men was 31.83, while it was 33.69 in women, and also that the difference between the two was most obvious at younger ages. It was claimed that this discrepancy may be due to fat distribution, as men generally have more fat around their stomach and liver.
Lead researcher, Naveed Sattar, from the Institute of Cardiovascular and Medical Sciences, commented "Previous research has indicated that middle-aged men are at a higher risk of developing diabetes than women and one possible explanation is that men have to gain less weight than women to develop the condition."
Source: www.diabetes.co.uk
The Diabetes Research Network (DRN) has launched a new campaign with the aim of encouraging people suffering from diabetes to provide permission to allow them to be approached regarding being involved in future clinical research studies.
The Help Diabeates campaign, which will last for the next year and a half across three different areas of England, the North West, the South West and the North East area of London, has been approved by the National Institute for Health Research (NIHR). The research is targeting a range of improvements in the current treatment of diabetes, as well as for future therapies.
People happy to be recruited for the campaign would first approach the DRN, and then would be contacted by an NHS call centre to see how they can help out with particular research projects in the future, and if they agree to be on their consent for approach database.
David Matthews, who is co-director of the DRN and professor of diabetes medicine at the Oxford Centre for Diabetes, commented "This is a refreshing approach to recruit patients to a ‘consent for approach’ database."
He added "It means that diabetes patients are agreeing to be contacted in the future if a study becomes available which might suit them. It also means that clinical trials can be set up much faster which is ideal for diabetes research."
Source: www.diabetes.co.uk
The NHS has spent an estimated £625 million over the past decade on synthetic forms of insulin when the recommended human alternatives, which are considerably cheaper, would have probably been just as effective, according to new research published in BMJ Open.
Over the 10 years, the NHS spent a total of £2,732 million on insulin, with the annual cost rising from £156 million to £359 million to give an increase of 130%, say authors Sarah Holden, Chris Poole and Christopher Morgan of the Cardiff Medicentre at the University Hospital of Wales, and Craig Currie of Cardiff University School of Medicine. The researchers base their findings on an analysis of publicly-available data from the four UK prescription pricing agencies of England, Wales, Scotland and Northern Ireland for 2000-2009, adjusting the costs for inflation and reporting them at 2010 prices.
During the decade, the annual cost of synthetic (analogue) insulin rose from £18.2 million, or 12% of the total, to £305 million, or 85% of the total, while the cost of human insulin fell from £131 million (84% of the total) to £51 million (14% of the total), the researchers find.
On the assumption that all patients prescribed insulin analogues could have been prescribed human insulin instead, the NHS could have saved itself £625 million, according to the authors, and they add that, even if only half of those patients could have been switched, that is still more than £300 million savings for the NHS.
The number of people diagnosed with diabetes in the UK has risen to 2.8 million, around 90% of whom have type 2 disease, and while those with type 1 disease require insulin from the start, those with type 2 diabetes tend to be started on insulin later on, the authors note. Insulin analogues were developed to better mimic the actions of the insulin manufactured by the body but it is not clear if the benefits are sufficient to justify their additional costs, they suggest.
"We know that the rise of insulin analogues has had a substantial financial impact on the NHS, yet over the same period there has been no observable clinical benefit to justify that investment," they say.
"It is likely that there was - and is - considerable scope for financial savings," they conclude, adding that, "most worryingly, the clinical role and safety of insulin for use in people with type 2 diabetes is being questioned."
Source: www.pharmatimes.com
Research has shown that snacking on fatty foods during the day or night is not the best way to manage type 2 diabetes, and could even lead to what is known as a leaky gut.
The study, which was presented at the annual meeting of the European Association for the Study of Diabetes, also said that people with diabetes and impaired glucose tolerance who eat meals with high-fat content could trigger bacterial endotoxins to pass through the intestinal wall. This could increase the amount of inflammatory cytokines already implicated in the metabolic condition.
This so-called leaky gut effect could be made worse by eating small amounts of food more often, as it contributes to a build up of the lipopolysaccharide endotoxin in the bloodstream.
The study involved 54 patients with different weight levels, glucose tolerance and type 2 diabetes. Those with diabetes who ate a high-fat meal experienced a significant rise in lipopolysaccharides and impaired glucose tolerance.
Researcher Alison Harte, from the University of Warwick, commented "Our data highlight that these people can be exposed to as much as 126% more circulating lipopolysaccharide after a high-fat meal."
She added "A continual grazing routine will cumulatively promote their pathogenic condition more rapidly than other individuals’ due to the elevated exposure to endotoxin."
Source: www.diabetes.co.uk
The X Factor star Amelia Lily has talked about the impact of having type 1 diabetes has had on her bid to become the next teen singing sensation coming out of the reality television competition.
She has to inject herself with insulin four times each day to manage her condition and prevent her getting a hypo if her levels of blood sugar went dramatically down. Lily, who has suffered from the condition since she was three years old, is now 16 and a student based in Liverpool, has discussed her concerns that her diabetes condition could affect her hopes of following her hero and being the next Lady GaGa, admitting "Singing is tiring."
However, she made it to bootcamp due to all the judges were impressed by her performance. She gave a stunning performance of Janis Joplin’s classic ‘Piece Of My Heart’.
Lily added "I make sure I have carbohydrates and bananas so my blood sugar is a bit higher than normal because singing uses a lot of energy. But I just have to deal with it."
The teen sensation has said she is worried about the impact her condition could have on her career, but will keep a watchful eye on what she eats and drinks, as well as ensuring that she gets sufficient rest and takes her insulin injections every day.
Source: www.diabetes.co.uk
A new study has shown that drinking wine in moderation could help people to lose weight, and that the old theory linking alcohol with obesity could be incorrect. The researchers now claim that, although drinking heavily will mean you put on weight, having the occasional glass of wine could actually help you prevent putting on weight.
The study, by scientists at Navarro University in Spain and published in the journal Nutrition Reviews, showed that the moderate consumption of alcohol, especially wine, was more likely to protect against weight gain, while drinking spirits was positively associated with weight gain.
The team assessed the findings of 31 separate studies carried out between 1984 and 2010, finding that there were contradictions that meant there was no conclusively confirmation of a link between drinking and weight gain. The research that did highlight such a link tended to be focused on heavy drinking . As the study stated "It is possible that heavy drinkers may experience such an effect more commonly than light drinkers."
It was also added that "The type of alcoholic beverage might play an important role in modifying the effect of alcohol consumption on weight gain."
Previous studies had indicated that people who drink moderately are at 30 per cent less risk of developing type 2 diabetes, meaning that even obese people do not have to give up alcohol for this reason.
Source: www.diabetes.co.uk
Up to one million people with diabetes could lose their driving licences because of harsh new European rules classifying them as unfit to drive.
Experts claim the ‘unnecessarily strict’ changes will affect hundreds of thousands who have been driving for decades without problems.
They say the rules amount to a blanket ban on diabetics taking insulin who occasionally have ‘hypos’ – episodes of hypoglycaemia, or low blood sugar, which may cause blackouts if not countered with a sugary snack.
Under a new definition of the rules to meet an EU directive, a diabetic who has two hypos in a year – even while in bed – will end up banned from driving.
The charity Diabetes UK has protested to the Department for Transport about the changes, due to take effect in October.
It has told officials that up to a million people with type 1 and type 2 diabetes who use insulin could be ‘negatively affected’ by the changes, but says there is no evidence that drivers with diabetes pose a greater risk than others.
The charity fears the Driving and Vehicle Licensing Agency (DVLA) is applying the EU directive far more strictly than other countries.
In fact some diabetics have found the DVLA is already using the new interpretation to ban them from the roads. Simon O’Neill, of Diabetes UK, said the new DVLA definitions of ‘severe’ and ‘recurrent’ hypoglycaemia threatened a blanket ban for many.
Up until now, severe hypos were defined as episodes where another person was needed to administer carbohydrate or take other actions during waking hours to assist the diabetic.
The new definition used by the DVLA also includes hypoglycaemia when the individual is asleep.
Mr O’Neill said the EC Directive itself does not specify nocturnal hypoglycaemia, yet the DVLA has chosen to include it in assessing fitness to drive.
He added: ‘We believe nocturnal hypoglycaemia has no medical basis of relevance to driving.’
Professor Geoff Gill, professor of diabetes at Aintree University Hospital, Liverpool, said a tighter definition of hypoglycaemia was unnecessary as the current system required drivers to report when they had an episode they could not manage alone.
He said: ‘We’re not looking for a softer option, we don’t want people driving who are a danger. This is about an interpretation of the rules that will unfairly impact on the lives of many diabetics.
‘It could mean that people with diabetes who have been driving safely for years will lose the right to drive under these changes.
A DVLA spokesman said: ‘We aim to strike the right balance – making sure that only those who are safe to drive are allowed on our roads, while at the same time avoiding placing unnecessary restrictions on people’s independence.
‘We must apply European medical standards but we consider every case individually and refuse licences only where absolutely necessary.’
Source: www.dailymail.co.uk
79 million American adults have prediabetes and will likely develop diabetes later in life, according to the Centers for Disease Control and Prevention. As the number of people diagnosed with diabetes continues to grow, researchers are focusing on discovering why the prevalence of the disease is increasing. John Thyfault, an assistant professor in MU's departments of Nutrition and Exercise Physiology and Internal Medicine, has found that ceasing regular physical activity impairs glycemic control (control of blood sugar levels), suggesting that inactivity may play a key role in the development of type 2 diabetes.
"We now have evidence that physical activity is an important part of the daily maintenance of glucose levels," Thyfault said. "Even in the short term, reducing daily activity and ceasing regular exercise causes acute changes in the body associated with diabetes that can occur before weight gain and the development of obesity."
Thyfault studied the relationship between low levels of physical activity and elevated levels of postprandial glucose (PPG), or the spikes in blood sugar that occur after a meal. PPG is a risk factor for the development of type 2 diabetes and has been associated with increased incidences of cardiovascular disease and death. Thyfault found that when healthy individuals reduced their physical activity by about half for three days, their PPG responses to meals doubled.
"A single bout of moderate exercise can improve the way the body maintains glucose homeostasis (blood glucose regulation) and reduce PPG, but becoming inactive for a short period of time quickly disrupts glucose homeostasis," Thyfault said. "This study shows that physical activity directly impacts health issues that are preventable."
In the study, Thyfault monitored the activity levels and diets of healthy and moderately active young adults. Participants then reduced their physical activity by 50 percent for three days while replicating the diet they consumed when they were active. Continuous glucose monitors worn by the subjects during the period of inactivity revealed significantly increased levels of PPG. Spikes in blood glucose after meals can indicate increased risks for type 2 diabetes and cardiovascular disease.
"It is recommended that people take about 10,000 steps each day," Thyfault said. "Recent evidence shows that most Americans are only taking about half of that, or 5,000 steps a day. This chronic inactivity leads to impaired glucose control and increases the risk of developing diabetes."
The study, "Lowering Physical Activity Impairs Glycemic Control in Healthy Volunteers," will be published in Medicine & Science in Sports & Exercise. It was funded by the University of Missouri Institute for Clinical and Translational Sciences, the MU Research Council and the National Institutes of Health (NIH). The Department of Nutrition and Exercise Physiology is jointly administered by MU's College of Agriculture, Food and Natural Resources, College of Human Environmental Sciences and School of Medicine. Thyfault has a joint appointment in the Department of Internal Medicine in the School of Medicine.
Source: University of Missouri-Columbia
A simple finger prick test during routine eye examinations at high street opticians could help to identify millions of people with previously undiagnosed Type 2 diabetes, according to new research.
The researchers suggest earlier diagnosis could set people on the road to better management of the disease, which is the leading cause of blindness in the working age population, and that this could ultimately result in cost-savings for the NHS.
The Durham University study suggests that screening for the condition in unconventional settings, such as opticians, chiropodists or dentists, could find those people who would not routinely visit their GP, and could have potential worldwide.
It is estimated that 150 million people worldwide have diabetes but up to 50 per cent of people who have the condition are thought to be undetected and may only be diagnosed when complications occur.
It has already been shown that pharmacies and chiropodists have the capacity to carry out simple blood tests to identify Type 2 diabetes. The researchers say other places such as dentists could potentially be used to offer the test.
The pilot study, carried out by Durham University and The James Cook University Hospital in Middlesbrough, focused on opticians and the findings are published in the British Journal of General Practice.
It found that out of 1,000 people visiting their opticians for an eye test who were found to have one or more risk factors of diabetes, such as increased body mass index or aged over 40, almost 32 per cent were referred to their GP for further investigation after having their blood glucose levels checked.
The researchers say high street opticians are an under-utilised resource in the efforts to identify the large numbers of people with undiagnosed diabetes.
Currently, most screening for diabetes is carried out in medical settings, mostly by family doctors, but there are many people who do not visit their GP for preventative care, even if they are in an at-risk group.
While optometrists have an established role in screening people with known diabetes for eye disease, they are presently not involved in identifying diabetes.
Lead author and former optician, Dr Jenny Howse from Durham University's School of Medicine and Health, said: "Charities' campaigns have managed to reduce the proportion of people with undiagnosed diabetes but there is still a 'hard-to-reach' group who remain undiagnosed. Opticians could provide routine, non-emergency care and the simple screening can be done outside usual medical settings, such as GP surgeries."
In the study, which involved five high street optometry practices, people were asked a number of questions to identify any diabetes risk factors. If they had one or more, optical assistants conducted a simple finger prick test, called a random capillary blood glucose (rCBG) test, to assess the blood glucose levels.
In keeping with current Royal Pharmaceutical Society and Diabetes UK guidelines for screening in pharmacies, those with raised blood glucose levels were advised to visit their GP for further investigations.
Dr Howse said: "The screening test is less invasive and time consuming than fasting blood glucose and oral glucose tolerance tests.
"Already pharmacists and chiropodists have shown it is feasible to offer screening in their practices, here in the UK as well as in Australia and Switzerland. In the US, 60 per cent of adults visit dentists at least once a year for standard check-ups and those practices could be suitable locations to screen for diabetes.
"In the UK, our initial results show screening for diabetes in opticians is a feasible option but we now need to look at the practicalities of delivering it, including liaison between opticians and GPs and the time costs for opticians."
Type 2 diabetes is the most common type of diabetes and the risk of developing it increases as you get older. It develops when the body does not produce enough insulin to maintain a normal blood glucose level, or when the body is unable to effectively use the insulin that is being produced.
The study was set in five optometry practices of different sizes and locations in northern England with 1,002 people taking part in the research. 318 people had random capillary blood glucose (rCBG) levels of 6.1 or higher and so were advised to see their doctor for further tests and five had a rCBG of 12.1 or more who were told to see their GP urgently. 162 people took the advice and went to see their GP, and of these 138 reported they were investigated further. Nine people were diagnosed with pre-diabetes and seven with diabetes.
The research received funding from the Francis J Bell Fund, County Durham Community Foundation.
CASE STUDY
Faye McDearmid is an optometrist who works at Campbell & McDearmid Optometrists in Redcar and at The James Cook University Hospital in Middlesbrough. Her practice took part in the university research.
Faye said: "Blindness is devastating and irreversible, and diabetic retinopathy is currently the leading cause of blindness in people of working age in the UK. As an optometrist practicing in the community and in the hospital, I regularly see the detrimental effects this can have on the patient and their family and friends. Given that up to 60% of people with type 2 diabetes have a significant degree of retinopathy at the time of diagnosis, I feel that earlier detection is crucial.
"The value of screening by optometrists stems from the fact that we have regular contact with members of the community. We have the opportunity to offer and deliver this service in the privacy of the consulting room and we already have existing, regular communication links with local GPs.
"When a person comes for a sight test they are told that part of the eye test is to look for signs of general health disease, like diabetes or high blood pressure. While patients are with us in the practice, it's a great opportunity to offer further health screening where appropriate.
"Although screening is something which could be offered by optometrists for the benefit of patients, it would require funding as an enhanced service which is currently not available."
Source: Durham University
Some diabetic patients receive no warning before they pass out from low blood sugar. A modern sweat meter could alert patients in time. Biathletes and ME patients might also benefit from the sweat meter.
By Yngve Vogt, research magazine Apollon, University of Oslo, Norway
25,000 Norwegians have type 1 diabetes. 175,000 have type 2 diabetes. Add to this the large number of people who are unaware that they are diabetic. When the concentration of sugar in the blood drops, most patients have a hypo (a hypoglycaemic attack). Symptoms may include palpitations, sweating, a tingling feeling in your face, altered sensory experiences and intense hunger.
After many years with diabetes some patients lose warning symptoms of low blood sugar. It's a very scary condition because they can then lose consciousness or die. Today there are no good instruments that can measure this without the patient pricking themselves with a needle.
In a few years diabetes patients may get help with avoiding dangerously low blood sugar.
It is known that diabetic patients change their sweat pattern when their blood sugar levels are too low. A sweat meter developed at the University of Oslo and the National Hospital can send a discreet alert - via a mobile phone before a patient suffers an attack due to low blood sugar.
"The advantage of the sweat meter is that the patient doesn't have to prick themselves. All you need to do is paste an electrode on your skin," says Professor Ørjan G. Martinsen, Department of Physics at the University of Oslo to the research-magazine Apollon at University of Oslo, Norway.
"We envisage that the device will be able to measure sweat activity continuously, providing an indication of whether the patient is about to experience low blood sugar. It can communicate directly or via a smartphone. The warning system will then not be very bothersome for the patient," says Christian Tronstad, a medical technology researcher at Oslo University Hospital, the National Hospital
Medical interest. Diabetes expert Professor Trond Geir Jenssen at the National Hospital told Apollon that he has great faith that the sweat meter will be helpful to diabetics.
With support from the Norwegian Diabetes Association, the researchers will now carry out sweat measurements of diabetic patients when their blood sugar level dips.
"In the study we will compare the continuous measurements of sweat activity and blood sugar in patients to see if we can get a good enough warning of a low sugar level in the blood," says Tronstad.
Professor of Medicine Kåre Birkeland, head of the medical council of the Diabetes Association, says the sweat meter is exciting.
"It can be developed into a practical, usable device that can help those who have a hypo when their blood sugar gets too low. The patient can then take the necessary precautions," says Birkeland.
He noted that more studies have to be done before the sweat meter can be used.
Electrical resistance in tissues. Professor Martinsen's research group leads the world in knowledge of the electrical properties of the skin. Together with Sverre Grimnes, professor emeritus of medical technology, he has, over the last 20 years, researched bioimpedance, i.e. electrical resistance of biological tissues. The research group in Oslo has therefore called itself the Bioimpedance Group.
They have started the world's only scientific journal on bioimpedance. Martinsen is also president of the International Society for Electrical Bio-Impedance.
Unnoticable palm sweat. The sweat meter was originally designed to diagnose hyperhidrosis, a nasty disease that causes sufferers to sweat excessively. Researchers are currently using the sweat meter to examine diabetes patients at the National Hospital and Akershus University Hospital (Ahus).
Sweating has two causes. The best known is thermal sweat. When it's hot, the body reacts by secreting sweat on the surface of the skin. The perspiration needs energy to evaporate. This cools the skin down.
The second type of sweat is emotionally controlled and occurs primarily in the palm. The palm has more than 250 sweat ducts per square centimeter. This is the highest density of sweat glands in the body. In comparison, the forearm doesn't have more than 100 sweat ducts per square centimeter.
"Although emotionally controlled sweat can be unnoticeable, it can have a great impact on measurements, even when you're only calculating a few difficult math problems in your head," says Martinsen.
The sweat meter sends a small electrical current through the outer part of the skin, into the sweat glands and out onto the surface again. This layer of skin, which consists of dead horn cells, is as thin as the plastic film you use to wrap food, only 10 to 15 micrometers thick. Horn cells are poor conductors of electricity. On the other hand, sweat is a good conductor of electricity. Sweat is made up of saltwater. As is known, saltwater conducts electricity. The conductivity of the skin increases, therefore, when the sweat pores are filled with sweat.
Over the past year, several medical research institutes have expressed an interest in the sweat meter.
Athletes and stress. The sweat meter can be used to see how upset or excited you are.
"Imagine a biathlete! He has to ski extremely fast and then has to suddenly calm down to shoot at the target. With the sweat meter, he can practice relaxing as quickly as possible. Perhaps it's wise to count to ten, wait a few seconds or even think about Christmas dinner. The point is that the athlete gets feedback on what works," says Martinsen.
Chronic Fatigue Syndrome. Vegard Bruun Wyller, chief physician at the Paediatric Cardiology Department at Oslo University Hospital and associate professor at the University of Oslo, will test the sweat meter on children with chronic fatigue syndrome (ME).
Even when ME patients rest quietly and should be relaxed, their bodies behave as though they are persistently stressed. Many complain of sweating.
"We want to use the sweat meter to see if people with ME have increased sweat secretion. If this can be verified, it may be appropriate to proceed with more sophisticated, experimental studies," says Bruun Wyller.
Night sweats. Some people sweat profusely at night. Oslo researchers have also started a collaboration with the world's leading experts on night sweating at Lynn Health Science Institute and the University of Oklahoma, to use the sweat meter to monitor night sweating.
Technology. Although the sweat meter looks simple, it is packed with advanced technology.
A current passes through the electrodes. The sweat meter requires at least three electrodes.
"With two electrodes, it's not possible to separate the signals from the various electrodes from each other. By using multiple measuring points, we get a control system where we can keep track of the contributions of each electrode," says Tronstad.
They have developed special electrodes that do not affect the measurements.
"This ensures optimal focus on the outer part of the skin where sweating occurs."
The electrodes in the old models, which University of Oslo researchers developed a few years ago, created artificial signals. The measurements were not that reliable.
While the old, familiar lie detectors use direct current, the new sweat meter uses alternating current. With DC the current direction is constant. With AC the direction of the current changes all the time.
"DC has a long history and is used in conservative research communities. Some scientists in psychological communities cling to this method. We were met with scepticism, but were eventually accepted."
The natural electrical power of the body, such as muscle and nerve cells, is equal to 0.15 V, one-hundredth of an ordinary 1.5 V battery.
"This current is direct current. The problem is that it's not possible to measure direct current with direct current, since it isn't possible to separate these two direct currents from each other. Moreover, AC doesn't affect biological material as much as DC."
New electrical component. The research group has also begun using a completely new component of electric circuits.
In traditional physics electric circuits consist of three components: resistor, capacitor and inductor. Resistance is defined in the famous Ohm's law as voltage equals resistance times current.
"You can compare these concepts with a water hose: The voltage is the water pressure. Resistance is how much you squeeze the hose. The current is the water that forces its way through the hose."
In recent years, physicists have discovered a fourth basic component of electric circuits. It is called a memristor.
A memristor is resistance with memory. This means that resistance is dependent on the amount of charges that have already come through.
"This may sound commonplace, but the memristor was not theoretically described until 1971."
Not until 2009 did scientists manage to make a nanomemristor.
"A memristor is perfect for creating electrical models of the skin. We're the first scientists in the world to have adopted this theory in bioimpedance. It enables us to create even better methods of measuring electricity in the skin and thus better models of sweat ducts. Memristors can also be used to improve models of nerve signals, and have actual consequences for all fields that deal with electricity," explains Ørjan Martinsen.
The memristor research of the Oslo physicists was recently published in the prestigious journal New Scientist.
Checking acupuncture. Knowledge of bioimpedance is also important for understanding acupuncture. In traditional Chinese medicine our bodies have meridians (median lines) or pathways. They believe that life energy flows along these paths and that diseases are caused when the flow of energy is disrupted.
"They therefore dissolve the obstacles by inserting acupuncture needles into these meridians. Many believe that these meridians have special electrical properties. The problem is that many scientific papers in this field do not have a high enough standard. We have set up guidelines for how the studies should be done, and want get to the bottom of whether the meridians exist and whether acupuncture points have special electrical properties," says Martinsen.
In collaboration with the Massachusetts Institute of Technology, University of California and Harvard University, the Norwegian scientists will now measure whether the skin has line patterns or acupuncture points with special electrical properties.
Source: Oslo University
An international team of researchers led by Imperial College London has identified six new genetic variants associated with type-2 diabetes in South Asians. The findings, published in Nature Genetics, give scientists new leads in the search for diagnostic markers and drug targets to prevent and treat this major disease.
People of South Asian ancestry are up to four times more likely than Europeans to develop type 2 diabetes, which is a major risk factor for heart disease and stroke. Around 55 million South Asian people are affected worldwide, and the number is projected to rise to 80 million by 2030.
This new study is the first to focus on genes underlying diabetes amongst people originating from South Asia (India, Pakistan, Sri Lanka and Bangladesh). The researchers from around the world examined the DNA of 18,731 people with type 2 diabetes and 39,856 healthy controls. The genomes of the participants were analysed to look for locations where variations were more common in those with diabetes. The results identified six positions where differences of a single letter in the genetic code were associated with type 2 diabetes, suggesting that nearby genes have a role in the disease.
Dr John Chambers, the senior author of the study, from the School of Public Health at Imperial College London, said: "Type 2 diabetes is more common in South Asian populations than any other ethnic group, but the reason for this increased risk is unclear. Although lifestyle factors such as unhealthy diet, physical inactivity and obesity are important causes of diabetes in South Asians, these are only part of the explanation. Genetic factors have been widely considered to play a role in the increased risk of type 2 diabetes in Asians, but to date have not been systematically explored in this population."
"Our study identifies six new genetic variants linked to type 2 diabetes in South Asians. Our findings give important new insight into the genes underlying of diabetes in this population, which in the long term might lead to new treatments to prevent diabetes."
Professor Jaspal S Kooner, from the National Heart and Lung Institute at Imperial College London, the lead author for the study said: "This is the first genome-wide association study in South Asians, who comprise one-quarter of the globe's population, and who carry a high burden of the disease and its complications, including heart attack and stroke. We have shown that the genetic variants discovered here in South Asians also exist and contribute to diabetes in Europeans. Our studies in Asians and European populations highlight the importance and gain in examining the same problem in different ethnic groups."
The collaboration included leading researchers from Imperial College London, University of Oxford, University of Cambridge, the University of Birmingham, and the Peninsular Medical School in the UK, as well National University of Singapore, University of Mauritius, Baker IDI (Australia), Mohan Diabetes Centre (India), University of Kelaniya (Sri Lanka), NCGM (Japan), University of Houston (USA), Aga Khan University (Pakistan) and other institutions.
The research was funded by the Imperial Comprehensive Biomedical Research Centre award from the National Institute of Health Research; the Medical Research Council, the Wellcome Trust and other sources.
Source: Imperial College London
Diabetes prescriptions now account for 8.4 per cent of the entire NHS net bill for primary care drugs in England, according to a new report from the NHS Information Centre.
'Prescribing for Diabetes: England 2005/06–2010/11' shows an increase in the cost of prescribing from £513 million in 2005/06 to £725 million in 2010/11 – an increase of 41.1 per cent. Over the same period, the number of items dispensed to treat the condition rose by 41.2 per cent, from 27.1 million to 38.3 million. This means that one in every 25 prescription items written is now for diabetes.
Around two thirds of these items are anti-diabetic drugs such as metformin, which help the body’s own production and use of insulin, with various forms of insulin making up a further 15 per cent of prescribed items.
Planning how best to address the condition
Tim Straughan, NHS Information Centre chief executive, said: "This report paints a picture of an ever-increasing drugs bill to cope with the demands of society triggered by diabetes...
"This information will help people and health professionals see the impact that caring for diabetes has on NHS prescribing; and support the NHS in planning for how to best address the condition."
Access to the most appropriate treatments
Bridget Turner, Head of Policy and Care Improvement at Diabetes UK, said, "This report reinforces that diabetes is one of the biggest health challenges this country faces. Increasing diabetes prevalence has largely caused this rise in cost and numbers of prescriptions.
"Diabetes UK believes that people should have access to the most appropriate treatment to manage their diabetes and reduce the risk of devastating complications. The long term costs of poor diabetes management such as caring for someone who’s had a heart attack or stroke, lost their sight or lower limb, far outweigh those of the drugs that help prevent such complications.
"Investment in education, support and improving access to reduce variations of care will empower people to effectively self-manage their condition. This will tackle the spiralling rates and costs of diabetes and help those diagnosed with the condition stay healthy."
Source: www.diabetes.org.uk
It's common enough for researchers to look at the impacts of prescribed drugs on the body. And if you're a diabetes researcher who believes that exercise has great benefits for those with type 2 diabetes, you're hoping your research will show that. But when Normand Boule looked at the dual impacts of exercise and metformin - two of the most commonly-prescribed modalities for glucose control - on that very outcome, the hoped-for double whammy wasn't the result.
"The study had three objectives: we wanted to look at the effect of metformin on exercise in people with type 2 diabetes, examine the effect of exercise on metformin concentrations in the body, and finally to look at the effects of metformin and exercise on glucose control, which is essential for people with diabetes," says Boulé, whose study - a randomized, double-blind, crossover study - involved a multi-disciplinary team of researchers from five faculties at the U of A.
Ten men and women between 30 and 65 with type 2 diabetes, but not taking glucose-lowering medication or insulin for their condition were recruited into the study. Participants were randomly assigned to take metformin or a placebo for the first 28 days of the study, then crossed over so those taking the placebo received metformin and vice versa for a second 28 day period. On days 27 and 28, participants spent six hours in the exercise physiology lab and performed different tests, including approximately 40 minutes of exercise on day 28.
"Metformin reduces glucose in the blood and many believe it does so by activating exercise-like pathways," explains Boulé. "As expected, in our study metformin lowered the blood glucose concentrations measured during a two-hour period after lunch. But we found that on the non-exercise day metformin led to better glucose control after lunch than on the day our participants took metformin and exercised."
Boulé thinks that because both metformin and exercise act to lower glucose levels, the combination may have triggered a counter regulatory response by the body to prevent glucose levels dipping too much. "During exercise, glucagon concentrations increased in the blood (a hormone secreted by the pancreas that raises glucose levels) but when we combined exercise and metformin the glucagon levels were almost twice as elevated."
He also said that the combination of metformin and exercise is not always worse than metformin alone. The findings of their study was likely impacted by the timing of meals relative to the exercise session participants underwent and that the intensity of exercise may have had an impact as well, including the fact that these levels were measured after a single bout of exercise as opposed to regular daily exercise.
He also said that the combination of metformin and exercise is not always worse than metformin alone. The findings of their study was likely impacted by the timing of meals relative to the exercise session participants underwent and that the intensity of exercise may have had an impact as well, including the fact that these levels were measured after a single bout of exercise as opposed to regular daily exercise.
"Also surprising is that throughout the day that they exercised, metformin concentrations were higher than on the day that they didn't," says Boulé. The reasons for this are not well understood.
Boulé says despite these findings, "exercise has hundreds of benefits" and should still be an important part of a healthy approach to glucose control for those with diabetes, including those taking metformin.
"What we've learned is that the relationship between exercise and metformin is complex, and this opens the door for more research to examine how different treatments work together, especially because exercise is widely prescribed for people with diabetes and metformin is often the first line drug of choice for treating type 2 diabetes."
Source: Diabetes Care
Researchers at the Joslin Diabetes Center have shown that an enzyme found in the mitochondria of cells is decreased in the skeletal muscle of those with type 2 diabetes, a finding that could lead to the development of drugs to boost the activity of this enzyme in an effort to fight the disease.
A paper in published online today in the Proceedings of the National Academy of Sciences, showed that the enzyme, Sirt3, is decreased in the skeletal muscle of humans and animals with diabetes by at least half, compared to those without diabetes and that this may contribute to development of insulin resistance, one of the earliest manifestations of the disease. Sirt3 is found in the mitochondria, the power producers of cells that convert energy into usable forms.
"Ours is perhaps the first study to understand what is going wrong in the mitochondria of those with diabetes," said senior author C. Ronald Kahn, M.D., Head of the Joslin Section on Integrative Physiology and Metabolism and the Mary K. Iacocca Professor of Medicine at Harvard Medical School. "Many studies have shown that the mitochondria don't work well in those with diabetes. This points to a cause of why they don't work well."
Dr. Kahn said the study sought to look at how decreased Sirt3 levels might affect the metabolism of cells, particularly how it could affect insulin action in cells. "We know that one of the hallmarks of early diabetes is insulin resistance in muscle, but we didn't know what caused it," he said.
He said the study showed that when Sirt3 levels are low, as they are in the case of diabetes, the mitochondria of the cells are not as efficient in energy metabolism as they should be.
When the mitochondria become inefficient, they generate what are known as reactive oxygen species (ROS), chemically reactive molecules containing oxygen, which create insulin resistance in the muscles, he said.
"This is the first time this has been shown," Dr. Kahn said.
The goal for the future will be to find ways to restore levels of Sirt3 or increase the activity of the existing Sirt3, perhaps with a drug, in a bid to improve insulin resistance in the muscle and improve muscle metabolism, he said.
"It is a new target," he said.
Dr. Kahn noted that this study is one of the first demonstrations of a single defect that could affect mitochondrial metabolism and insulin signaling in the muscle.
"In further studies we will try to understand what proteins Sirt3 acts on," he said.
He noted that one of the earliest hallmarks of diabetes is insulin resistance in the skeletal muscle. As a result, a drug to boost Sirt3 levels could be useful in the treatment of prediabetes or in those newly diagnosed with the disease, he said.
"Agents which increase Sirt3 activity could, therefore, potentially reverse at least some of the adverse effects of type 2 diabetes," the paper concludes.
Source: Joslin Diabetes Center
f there's a universal truth in health news lately, it's that being overweight isn't good for your health. Extra weight, especially in the form of fat, can lead to heart disease, diabetes and high blood pressure, among other problems. But a new study hints that being lean doesn't get you entirely off the health hook either. In a genetic analysis involving more than 75,000 people, an international group of scientists led by Ruth Loos at the Medical Research Council in the U.K. found that lean people with a specific genetic variant were at higher risk of developing type 2 diabetes and heart disease despite their lower body fat.
The key, say the scientists, is to focus on not just the amount of fat, but the type of fat that you might have. A growing body of evidence shows that fat deposited just under the skin doesn't contribute that much to the development of metabolic disorders such as diabetes or heart problems. But fat accumulated in deeper tissues and organs, within muscle and embedded in organs like the liver, for example, can put you at greater risk of these diseases. And that goes for lean people too: they might not have much visible fat under the skin, but may be sequestering so-called visceral fat inside their body. What regulates where you store fat? Unfortunately, says Loos, much of it is out of your control - it's largely genetic and gender based. Women tend to store fat under the skin, while men are more likely to deposit it deeper in tissues. As for the genetic factor, in the current study, the researchers identified one variant out of more than 2.5 million candidate sites on the genome linked to body fat. This genetic variant seems to predispose people to depositing visceral fat as opposed to the more benign subcutaneous fat. "We think the gene we found causes an error such that it's harder for these people to store fat under the skin," she says. "So the fat is stored elsewhere, around the organs and in muscle where it disturbs the normal function of these organs."
What surprised the scientists was the power of this genetic abnormality on metabolic factors such as cholesterol and triglyceride levels and insulin resistance. Even people with low body fat but who possessed this version of the gene, consistently had higher levels of blood cholesterol and were more likely to show some resistance to processing insulin, one of the first signs of diabetes. Many of these individuals showed normal body mass index or BMI readings, which assess weight but don't take into account the percentage of body fat. The findings highlight the importance of refining our understanding of the relationship between weight, body fat and disease, says Loos. Many people who look lean may assume they are healthy and may not be as likely to get regular blood tests to check their cholesterol and blood glucose levels. That may put them at higher risk of having a heart attack or suffering from tissue and organ damage due to diabetes because they never knew they were at risk. Getting regular checkups, regardless of your weight, she says, may help more people to stay healthy and avoid diabetes and heart problems.
Source: www.diabetesnews.com
Many Americans suffer from diabetes and hypertension and, according to a study by researchers at the University of Michigan Kellogg Eye Center, these individuals may have an increased risk of developing open-angle glaucoma (OAG).
Joshua D. Stein, M.D., M.S., a glaucoma specialist at Kellogg, led a research team that recently reviewed billing records of more than 2 million people aged 40 and older who were enrolled in a managed care network in the United States and who visited an eye care provider one or more times from 2001 to 2007. The researchers found that people with diabetes alone had a 35 percent increased risk of developing OAG and those with hypertension alone had a 17 percent increased risk. For people with both diabetes and hypertension, there was a 48 percent increased risk of developing OAG, the most common form of glaucoma in the country.
The study focused on the possible associations between various components of metabolic syndrome a collection of conditions that includes obesity, hypertension, diabetes, and hyperlipidemia (high cholesterol and high triglyceride levels) that affects one fifth of the U.S. population. The Kellogg researchers also examined how each component increased or decreased the risk of glaucoma.
While the researchers found that diabetes and hypertension increased the risk of OAG, the study showed that hyperlipidemia actually reduced by 5 percent the risk for developing the disease. Further research is under way to evaluate whether it is the hyperlipidemia itself, the medications used to treat the condition, or both that reduces the risk of glaucoma. Findings from this research may eventually lead to novel treatments for glaucoma.
"Patients who have diabetes and hypertension are already known to be at elevated risk for eye conditions like diabetic retinopathy, a condition that harms the blood vessels in the retina," says Dr. Stein. "This study and others suggest that, for these patients, an increased likelihood of glaucoma is also a concern."
Glaucoma is a leading cause of irreversible blindness worldwide. In the United States, more than 2.2 million individuals have this disease. And, as the U.S. population ages, glaucoma diagnoses are expected to increase. Because OAG symptoms usually don't surface until the disease has progressed, understanding the risks associated with OAG elevated intraocular pressure, positive family history of glaucoma, increased age and non-white race will help physicians identify which patients would benefit most from screening and monitoring.
"This study reinforces the importance of regular eye examinations for patients at increased risk of glaucoma, including those with diabetes and hypertension," says Dr. Stein. "
Source: University of Michigan Health System
The first study to investigate the effect of the breast cancer drug trastuzumab (Herceptin) on heart and vascular function in elderly patients has found that it increases the risk of heart problems, particularly in women with a history of heart disease, diabetes or both.
Authors of the study, published in the cancer journal, Annals of Oncology today [1], looked at records for 45 women aged between 70 and 92 who had been treated with trastuzumab since 2005 and found that 26.7% (12) of the patients developed heart problems caused by the drug - a slightly higher rate than seen in earlier, clinical trials in younger, healthier women. Thirty-three percent of the women with a history of heart disease developed either asymptomatic and symptomatic heart problems as a result of taking trastuzumab, compared to only 9.1% of women without such a history, and 33.3% of women with diabetes developed problems compared to only 6.1% without the condition. When trastuzumab treatment was stopped, all but one of the women recovered fully and five of them were able to re-start the treatment.
Trastuzumab is the current standard of care for women diagnosed with the type of breast cancer that expresses the protein HER2 on the surface of the cancer cells (HER2 positive breast cancer). Although breast cancer is most common in elderly women, clinical trials of trastuzumab have been carried out in younger women, "ideal patients", who have few if any other health-related issues.
Dr César Serrano, who carried out the research while working as a clinical fellow at the Department of Medical Oncology Breast Cancer Centre at the Vall d'Hebron University Hospital in Barcelona, Spain, said: "This is the first study specifically to assess trastuzumab-related cardiac toxicity and the cardiovascular factors that are associated with an increased risk in a selected population of elderly breast cancer patients.
"Trastuzumab is generally well-tolerated and, although there are some concerns about it causing heart problems, until now few risk factors have been identified among patients in clinical trials, most of whom are usually younger than 70 years and have good general health. Our study has demonstrated a significantly increased incidence of cardiac events among patients aged 70 and over with cardiovascular risk factors such as a history of cardiac disease and diabetes.
"Approximately 70% of all newly diagnosed cancers occur in patients older than 65 and, given the expected increase in the absolute number of elderly cancer patients over the coming decades in Western countries, there is an unmet need for information about the efficacy and safety of anti-cancer treatments in daily clinical practice. Data obtained in this report can serve to advise clinicians to be aware of symptomatic and asymptomatic cardiac dysfunction in elderly patients. We think that it is reasonable to refer elderly breast cancer patients to a cardiologist if one or more cardiovascular risk factors are present before or during treatment with trastuzumab. Moreover, a closer surveillance of early symptoms and cardiac function is highly recommended."
Asymptomatic cardiotoxicity is defined as when there are no obvious symptoms of any heart problems, but assessment (usually via scanning or echocardiography) of the function of the heart's left ventricle shows an absolute drop of 10% or more, resulting in a left ventricle ejection fraction (LVEF) of less than 50% of normal its normal function, or an absolute drop of more than 20%. Symptomatic cardiotoxicity, such as congestive heart failure, has obvious physical symptoms such as shortness of breath and swelling limbs.
Out of the 12 patients who developed heart problems, eight developed asymptomatic LVEF decline and four developed symptomatic congestive heart failure. All eight, asymptomatic patients recovered completely after they stopped taking trastuzumab, and then the drug was reintroduced in four patients. Only one of these had a repeat asymptomatic drop in LVEF, which improved without withdrawing the treatment.
"One of the main characteristics of trastuzumab cardiotoxicity is its reversibility. It is a well-known phenomenon that differs from other chemotherapeutic agents such as anthracyclines. Reversibility normally happens with treatment discontinuation, but also can also occur spontaneously," explained Dr Serrano. "The decision to reintroduce trastuzumab, or to continue with it, must be taken case-by-case together with a cardiologist."
Of the four patients who developed symptomatic congestive heart failure, three recovered their cardiac function after discontinuing trastuzumab and receiving standard cardiac therapy, and one was able to restart trastuzumab without any further problems. The fourth woman did not recover cardiac function, showing only a slight improvement and the doctors did not reintroduce any cancer treatment because of this. She died three months later due to progression of her cancer.
Dr Serrano, who is now working as a postdoctoral research fellow at the Brigham and Women's Hospital in Boston, USA, concluded: "It's important to be cautious when interpreting our data given the small number of women involved in the study and the very limited power to detect small differences. However, until safety cardiac data in elderly patients receiving trastuzumab becomes available from prospective clinical trials, this study may contribute to identifying those elderly women with breast cancer who are most likely to develop heart problems during treatment with trastuzumab."
source: www.medicalnewstoday.com
Scientists in the UK have identified a link between coeliac disease, a food intolerance disorder, and type 1 diabetes.
The study, partly funded by the Juvenile Diabetes Research Foundation (JDRF), showed that both conditions shared a common genetic origin, which suggested that they may also be brought on by similar environmental factors. This lead the researchers to claim that the protein gluten, which is known to cause coeliac disease, could also be a trigger for type 1 diabetes.
The research, carried out by the University of Cambridge, Barts and the London School of Medicine and Dentistry and which was published in the New England Journal of Medicine, showed that both conditions are due to a malfunctioning immune system. It examined data from almost 20,000 tissue samples in order to monitor genetic similarities between the two conditions, and found seven chromosome regions that are shared.
These regions may help regulate the immune system in attacking the beta cells in both the pancreas and the small intestine, although further research is needed to identify how genetic and environmental factors combine to trigger the conditions.
One of the researchers, David van Heel, commented "These findings suggest common mechanisms causing both coeliac and type 1 diabetes – we did not expect to see this very high degree of shared genetic risk factors."
source: www.diabetes.co.uk
Newly diagnosed type 2 diabetics tend to have one thing in common: obesity. Exactly how diet and obesity trigger diabetes has long been the subject of intense scientific research. A new study led by Jamey D. Marth, Ph.D., director of the Center for Nanomedicine, a collaboration between the University of California, Santa Barbara and Sanford-Burnham Medical Research Institute (Sanford-Burnham), has revealed a pathway that links high-fat diets to a sequence of molecular events responsible for the onset and severity of diabetes. These findings were published online August 14 in Nature Medicine.
In studies spanning mice and humans, Dr. Marth's team discovered a pathway to disease that is activated in pancreatic beta cells, and then leads to metabolic defects in other organs and tissues, including the liver, muscle and adipose (fat). Together, this adds up to diabetes.
"We were initially surprised to learn how much the pancreatic beta cell contributes to the onset and severity of diabetes," said Dr. Marth."The observation that beta cell malfunction significantly contributes to multiple disease signs, including insulin resistance, was unexpected. We noted, however, that studies from other laboratories published over the past few decades had alluded to this possibility."
In healthy people, pancreatic beta cells monitor the bloodstream for glucose using glucose transporters anchored in their cellular membranes. When blood glucose is high, such as after a meal, beta cells take in this additional glucose and respond by secreting insulin in a timed and measured response. In turn, insulin stimulates other cells in the body to take up glucose, a nutrient they need to produce energy.
In this newly discovered pathway, high levels of fat were found to interfere with two key transcription factors - proteins that switch genes on and off. These transcription factors, FOXA2 and HNF1A, are normally required for the production of an enzyme called GnT-4a glycosyltransferase that modifies proteins with a particular glycan (polysaccharide or sugar) structure. Proper retention of glucose transporters in the cell membrane depends on this modification, but when FOXA2 and HNF1A aren't working properly, GnT-4a's function is greatly diminished. So when the researchers fed otherwise normal mice a high-fat diet, they found that the animals' beta cells could not sense and respond to blood glucose. Preservation of GnT-4a function was able to block the onset of diabetes, even in obese animals. Diminished glucose sensing by beta cells was shown to be an important determinant of disease onset and severity.a
"Now that we know more fully how states of over-nutrition can lead to type 2 diabetes, we can see more clearly how to intervene," Dr. Marth said. He and his colleagues are now considering various methods to augment beta cell GnT-4a enzyme activity in humans, as a means to prevent and possibly cure type 2 diabetes.
"The identification of the molecular players in this pathway to diabetes suggests new therapeutic targets and approaches towards developing an effective preventative or perhaps curative treatment," Dr. Marth continued. "This may be accomplished by beta cell gene therapy or by drugs that interfere with this pathway in order to maintain normal beta cell function."
In the United States, more than 24 million children and adults - nearly eight percent of the population - have diabetes. In adults, type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes. This study was primarily funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH). Co-authors of this study include Kazuaki Ohtsubo at Sanford-Burnham and Mark Z. Chen and Jerrold M. Olefsky from the University of California, San Diego.
source: Sanford-Burnham Medical Research Institute
ust two rashers of bacon a day can increase the risk of diabetes by more than 50 per cent, scientists claim.
Eating a single sausage, small burger or a few slices of salami every day drastically raises the chances of developing the illness.
Research has found that just 100g of red meat every day – or half a normal size steak – increases the likelihood of type 2 diabetes by a fifth.
But they found that processed meat, including products made from mince and cold meats such as ham and salami, had a far greater effect.
Just 50g a day, the equivalent of two slices of bacon, one sausage or one small burger, increases the risk by more than 50 per cent.
At least 2.5million Britons suffer from type 2 diabetes, the form linked to obesity, and experts suspect a further million have the condition but have not yet been diagnosed.
It occurs when their body does not produce enough of the hormone insulin to control its blood sugar levels.
Symptoms of type 2 diabetes include feeling very thirsty, needing to go to the toilet and constant tiredness.
Although the illness is treatable with tablets and injections, it can cause serious complications including blindness, kidney failure, heart attacks and strokes.
Researchers at Harvard University looked at the health records and diets of more than 440,000 men and women spanning a period of between 14 and 28 years.
The study, published in the American Journal of Clinical Nutrition, found that people who ate 100g of red meat a day were 19 per cent more likely to develop type 2 diabetes.
And those who had 50g of processed meat every day – one sausage or frankfurter or two slices of bacon – increased their risk by 51 per cent.
But the scientists found that those who normally eat one portion of red meat a day could lower their risk by a fifth if they ate other proteins including nuts, low fat cheese or brown rice instead.
There is now widespread evidence that red meat drastically increases the likelihood of major health problems including heart disease, strokes and some types of cancer.
The Department of Health has issued guidelines saying adults should eat no more than 500g of red meat a week. This amounts to three sausages, one small steak, one quarter-pounder and three slices of lamb.
Until now, however, there was little evidence that relatively small amounts of processed red meat could increase the chance of diabetes.
The researchers say the risks posed by eating too much red meat are now known to be so great that the public should be advised to cut back and eat poultry, fish and pulses instead.
But Dr Iain Frame from Diabetes UK, said: ‘Based on analysis of previous studies, this research simply suggests eating a daily portion of red meat may increase someone’s risk of developing Type 2 diabetes.
‘The suggested increased risk is small so people should not be afraid of eating red meat as part of a healthy balanced diet.’
source: www.dailymail.co.uk
Type 2 diabetes patients, who face higher risk of cardiovascular disease, often take a combination of medications designed to lower their LDL or "bad" cholesterol and triglyceride levels while raising their HDL or "good" cholesterol because doctors long have thought that taken together, the drugs offer protection from heart attacks and improve survival.
But in a commentary in the current New England Journal of Medicine, a trio of doctors who served on a recent Food and Drug Administration panel that evaluated the drugs' effectiveness says the commonly prescribed medications have not been proven successful at preventing heart attacks in Type 2 diabetes patients with elevated cholesterol.
The drugs, called fibrates, seek to lower blood triglyceride levels and raise the amount of HDL cholesterol. They often are prescribed to diabetes patients as an add-on to statins, drugs that lower LDL cholesterol. Annual sales in the U.S. for the three fibrates now approved by the FDA gemfibrozil (Lopid), fenofibrate (Tricor) and fenofibric acid (Trilipix) amount to billions of dollars.
"There have been few studies regarding the clinical outcome efficacy of fibrates," said Sanjay Kaul, MD, a commentary author and director of the Cardiology Fellowship Training Program at the Cedars-Sinai Heart Institute. "Thousands and thousands of Americans take fibrates every day but so far, there are no long-term studies showing that fibrates lower cardiovascular risk or improve survival among diabetes patients who are also on statins."
The commentary calls for more studies. Meantime, the authors suggest that doctors prescribe the statin-fibrate combination only to diabetic patients at high risk for a heart attack and only after optimal control of LDL cholesterol has been achieved with statin treatment.
Source: Cedars-Sinai Medical Center
Type 2 diabetes and obesity in pregnancy is a daunting duo, according to new research published this month in The Journal of Maternal-Fetal and Neonatal Medicine. The study shows that both conditions independently contribute to higher risks, opening the door to a wide range of pregnancy, delivery and newborn complications.
Study authors say the findings are important because obesity and type 2 diabetes are skyrocketing in women of childbearing age. A study in The Journal of the American Medical Association reports that between 2007 and 2008 the prevalence of obesity among adult women in the United States was more than 35 percent. A report from the Centers for Disease Control and Prevention states that approximately 11 percent of women above the age of 20 had diabetes in 2010.
Loralei Thornburg, M.D., senior study author and a high-risk pregnancy expert at the University of Rochester Medical Center, emphasizes that the research is needed now more than ever. "We've never seen the degree of obesity and type 2 diabetes in women that we are seeing right now, because for a very long time diabetes was a disease of an older population, so we rarely dealt with it in prenatal care. We hope this new knowledge will help physicians better understand and care for this rapidly expanding group of high-risk women."
While numerous studies have established that obesity, in the absence of diabetes, is associated with problems in pregnancy - preterm birth, birth trauma, blood loss and a prolonged hospital stay, to name a few - less is known about type 2 diabetes and what causes difficulties when the two conditions coexist. Researchers from Rochester wanted to determine if obesity alone accounts for the increased risks in this "dual-diagnosis" group, or if diabetes plays a role as well.
To determine the influence of obesity and type 2 diabetes when the conditions coexist in pregnancy, Thornburg and lead study author Kristin Knight, M.D., used clinical records and the hospital's birth certificate database to identify 213 pairs of women who delivered babies at the Medical Center between 2000 and 2008. Each pair included a diabetic and a non-diabetic patient with approximately the same pre-pregnancy body mass index (BMI). The majority of women in the study were overweight, obese or morbidly obese.
"We matched the pairs pound for pound, because if obesity was the main problem, we'd see similar outcomes between women, whether they had diabetes or not. But if we saw different outcomes between pairs, we'd know the diabetes was impacting outcomes as well," said Thornburg.
Using mathematical models and controlling for outside factors, such as age and tobacco use, researchers found that the patients with type 2 diabetes had overall worse pregnancy, delivery and newborn outcomes than their BMI-matched counterparts. Specifically, diabetic patients had higher rates of preeclampsia, cesarean delivery, shoulder dystocia, preterm delivery, large for gestational age infant, fetal anomaly and admission to the neonatal intensive care unit.
"Women and their physicians need to be aware that each condition on its own increases risk in pregnancy, so when they coexist the situation is even more worrisome," said Knight, a maternal fetal medicine fellow at Rochester. "Pregnancy is a time of great change, and fortunately many women are very open to making modifications during this period in their life. Anything a woman can do to improve her condition, from controlling blood sugar and exercising, to eating nutritious foods and maintaining an optimal weight, will help her deliver a healthier baby."
Knight originally focused her research on the effects of type 1 and type 2 diabetes on pregnancy. In a previous study, she found that women with type 2 diabetes, most of whom were also obese, had poorer outcomes. Consequently, her research turned to obese, type 2 diabetics and their experiences in pregnancy.
"If a woman enters pregnancy obese, but hasn't developed type 2 diabetes, she is in a better place than if she had both," concluded Thornburg.
In addition to Knight and Thornburg, Eva K. Pressman, M.D., and David N. Hackney, M.D., from the Medical Center, also participated in the research.
Source: Emily Boynton, University of Rochester Medical Center
Up to 30 percent of all patients develop diabetes mellitus within the first year after a kidney transplantation. This high rate could soon fall rapidly. A Medical University of Vienna research team at Vienna General Hospital's University Department of Internal Medicine III has discovered in the context of a study that pre-emptive insulin therapy drastically reduces this rate.
"We give the patients insulin immediately after the transplant even before diabetes mellitus occurs. The new thing about this is that we are giving insulin to non-diabetics and are hereby treating patients preventatively", explains Marcus Säemann from the Clinical Department of Nephrology and Dialysis. This has been a success; in a group of 25 patients who were treated with insulin therapy for the three months immediately following a transplant, the risk of developing diabetes could be reduced by around 75 percent. In the control group, which had been treated according to current care standards over the same period, over 45 percent developed diabetes within one year of the transplant. Manfred Hecking, study supervisor says, "This is sensational data that we have obtained from thousands of blood sugar measurements."
A multicenter study managed by MedUni Vienna
The first results of the study also received such great international attention that the MedUni Vienna could attract the University of Michigan (USA) as a cooperation partner. From the end of 2011 the results shall be expanded upon in a multicenter study sponsored by the US National Institutes of Health (NIH). The three to five year Vienna study shall be coordinated under the leadership of Säemann and Hecking, and further centres in Europe, for example in France, Spain, Italy and Germany, shall take part.
Diabetes mellitus in the first year following a transplant is predominantly caused by the stress from the operation and the initially high dose of the immunosuppression which is necessary to prevent acute rejections. Säemann says, "The patient shall be, so to say, swept away from a wave of acute disease." New onset diabetes following a transplant significantly reduces the patient's life expectancy and their quality of life. Furthermore it also reduces the life of the transplant. Until now this specific form of diabetes could not be treated effectively nor avoided. "Our study is a great advance for transplant medicine generally." Currently around 1,100 patients are being treated as outpatients following a kidney transplant at the Vienna General Hospital.
Sources: Medical University of Vienna, AlphaGalileo Foundation
Hydrogen sulfide is a foul-smelling gas with an odor resembling that of rotten eggs. Sometimes called "swamp gas," this toxic substance is generally associated with decaying vegetation, sewers and noxious industrial emissions. And - as odd as it may seem - it also plays a critical role in protecting blood vessels from the complications of diabetes, according to a new study from the University of Texas Medical Branch at Galveston.
In the last few years, work from several laboratories has shown that hydrogen sulfide is produced by the body in small amounts, and that this gas plays important roles in the circulatory system. In their new paper, published in the online early edition of the Proceedings of the National Academy of Sciences, the UTMB researchers describe experiments with human endothelial cells (cells from the innermost layer of blood vessels) and diabetic rats that demonstrate the importance of hydrogen sulfide levels in determining whether diabetes will lead to blood vessel complications.
Dr. Szabo's team started by exposing endothelial cells to sugar at a concentration that mimicked a level found in the blood vessels of someone with diabetes. "Upon exposure to such high sugar levels, the cells started to produce increasing amounts of highly reactive toxic free radicals, and as a consequence, they began to die," said Dr. Csaba Szabo, a UTMB professor and the paper's lead author. "Low hydrogen sulfide levels accelerated this process, while constant replacement of hydrogen sulfide protected the cells against the toxic effects of high sugar."
The researchers went on to show that diabetic rats have lower levels of hydrogen sulfide in their circulatory systems than other animals. Furthermore, the team showed that treating diabetic rats for a month with hydrogen sulfide improved the function of their blood vessels.
"The loss of endothelial cell function in diabetes is a first step that leads to many complications, such as eye disease, heart disease, kidney disease, foot disease and others," Szabo said. "The observation that hydrogen sulfide can control an early checkpoint in all of these processes may open the door for new therapies."
The National Institutes of Health, the Juvenile Diabetes Foundation and the Shriners Hospital for Children supported this research.
Source: University of Texas Medical Branch at Galveston
Research published in The Cochrane Library found that the risk of death and cardiovascular disease, such as stroke, was unchanged whether glucose control was intense or conventional. They did find, however, that when aiming to keep blood glucose levels at the lower intensive level, the chance of damaging small blood vessels in the body, potentially leading to damage in the eyes and kidneys, is reduced. But aiming for this lower level with the more intensive glucose control substantially increased the risk that a person's blood glucose could drop too low, potentially resulting in loss of consciousness or even death if untreated.
Bianca Hemmingsen and colleagues from the Copenhagen Trial Unit in Denmark reached these conclusions after studying all published clinical trials comparing intensive glycaemic control with conventional glycaemic control. They identified 20 trials on patients with type 2 diabetes that together involved a total of 29,986 participants.
Keeping blood glucose levels under control is the goal of all treatments for people with type 2 diabetes. There is an active debate between experts about the level of blood glucose that patients should aim for. Some argue that they should aim to keep blood glucose about or slightly above normal, and thereby avoid the risks of too low blood glucose, what doctors call hypoglycaemia. Others think patients should use a more intensive control that keeps blood glucose at the lower levels seen in non-diabetic people so that they avoid the risks associated with having too much blood glucose hyperglycaemia.
The researchers did not find enough information to properly compare quality of life between people who aimed for the two different targets. However, Hemmingsen and colleagues hypothesized that intensive glycaemic control may negatively affect a person's quality of life when compared with aiming for conventional levels. "Targeting the intensive levels means that many patients have to cope with complex and time consuming treatment. On top of this, they have the fear that their blood glucose might drop too low," says Hemmingsen.
In most people, cells in their pancreas monitor blood glucose and release precise amounts of the glucose-regulating hormone insulin so that the glucose level is maintained. In people with type 2 diabetes, this insulin regulating system fails. These people have to manage their own glucose levels through a mixture of exercise, weight control, diet and the use of a range of different medications.
"With the numbers of people in the world with type 2 diabetes increasing, it is important that we work out the best way of helping them to manage their blood glucose levels," says Hemmingsen. She believes that there is still a clear need for large clinical trials investigating patient-relevant outcomes that randomly assign patients to clearly defined different glycaemic targets.
Sources: Wiley-Blackwell, AlphaGalileo Foundation
Obesity is the main culprit in the worldwide avalanche of type 2 diabetes. But how excess weight drives insulin resistance, the condition that may lead to the disease, is only partly understood. Scientists at Joslin Diabetes Center now have uncovered a new way in which obesity wreaks its havoc, by altering the production of proteins that affect how other proteins are spliced together. Their finding, published in Cell Metabolism, may point toward novel targets for diabetes drugs.
Scientists in the lab of Mary-Elizabeth Patti, M.D., began by examining the levels of proteins in the livers of obese people, and finding decreases in number for certain proteins that regulate RNA splicing.
"When a gene is transcribed by the cell, it generates a piece of RNA," explains Dr. Patti, who is also an Assistant Professor of Medicine at Harvard Medical School. "That piece of RNA can be split up in different ways, generating proteins that have different functions."
"In the case of these proteins whose production drops in the livers of obese people, this process changes the function of other proteins that can cause excess fat to be made in the liver," she adds. "That excess fat is known to be a major contributor to insulin resistance."
Additionally, the researchers showed that these RNA splicing proteins are diminished in samples of muscle from obese people.
The investigators went on to examine a representative RNA-splicing protein called SFRS10 whose levels drop in muscle and liver both in obese people and in over-fed mice. Working in human cells and in mice, they demonstrated that SFRS10 helps to regulate a protein called LPIN1 that plays an important role in synthesizing fat. Among their results, mice in which they suppressed production of SFRS10 made more triglycerides, a type of fat circulating in the blood.
"More broadly, this work adds a novel insight into how obesity may induce insulin resistance and diabetes risk by changing critical functions of cells, including splicing," says Dr. Patti. "This information should stimulate the search for other genes for which differences in splicing may contribute to risk for type 2 diabetes. Ultimately, we hope that modifying these pathways with nutritional or drug therapies could limit the adverse consequences of obesity."
Source: Joslin Diabetes Center
Obesity is the main culprit in the worldwide avalanche of type 2 diabetes. But how excess weight drives insulin resistance, the condition that may lead to the disease, is only partly understood. Scientists at Joslin Diabetes Center now have uncovered a new way in which obesity wreaks its havoc, by altering the production of proteins that affect how other proteins are spliced together. Their finding, published in Cell Metabolism, may point toward novel targets for diabetes drugs.
Scientists in the lab of Mary-Elizabeth Patti, M.D., began by examining the levels of proteins in the livers of obese people, and finding decreases in number for certain proteins that regulate RNA splicing.
"When a gene is transcribed by the cell, it generates a piece of RNA," explains Dr. Patti, who is also an Assistant Professor of Medicine at Harvard Medical School. "That piece of RNA can be split up in different ways, generating proteins that have different functions."
"In the case of these proteins whose production drops in the livers of obese people, this process changes the function of other proteins that can cause excess fat to be made in the liver," she adds. "That excess fat is known to be a major contributor to insulin resistance."
Additionally, the researchers showed that these RNA splicing proteins are diminished in samples of muscle from obese people.
The investigators went on to examine a representative RNA-splicing protein called SFRS10 whose levels drop in muscle and liver both in obese people and in over-fed mice. Working in human cells and in mice, they demonstrated that SFRS10 helps to regulate a protein called LPIN1 that plays an important role in synthesizing fat. Among their results, mice in which they suppressed production of SFRS10 made more triglycerides, a type of fat circulating in the blood.
"More broadly, this work adds a novel insight into how obesity may induce insulin resistance and diabetes risk by changing critical functions of cells, including splicing," says Dr. Patti. "This information should stimulate the search for other genes for which differences in splicing may contribute to risk for type 2 diabetes. Ultimately, we hope that modifying these pathways with nutritional or drug therapies could limit the adverse consequences of obesity."
Source: Joslin Diabetes Center
n interactive computer software program appears to be effective in helping patients manage their Type 2 diabetes using their mobile phones, according to a new study by University of Maryland School of Medicine researchers. The study is being published in the September issue of the journal Diabetes Care. The study, one of the first to scientifically examine mobile health technology, found that a key measure of blood sugar control - the amount of hemoglobin A1c in a person's blood - was lowered by an average of 1.9 percent over a period of one year in patients using the mobile health software. The findings support the further exploration of mobile health approaches to manage many chronic conditions, including diabetes.
"These results are very encouraging," says Charlene C. Quinn, Ph.D., R.N., an assistant professor of epidemiology and public health at the University of Maryland School of Medicine and the principal investigator. "The 1.9 percent decrease in A1c that we saw in this research is significant. Previous randomized clinical trials have suggested that just a 1 percent decrease in A1c will prevent complications of diabetes, including heart disease, stroke, blindness and kidney failure."
The study indicates that using mobile phones, the Internet and other mobile communications technology to keep patients healthy may have broad applications to help patients and their physicians manage many health conditions.
"Mobile health has the potential to help patients better self-manage any chronic disease, not just diabetes," Dr. Quinn explains. "This is one of the first large, reported, randomized clinical studies examining the mobile health industry, which is rapidly growing. The U.S. Food & Drug Administration just last month released draft guidance on how it intends to regulate the field. Our results can help define the science behind this new strategy for disease management."
People with Type 2 diabetes either do not produce enough insulin to convert sugar into energy or their cells ignore the insulin. A key measure of blood sugar control is the amount of hemoglobin A1c in a person's blood. A1c is a molecule in red blood cells that binds itself to blood sugar. The higher the level of sugar in the blood, the higher the level of A1c.
An A1c test provides a snapshot of a patient's average daily blood glucose levels over the previous two to three months. The American Diabetes Association recommends that a person's A1c be less than 7 percent. Most Americans with Type 2 diabetes have an average level of more than 9 percent, which greatly increases their risk for complications.
"We tell patients that they can meet these goals if they eat a healthy diet, exercise daily and take their medication as directed, but we don't really give them the tools to do that," says Dr. Quinn.
The yearlong study enrolled 163 patients with the help of 39 primary care doctors in Baltimore County, Baltimore City, Montgomery County and Anne Arundel County. Patients were divided into four groups based on the research assignment of their physician. Three patient groups received mobile phones loaded with the diabetes management software and the fourth group served as a control group. All patients in the study received a free blood glucose meter and testing supplies.
The software examined in the research provided real-time feedback on patients' blood sugar levels, displayed medication regimens and served as a "virtual coach." A patient's blood sugar test results were sent wirelessly from a blood glucose monitor to the mobile phone. If the level was too low or too high, the software on the phone prompted the person to take steps to correct it. The system also analyzed blood sugar levels and other patient information and sent computer-generated logbooks and suggested treatment plans to the patients' primary care doctor.
Source: University of Maryland Medical Center
A recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM) found that the greater an individual's total muscle mass, the lower the person's risk of having insulin resistance, the major precursor of type 2 diabetes.
With recent dramatic increases in obesity worldwide, the prevalence of diabetes, a major source of cardiovascular morbidity, is expected to accelerate. Insulin resistance, which can raise blood glucose levels above the normal range, is a major factor that contributes to the development of diabetes. Previous studies have shown that very low muscle mass is a risk factor for insulin resistance, but until now, no study has examined whether increasing muscle mass to average and above average levels, independent of obesity levels, would lead to improved blood glucose regulation.
"Our findings represent a departure from the usual focus of clinicians, and their patients, on just losing weight to improve metabolic health," said the study's senior author, Preethi Srikanthan, MD, of the University of California, Los Angeles (UCLA). "Instead, this research suggests a role for maintaining fitness and building muscle. This is a welcome message for many overweight patients who experience difficulty in achieving weight loss, as any effort to get moving and keep fit should be seen as laudable and contributing to metabolic change."
In this study, researchers examined the association of skeletal muscle mass with insulin resistance and blood glucose metabolism disorders in a nationally representative sample of 13,644 individuals. Participants were older than 20 years, non-pregnant and weighed more than 35 kg. The study demonstrated that higher muscle mass (relative to body size) is associated with better insulin sensitivity and lower risk of pre- or overt diabetes.
"Our research shows that beyond monitoring changes in waist circumference or BMI, we should also be monitoring muscle mass," Srikanthan concluded. "Further research is needed to determine the nature and duration of exercise interventions required to improve insulin sensitivity and glucose metabolism in at-risk individuals."
Also working on the study was Arun Karlamangla, PhD, MD, of the David Geffen School of Medicine at UCLA.
The article, "Relative muscle mass is inversely associated with insulin resistance and pre-diabetes. Findings from The Third National Health and Nutrition Examination Survey," appears in the September 2011 issue of JCEM.
Source: Endocrine Society
Menopause has little to no impact on whether women become more susceptible to diabetes, according to a one-of-a-kind study.
Postmenopausal women had no higher risk for diabetes whether they experienced natural menopause or had their ovaries removed, according to the national clinical trial of 1,237 women at high risk for diabetes, ages 40 to 65.
"In our study, menopause had no additional effect on risk for diabetes," says study lead author Catherine Kim, M.D., M.P.H., an associate professor of internal medicine and obstetrics and gynecology at the University of Michigan Health System. "Menopause is one of many small steps in aging and it doesn't mean women's health will be worse after going through this transition."
Kim and colleagues in the Diabetes Prevention Program Research Group will publish their results in the August issue of Menopause.
The findings also shed light on the impact of diet and exercise and hormone replacement therapy on the health of postmenopausal women.
Previous evidence has suggested that menopause would speed the progression to diabetes because postmenopausal women have relatively higher levels of the hormone testosterone, which is considered a risk factor for diabetes. But the recent study shows healthy outcomes for postmenopausal women.
The women in the study were enrolled in the Diabetes Prevention Program, a clinical trial of adults with glucose intolerance, meaning tests show their body's struggle to process glucose, or blood sugar, into energy.
Glucose intolerance is often a pre-stage to diabetes, a condition common later in life and is diagnosed when the body has abnormally high levels of blood sugar. Age, weight, physical activity and family history can contribute to type 2 diabetes.
But Diabetes Prevention Program researchers have shown lifestyle intervention and the blood sugar-lowering drug metformin can prevent diabetes in those with glucose intolerance. The interventions work well in women who have gone through menopause.
Menopause is the end of monthly periods and chance for pregnancy and estrogen production by the ovaries stops. In the United States, menopause happens around age 51 or 52.
The research is considered the only menopause study that specifically analyzed the impact of diabetes on women who had natural menopause and those who had their ovaries removed. Most other studies mixed them together or excluded one group.
According to the new study, for every year 100 women were observed, 11.8 premenopausal women developed diabetes, compared to 10.5 among women in natural menopause and 12.9 cases among women who had their ovaries removed.
However for women whose estrogen production ended as a result of having their ovaries removed, and engaged in lifestyle changes, cases of diabetes were extremely low. For every year 100 of these women were observed, only 1.1 women developed diabetes.
Lifestyle changes included losing 7 percent of their body weight and exercising for at least 150 minutes a week. For instance, a 180-pound postmenopausal woman would see benefits from losing 12.6 pounds.
The results among this group were surprising considering almost all of the women who had their ovaries removed were on hormone replacement therapy, a regime that women and doctors fear puts them at risk for a host of health issues. Study authors say more research is needed on the role of hormone therapy and diabetes risk.
"Physicians can be empowered to tell women that lifestyle changes can be very effective, and that menopause does not mean that they have a higher risk of diabetes," Kim says.
Source: Shantell M. Kirkendoll, University of Michigan Health System
Better data are needed to evaluate access to care by minority groups at increased risk for diabetes, such as older African Americans, and to assess the benefits of new community-based treatment strategies, including greater use of health information technology and access to multilevel diabetes education teams, according to a report in Population Health Management, the Official Journal of The Care Continuum Alliance, a peer-reviewed journal published by Mary Ann Liebert, Inc. The article is available free online.
Older adults of racial or ethnic minority descent tend to have a higher incidence of diabetes than whites, and these populations often have less access to quality health care. Karen Fitzner, PhD, American Association of Diabetes Educators (Chicago, IL), David Dietz, MSW, MHSA, U.S. Department of Health and Human Services (Rockville, MD), and Ernest Moy, MD, MPH, Agency for Healthcare Research and Quality (Rockville, MD) identify the gaps in care for underserved older adults and describe how better use of health information technology and multilevel diabetes education teams can help fill those gaps and improve health outcomes for older African Americans with diabetes.
The authors focus on treatment models that incorporate advances in information technology such as telehealth and geo-mapping for improved data sharing, Diabetes Self-Management Education and Training (DSME/T) programs, national collaboratives, and a multilevel diabetes education team approach that relies on less-skilled team members such as community health workers, supervised and supported by a multidisciplinary team of professional health care providers to facilitate community-based diabetes care, education, and prevention.
"We are thrilled to continue to publish critically important papers such as this one," says Journal Editor-in-Chief David B. Nash, MD, MBA, Dean, Jefferson School of Population Health (Philadelphia, PA).
Source: Vicki Cohn, Mary Ann Liebert, Inc./Genetic Engineering News
Diabetes rate increases in status Aboriginal adults in Alberta appear to be slowing compared with the general population, although diabetes is more common in status Aboriginals and death rates for this group are significantly higher than the general population, states an article in CMAJ (Canadian Medical Association Journal). Death rates have in fact remained unchanged for status Aboriginals who do not have diabetes.
Diabetes is increasing in virtually all populations world-wide. It is common in Aboriginals in Canada, with estimated rates of type 2 diabetes and its complications two to five times higher than in the general population. Most information available regarding diabetes in Aboriginals concerns status Aboriginals (First Nations) as opposed to Métis or Inuit peoples, about whom much less is known, and most of the information is static. There is little data on the long-term diabetes trends in Aboriginal populations.
Aboriginal and non-Aboriginal researchers at the University of Alberta and Calgary sought to compare the incidence and prevalence of diagnosed diabetes in adult status Aboriginals and the general adult population in Alberta between 1995 and 2007. They also looked at mortality from any cause in those with and without diabetes. In 2007, there were 2 506 420 adults living in Alberta, including 72 725 Status Aboriginals, with 161 268 cases of diabetes and 7055 respectively. Diabetes rates were higher for status Aboriginals than the general population but over time the increase in diabetes prevalence for status Aboriginals was less than that of the general population.
"Increases in the prevalence and incidence of diabetes from 1995 to 2007 were less pronounced in the Aboriginal population than in the general population," writes PhD student Richard Oster, University of Alberta, with coauthors. However, Oster does note that among status Aboriginals diabetes was increasing more quickly in men than in women.
Over the same period mortality rates in all people with diabetes were decreasing and the rates of decrease were not different between status Aboriginals and the general population. However, mortality rates for status Aboriginals were 1.5 to 2 times higher than that of the general population, and in those without diabetes the mortality rate gap was increasing.
"The decreases in mortality observed among status Aboriginal adults with diabetes over the study period are consistent with findings from a recent study of ours showing improved diabetes-related health among status Aboriginal adults in Alberta," says Dr. Ellen Toth, the lead investigator. She adds, "the growing divergence in mortality observed between status Aboriginals and the general population without diabetes is sadly in contrast to national trends from 1980 to 2001, which showed an improvement in life expectancy among registered Indians, from 60.9 to 70.4 years among men and from 68.0 to 75.5 years among women."
The study also noted lower diabetes rate differences between Status Aboriginals and the general population in Alberta compared with Saskatchewan, Manitoba and Ontario, although the study does not explain the differences between rates.
The researchers suggest more research is necessary to understand lower rates of diabetes differences in Status Aboriginals in Alberta compared with other provinces as well as the unchanged or increasing mortality rate over 12 years in Status Aboriginals without diabetes.
Surgeons at NewYork-Presbyterian Hospital/Columbia University Medical Center are innovating new ways to treat diabetes using techniques from weight-loss surgery, including experimental procedures to improve blood glucose levels and address a major complication of the disease.
Sleeve Gastrectomy Corrects Diabetes Complication
NewYork-Presbyterian/Columbia may be the first to use sleeve gastrectomy -- a surgical technique first developed for weight-loss surgery -- in the treatment of gastroparesis, a diabetes-related condition in which the stomach is unable to empty its contents into the intestines. Early results have been promising.
Because patients with gastroparesis cannot move food properly through their digestive system, they may experience symptoms including pain, nausea, vomiting, abdominal bloating and malnutrition. Although a number of conditions may cause gastroparesis, by far the most common is diabetes. In this case, continued high blood sugar levels damage the vagus nerve, which controls the movement of food through the digestive tract.
Conventional treatments may include medical therapies, dietary changes and implantation of a gastric electrical stimulator, or "gastric pacemaker," a device that helps to control nausea and vomiting. If all of these fail to help, however, patients may have no choice but to receive nutrients through feeding tubes.
When four patients with gastroparesis were unable to receive gastric pacemakers, surgeons at NewYork-Presbyterian/Columbia performed sleeve gastrectomy to see if it might help.
The technique, also known as a gastric sleeve or vertical or longitudinal gastrectomy, reduces the stomach to approximately 30 percent of its original size, explains Dr. Melissa Bagloo, who leads the gastroparesis program at NewYork-Presbyterian/Columbia and is assistant professor of clinical surgery at Columbia University College of Physicians and Surgeons.
According to Dr. Bagloo, "We had previously observed that after sleeve gastrectomy, patients who had difficulty emptying their stomachs showed significant improvement in their digestion. We do not know precisely why this is: Sleeve gastrectomy may have the effect of 'resetting' the natural gastric pacemaker, or it may be that the smaller size of the stomach increases intragastric pressure so that it helps facilitate gastric emptying. There could also be other reasons why the surgery helps."
The four patients who underwent sleeve gastrectomy in 2010 all had diabetes with severe gastroparesis. For various reasons, they were not eligible to receive a gastric pacemaker. After surgery, two of the patients did very well right away, and the other two needed nutritional support for several months. "At six months after surgery, all four were eating and drinking and were no longer experiencing nausea or vomiting. For patients who faced the prospect of lifelong feeding tubes, the benefits of such a successful outcome cannot be overstated," says Dr. Bagloo.
Neutrons have shown how massive enzyme complexes inside cells might determine whether sugar is burnt for energy or stored as fat. These findings will improve understanding of diabetes and a range of metabolic diseases.
Scientists using neutrons at the Institut Laue-Langevin (ILL) have shown how pyruvate dehydrogenase complexes (PDCs) could control the rate of sugar metabolism by actively changing their own composition. The research is published in the Biochemical Journal.
PDCs are found within all cell types from bacteria to mammals and are known to help regulate the level of sugar in the blood to meet the continuously changing metabolic demands of the body. The complexes have a unique, football-shaped central scaffold, forming a hollow ball with 12 open pentagonal faces. They are composed of 60 subunits made up of two related proteins. The first is a scaffolding enzyme that acts as the structural heart of the complex, whilst the second has binding role with a third enzyme (attached to the outside of the central football) to generate rapid metabolism.
Whilst the structure of the complex is well understood [1], the exact composition was undetermined. Most previous purification studies had suggested a ratio of 48 scaffold enzyme units to 12 binding units.
The team at the ILL synthesised human PDC in bacteria and identified the location of the two enzymes through low angle neutron scattering. This revealed a new, unexpected ratio of 40:20 in favour of the scaffold enzyme. However experiments on PDCs from cow heart cells confirmed the expected figure of 48:12.
With further mathematical modelling the team have shown that their synthesised PDC could vary its composition, with any ratio from 60:0 to 40:20 possible. This flexibility may explain why the PDC complex is so quick to react to changes in blood sugar levels, says Dr Phil Callow, an instrument scientist at ILL. "Our models show how the structural organisation of PDC could be fine-tuned through changes in its overall composition to promote maximal metabolic efficiency." These findings could provide vital information for future treatments of diseases caused by unusual blood sugar levels such as diabetes and those directly related to mutations in the PDC such as Biliary cirrhosis, a progressive form of liver inflammation.
Professor Gordon Lindsay, University of Glasgow: "Using neutron scattering at ILL, we have shown the potential of these football structures to vary their composition to allow the most efficient utilisation of sugars by the body and enables precise control of sugar breakdown. The next step is to see if this occurs naturally across different tissues of the body and in different living organisms."
Andrew Harrison, ILL's Director for Science: "ILL has a proud history carrying out fundamental research that underpins medical breakthroughs and potential new treatments. The PDC complexes studied by Dr Callow and his colleagues are too large for most other techniques. By using neutrons and the wide range of instruments available at ILL, they have given the medical world a new perspective on diseases that affect millions of people across the world."
A medicine designed to improve levels of "good" cholesterol may also help control blood sugar in people with diabetes who are taking cholesterol-lowering drugs, according to a new analysis in Circulation: Journal of the American Heart Association.
Researchers made the finding while analyzing data from a clinical trial on the drug torcetrapib that was halted five years ago. Torcetrapib is a cholesterol ester transfer protein (CETP) inhibitor, a type of drug that increases levels of high-density lipoproteins (HDLs, or "good" cholesterol).
The study found that 6,661 people with type 2 diabetes - also known as "adult-onset" diabetes - showed improved blood sugar control when taking torcetrapib along with a statin medication that reduces low-density lipoproteins (LDLs or "bad" cholesterol). Subjects who took a statin and a placebo did not see such improvements.
"The possibility that CETP inhibitor drugs may not only reduce the risk of heart attack and stroke, but may also improve the control of blood sugar in people with diabetes, is an exciting prospect that may translate into real health benefits for people with diabetes," said the study's lead author, Philip Barter, M.B.B.S., Ph.D., a professor of medicine and director of the Heart Research Institute at the University of Sydney in Australia.
About 220 million people worldwide have diabetes, according the World Health Organization. An estimated 90 percent to 95 percent of them have type 2 diabetes, which increases the risk for heart disease, stroke and various other health problems.
While the experimental drug was not as effective in taming diabetes as drugs that are commonly used for that purpose, it did reduce the adverse impact on blood sugar commonly seen with statin use, Barter said. "Inhibition of CETP has the potential to prevent a worsening of diabetic control that often occurs in people taking statin drugs," he said.
The clinical trial called ILLUMINATE (Investigation of Lipid Level Management to Understand its Impact in Atherosclerotic Events) involved more than 15,000 people ages 45 to 75. They all had a history of heart attack, stroke, chest pain, peripheral vascular disease or cardiac revascularization (angioplasty or bypass). All were taking medicine to help control their diabetes. The trial was stopped prematurely in 2006 when patients receiving torcetrapib and a statin called atorvastatin had more cardiovascular problems and deaths than those given atorvastatin and a placebo. Researchers later determined those problems were due to other effects of the drug, not its CETP inhibition.
While the development of torcetrapib was halted, two other CETP inhibitors that scientists say do not cause the adverse effects - dalcetrapib and anacetrapib - are in the government's drug approval pipeline.
The analysis of the ILLUMINATE data found:
- After three months of treatment, those given both drugs had fasting blood sugar 0.34 millimoles per liter lower than in the group receiving just the statin.
- Fasting insulin was 11.7 microunits per milliter lower in the group receiving both drugs, and insulin resistance was also improved.
- After six months, average levels of blood sugar control over a months-long period were lower in the group receiving both drugs (7.06 percent) versus the group receiving just the statin (7.29 percent).
Use of the CETP inhibitor also improved glucose and insulin measurements in study participants without diabetes, although not as much. In addition, the study found that HDL levels had risen 66.8 percent after a year of taking torcetrapib and the statin, compared with minimal change in the other group. It's unclear whether torcetrapib's impact on HDL may account in part for the improvement in diabetic control, the scientists noted.
A key strength of the study, Barter said, is the size of ILLUMINATE. Yet scientists must determine whether the blood sugar effects were due to the drug's CETP inhibition or some other mechanism - an issue that current trials with dalcetrapib and anacetrapib should help clarify, Barter said.
Researchers at Mount Sinai School of Medicine have identified how a gene for a protein that can cause Type 2 diabetes, also possibly kills nerve cells in the brain, thereby contributing to Alzheimer's disease.
The gene, called SorCS1, controls the generation of amyloid-beta (Abeta) in the brain. Abeta plays a key role in the development of Alzheimer's disease. The researchers previously linked SorCS1 to Alzheimer's disease and identified where the molecules lived in the cell, but not how they control Abeta. The new data were presented at the Alzheimer's Association's Annual International Conference in Paris.
FSam Gandy, MD, PhD, the Mount Sinai Professor in Alzheimer's Disease Research, Professor of Neurology and Psychiatry, and Associate Director of the Alzheimer's Disease Research Center at Mount Sinai School of Medicine, led the research team with Rachel Lane, PhD, a postdoctoral researcher in Dr. Gandy's lab.
The researchers determined various "traffic patterns" in the cell for the amyloid precursor protein (APP) that makes Abeta and uncovered how much APP is converted into the toxic, and ultimately nerve-killing, Abeta. In some experiments Drs. Lane and Gandy altered the dose of the diabetes gene, SorCS1, and evaluated how that changed the "traffic pattern" that APP used to move around the cell and generate Abeta. In other experiments, Dr. Lane made small changes in the SorCS1 gene's and again saw dramatic changes in the "traffic pattern" of APP around the cell.
These data suggest that SorCS1 controls the movement of APP within the cell between areas where Abeta is readily made to areas where Abeta is not so easily made. In turn, the "traffic pattern" of influences the amount of Abeta being made by cells. The implication is that people with deficiencies in SorCS1 are at higher risk of developing Alzheimer's disease because their APP spends too much time in the region of the cell where APP is broken down to make the toxic Abeta.
"The great thing about studying SorCS1," said Dr. Gandy, "is that we already have entirely new ideas about how to treat both Alzheimer's disease and type 2 diabetes. Our hunch is that SorCS1 also controls how the insulin receptor moves around the cell, but we have not yet proven that," he said. "With both diseases reaching epidemic proportions, this discovery is encouraging news that brings us one step closer to developing treatments."
This work was supported by the Cure Alzheimer's Fund.
In a study, Identification of unrecognized diabetes and pre-diabetes in a dental setting, published in the July 2011 issue of the Journal of Dental Research, researchers at Columbia University College of Dental Medicine found that dental visits represented a chance to intervene in the diabetes epidemic by identifying individuals with diabetes or pre-diabetes who are unaware of their condition. The study sought to develop and evaluate an identification protocol for high blood sugar levels in dental patients and was supported by a research grant from Colgate-Palmolive. The authors report no potential financial or other conflicts.
"Periodontal disease is an early complication of diabetes, and about 70 percent of U.S. adults see a dentist at least once a year," says Dr. Ira Lamster, dean of the College of Dental Medicine, and senior author on the paper. "Prior research focused on identification strategies relevant to medical settings. Oral healthcare settings have not been evaluated before, nor have the contributions of oral findings ever been tested prospectively."
For this study, researchers recruited approximately 600 individuals visiting a dental clinic in Northern Manhattan who were 40-years-old or older (if non-Hispanic white) and 30-years-old or older (if Hispanic or non-white), and had never been told they have diabetes or pre-diabetes.
Approximately 530 patients with at least one additional self-reported diabetes risk factor (family history of diabetes, high cholesterol, hypertension, or overweight/obesity) received a periodontal examination and a fingerstick, point-of-care hemoglobin A1c test. In order for the investigators to assess and compare the performance of several potential identification protocols, patients returned for a fasting plasma glucose test, which indicates whether an individual has diabetes or pre-diabetes.
Researchers found that, in this at-risk dental population, a simple algorithm composed of only two dental parameters (number of missing teeth and percentage of deep periodontal pockets) was effective in identifying patients with unrecognized pre-diabetes or diabetes. The addition of the point-of-care A1c test was of significant value, further improving the performance of this algorithm.
"Early recognition of diabetes has been the focus of efforts from medical and public health colleagues for years, as early treatment of affected individuals can limit the development of many serious complications," says Dr. Evanthia Lalla, an associate professor at the College of Dental Medicine, and the lead author on the paper. "Relatively simple lifestyle changes in pre-diabetic individuals can prevent progression to frank diabetes, so identifying this group of individuals is also important," she adds. "Our findings provide a simple approach that can be easily used in all dental-care settings."
In a study, Identification of unrecognized diabetes and pre-diabetes in a dental setting, published in the July 2011 issue of the Journal of Dental Research, researchers at Columbia University College of Dental Medicine found that dental visits represented a chance to intervene in the diabetes epidemic by identifying individuals with diabetes or pre-diabetes who are unaware of their condition. The study sought to develop and evaluate an identification protocol for high blood sugar levels in dental patients and was supported by a research grant from Colgate-Palmolive. The authors report no potential financial or other conflicts.
"Periodontal disease is an early complication of diabetes, and about 70 percent of U.S. adults see a dentist at least once a year," says Dr. Ira Lamster, dean of the College of Dental Medicine, and senior author on the paper. "Prior research focused on identification strategies relevant to medical settings. Oral healthcare settings have not been evaluated before, nor have the contributions of oral findings ever been tested prospectively."
For this study, researchers recruited approximately 600 individuals visiting a dental clinic in Northern Manhattan who were 40-years-old or older (if non-Hispanic white) and 30-years-old or older (if Hispanic or non-white), and had never been told they have diabetes or pre-diabetes.
Approximately 530 patients with at least one additional self-reported diabetes risk factor (family history of diabetes, high cholesterol, hypertension, or overweight/obesity) received a periodontal examination and a fingerstick, point-of-care hemoglobin A1c test. In order for the investigators to assess and compare the performance of several potential identification protocols, patients returned for a fasting plasma glucose test, which indicates whether an individual has diabetes or pre-diabetes.
Researchers found that, in this at-risk dental population, a simple algorithm composed of only two dental parameters (number of missing teeth and percentage of deep periodontal pockets) was effective in identifying patients with unrecognized pre-diabetes or diabetes. The addition of the point-of-care A1c test was of significant value, further improving the performance of this algorithm.
"Early recognition of diabetes has been the focus of efforts from medical and public health colleagues for years, as early treatment of affected individuals can limit the development of many serious complications," says Dr. Evanthia Lalla, an associate professor at the College of Dental Medicine, and the lead author on the paper. "Relatively simple lifestyle changes in pre-diabetic individuals can prevent progression to frank diabetes, so identifying this group of individuals is also important," she adds. "Our findings provide a simple approach that can be easily used in all dental-care settings."
Eating nuts every day could help control Type 2 diabetes and prevent its complications, according to new research from St. Michael's Hospital and the University of Toronto.
In the research, published online by the journal Diabetes Care, a team of researchers led by Dr. David Jenkins (University of Toronto Department of Nutritional Sciences; St. Michael's Hospital Risk Factor Modification Centre) reports that consuming two ounces of nuts daily as a replacement for carbohydrates proved effective at glycemic and serum lipid control for people with Type 2 diabetes. The article, entitled "Nuts as a Replacement for Carbohydrates in the Diabetic Diet," is available here.
"Mixed, unsalted, raw, or dry-roasted nuts have benefits for both blood glucose control and blood lipids and may be used as part of a strategy to improve diabetes control without weight gain," said Dr. Jenkins, who also has appointments with St. Michael's Division of Endocrinology and Metabolism and the U of T's Department of Medicine. He also serves as Canada Research Chair in Nutrition and Metabolism.
Jenkins and his colleagues provided three different diet supplements to subjects with Type 2 diabetes. One group was given muffins, one was provided with a mixture of nuts including raw almonds, pistachios, walnuts, pecans, hazelnuts, peanuts, cashews, and macadamias, and one group was given a mixture of muffins and nuts.
Subjects receiving the nut-only supplement reported the greatest improvement in blood glucose control using the glycosylated hemoglobin (HbA1c) test. The nut diet subjects also experienced a reduction in low-density lipoprotein cholesterol (known as LDL, or "bad cholesterol"). The subjects provided the muffin supplement or mixed muffin-and-nut supplement experienced no significant improvement in gylcemic control but those receiving the muffin-nut mixture also significantly lowered their serum LDL levels.
"Those receiving the full dose of nuts reduced their HbA1c [the long-term marker of glycemic control] by two-thirds of what the U.S. Food and Drug Administration recognizes as being clinically meaningful for therapeutic agents. Furthermore, neither in the current study nor in previous reports has nut consumption been associated with weight gain. If anything, nuts appear to be well suited as part of weight-reducing diets," Dr. Jenkins said.
"The study indicates that nuts can provide a specific food option for people with Type 2 diabetes wishing to reduce their carbohydrate intake."
Acknowledgments
This work was supported by the Canada Research Chair Endowment of the Federal Government of Canada, the International Tree Nut Council Nutrition Research & Education Foundation (representing almonds, Brazils, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios, and walnuts), and the Peanut Institute. None of the funding organizations or sponsors played any role in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript. Dr. Jenkins has also received honorariums for consultation from the International Tree Nut Council and the Almond Board of California.
For better or worse, a popular class of anti-diabetic drugs does more than lower blood sugar. One known as rosiglitazone (trade name Avandia) has been in the spotlight for its possible link to increased cardiovascular events, but it also seems to come with unexplained vascular benefits and an unwelcome tendency for weight gain. Now, two separate studies in the July Cell Metabolism, a Cell Press publication, explore those other effects of the drugs known collectively as thiazolidinediones (TZDs), both of which stem from their activity in fat.
The findings offer new biological insights into fat tissue and its role as a central component of metabolic control. They may also pave the way for the development of new and better drugs, according to the researchers.
"TZDs have lots of side effects," said Jonathan Graff of the University of Texas Southwestern Medical Center. "We may find ways to replace them with drugs that have fewer."
Earlier studies showed that TZDs remodel fat (adipose) tissue and that they lead to the recruitment of new fat cells known as adipocytes. "TZDs alter adipose tissue to make you fatter," Graff said.
His team wanted to know whether those effects could be traced to adipose stem cells as the source of all those new adipocytes. Adipose stem cells were earlier identified in the walls of the blood vessels that feed adipose tissue, suggesting they might be an accessible target for therapies.
Indeed, they show in mice that rosiglitazone markedly increases the evolution of adipose stem cells into new adipocytes, perhaps explaining why those taking the drugs tend to put on pounds. After two months on the drug, however, the animals' stem cells were "profoundly altered" both molecularly and functionally. At that point, "they don't proliferate in the same way and they no longer form fat cells," Graff said. It was as if the fat cell progenitors had worked overtime and were spent.
The findings offer important evidence that the biology of fat might be altered for therapeutic ends via stem cells, the researchers say. They also provide important new insight into how TZDs work and how they might be improved.
"Although TZDs are effective at lowering blood glucose levels, side effects and concerns that TZDs increase cardiovascular risk have hastened the need to find alternative therapeutics," Graff's team wrote. "A better understanding of whether and how TZDs modulate the adipose lineage may shed light on their insulin-sensitizing efficacy, and may also help to develop the next generation insulin-sensitizers."
In the second study, Yu Huang of Chinese University of Hong Kong and Aimin Xu of the University of Hong Kong tested whether the vascular benefits of rosiglitazone could be connected to the fat-derived hormone adiponectin. Adiponectin is unusual among fat hormones in that its levels generally decline in those who are obese and many earlier studies by Huang and Xu's team and others suggested it might have a protective effect on blood vessels.
In diabetic mice, the researchers found that adiponectin is required for the vascular benefits of treatment with rosiglitazone. Rosiglitazone treatment also stimulated the release of adiponectin from isolated fat tissue, and fat tissue transplanted from treated mice relaxed the blood vessels of untreated diabetic mice.
"Our study emphasizes the importance of adipose tissue-derived adiponectin in response to TZD," Huang said. "This suggests that development of pharmacological agents that can elevate adiponectin, but avoid the undesirable effects of TZDs, may represent an effective therapeutic approach for treating or preventing vascular diseases induced by obesity and diabetes."
He says they have also identified several natural compounds in edible herbs that boost adiponectin levels by other means. They plan to test whether those compounds might have therapeutic use.
n some cases, an apple a day may keep the doctor away, but for people with diabetes, regular, over-the-counter Aspirin may also do the job.
A new study by University of Alberta researcher Scot Simpson has shed light on the use of Aspirin as a preventative measure for cardiovascular disease and reoccurrence in patients with diabetes.
The study collected data from clinical trials that looked at whether taking Aspirin as a course of treatment would prevent a first or recurrent heart attack or stroke.
Using information from diabetic patients in these studies, Simpson discovered that patients with previous cardiac episodes who were taking a low dose of Aspirin daily had very little benefit in terms of prevention of a second heart attack or a decreased risk of mortality. However, in patients taking higher doses of Aspirin, the risk of a repeat heart attack and/or death was significantly lower.
"We took all of the data from 21 studies and focused specifically on diabetic patients who had suffered a previous heart attack or stroke to measure the ability of Aspirin to prevent a second event. We found that, if those patients took up to 325 milligrams of Aspirin per day, they had a 23 percent lower risk of death," said Simpson.
Simpson, an associate professor in the Faculty of Pharmacy and Pharmaceutical Sciences, says that people with diabetes are at an increased risk of cardiovascular disease, adding there is evidence that suggests as much as 60 per cent of deaths in diabetics are attributable to heart disease. Simpson says he always suspected the Aspirin dosage could play a role in treating cardiovascular disease in diabetics and felt because Aspirin was an over-the-counter medication, it's something that pharmacists could have an active role in administering.
"The pharmacists' best role for chronic disease management is working proactively with physicians and patients," said Simpson. "Whether that means working directly with the physician, and consulting about prescribed medications, or when the patient is deciding about whether or not to take Aspirin as part of a treatment plan, pharmacists can have a significant, positive impact."
Notes:
Simpson's study was recently published in the Journal of General Internal Medicine. Other researchers from the U of A include John-Michael Gamble, in the School of Public Health; Laurie Mereu, in the Faculty of Medicine & Dentistry, and Thane Chambers, in Library Services.
The first woman in Scotland to receive donated pancreatic cells to treat her diabetes has described the procedure as "life changing".
Kathleen Duncan, who has type 1 diabetes, no longer requires insulin after having a pancreatic islet cell transplant.
She is among patients being treated as part of a UK-leading transplant programme based in Edinburgh.
Health Secretary Nicola Sturgeon has also praised the programme.
She met Mrs Duncan when she visited the cell therapy suite at the Scottish National Blood Transfusion Service's (SNBTS) Islet Isolation Laboratory in Liberton.
The pioneering transplant programme was launched in 2009 and has now carried out three islet cell infusions in two patients.
People with type 1 diabetes often have problems managing their blood sugar and as a result can collapse without warning when their blood sugar is low, known as hypoglycaemic unawareness.
The transplant process involves the complex preparation of islets extracted from a deceased donor's pancreas.
These are then injected into diabetes patients at the Royal Infirmary of Edinburgh's transplant unit, allowing them to then make their her own blood sugar.
Mrs Duncan, who was diagnosed with type 1 diabetes more than 30 years ago and had been injecting insulin up to four times a day, said: "Before this treatment I felt absolutely helpless, as I had no awareness of my blood sugar levels or if I was about to collapse.
"It didn't just affect me, it has been years of worry for both my husband, Chris, and my son, David.
"I was so terrified that David would come home from school to find me unconscious that I would go out all day, knowing that if I collapsed in a public place, I would be taken to hospital."
Mrs Duncan said her life had totally changed since the transplants.
She added: "I have more control over my diabetes, the confidence to do everyday things and can lead a practically normal life.
"Chris and David are now more relaxed and don't have to worry about me just so much.
"I feel extremely lucky that matching donors were found and privileged to be the first person to have this treatment."
Donor plea
In Scotland about 28,000 people currently have type 1 diabetes, with about 2,000 experiencing hypoglycaemic unawareness.
Ms Sturgeon praised the work of staff at the SNBTS lab and the Transplant Unit at Edinburgh Royal Infirmary.
She added: "This service has shown how it has the potential to transform the lives of people with this condition.
"The ideal is to make them no longer dependent on insulin injections.
"Sadly, like all transplant programmes - the main challenge is the shortage of donor organs. That's why, during UK Transplant Week, I would repeat my calls for people to sign up to the NHS organ donor register so that more lives can be saved and turned around."
Mr John Casey, from the Scottish Islet Transplant Programme, said: "This is an important step in the treatment of diabetes in Scotland.
"The improved quality of life for both patients is excellent and we hope we can now offer this form of cell therapy to many, many more Scottish patients."
Two thirds of people with Type 1 diabetes and almost half of Type 2 patients do not receive all nine annual health checks to manage their diabetes effectively, according to the biggest ever audit of diabetes in England and Wales.
The National Diabetes Audit 2010 shows children and young people are less likely to receive all the recommended checks, such as blood pressure, blood glucose and foot checks.
At risk of developing long term complications
The figures cause concern that a whole generation with diabetes may require substantial hospital care in the future for the treatment of long term complications such as heart disease, blindness and kidney failure.
The report also revealed that more than 800,000 people with diabetes have high risk blood glucose levels putting them at increased risk of complications.
It also identified substantial regional variations in both the prevalence and treatment of complications such as kidney failure and dialysis.
Campaigning for improved care
Barbara Young, Chief Executive at Diabetes UK, said: “This highlights the need for urgent action to ensure that people with diabetes start to receive all the basic care processes, otherwise there will be more amputations, more people going blind, and more cases of kidney failure, heart disease and stroke.
“We will campaign to improve the levels of care and support for people affected by diabetes at a time of unprecedented change in the NHS.”
A team of engineers and scientists at the University of British Columbia has developed a device that can be implanted behind the eye for controlled and on-demand release of drugs to treat retinal damage caused by diabetes.
Diabetic retinopathy is the leading cause of vision loss among patients with diabetes. The disease is caused by the unwanted growth of capillary cells in the retina, which in its advanced stages can result in blindness.
The novel drug delivery mechanism is detailed in the current issue of Lab on a Chip, a multidisciplinary journal on innovative microfluidic and nanofluidic technologies.
The lead authors are recent PhD mechanical engineering graduate Fatemeh Nazly Pirmoradi, who completed the study for her doctoral thesis, and Mechanical Engineering Assoc. Prof. Mu Chiao, who studies nanoscience and microelectromechanical systems for biological applications.
The co-authors are Prof. Helen Burt and research scientist John Jackson at the Faculty of Pharmaceutical Sciences.
"We wanted to come up with a safe and effective way to help diabetic patients safeguard their sight," says Chiao who has a family member dealing with diabetic retinopathy.
A current treatment for diabetic retinopathy is laser therapy, which has side effects, among them laser burns or the loss of peripheral or night vision. Anti-cancer drugs may also used to treat the disease. However, these compounds clear quickly from the bloodstream so high dosages are required, thus exposing other tissues to toxicity.
Key to UBC's innovation is the ability to trigger the drug delivery system through an external magnetic field. The team accomplished this by sealing the reservoir of the implantable device - which is no larger than the head of a pin - with an elastic magnetic polydimethylsiloxane (silicone) membrane. A magnetic field causes the membrane to deform and discharge a specific amount of the drug, much like squeezing water out of a flexible bottle.
In a series of lab tests, the UBC researchers loaded the implantable device with the drug docetaxel and triggered the drug release at a dosage suitable for treating diabetic retinopathy. They found that the implantable device kept its integrity with negligible leakage over 35 days.
They also monitored the drug's biological effectiveness over a given period, testing it against two types of cultured cancer cells, including those found in the prostate. They found that they were able to achieve reliable release rates.
"The docetaxel retained its pharmacological efficacy for more than two months in the device and was able to kill off the cancer cells," says Pirmoradi.
The UBC device offers improvements upon existing implantable devices for drug delivery, says Chiao.
"Technologies available now are either battery operated and are too large for treating the eye, or they rely on diffusion, which means drug release rates cannot be stopped once the device is implanted - a problem when patients' conditions change."
Pirmoradi says it will be several years before the UBC device is ready for patient use. "There's a lot of work ahead of us in terms of biocompatibility and performance optimization."
Team members are also working to pinpoint all the possible medical applications for their device so that they can tailor the mechanical design to particular diseases.
he health service could face a "diabetes time bomb" according to an audit of patients in England and Wales.
The report says 800,000 Type 1 and Type 2 patients have elevated blood sugar levels which could lead to kidney failure, limb amputation and stroke.
It warned that many of the patients were young or middle aged and could require "substantial hospital care in a matter of years".
Diabetes UK said the findings highlighted the need for urgent action.
All forms of diabetes result in raised blood sugar levels. If this is not controlled then it can cause serious damage.
The NHS Information Centre report confirmed that the number of cases of diabetes, especially Type 2, is increasing - particularly in deprived communities.
When it came to controlling blood sugar levels, around a third of more than 2 million patients had raised levels that placed them at risk of developing complications.
This was a greater problem for the under 55s.
Nearly 300,000 people were at "high risk" and 144,000 were at "dangerously high risk" in that age category.
Poor care
The report also found nearly half of patients were not getting the appropriate checks.
The National Institute for Health and Clinical Excellence recommends patients with diabetes receive nine checks annually including: blood sugar levels, whether they are smoking, and an assessment of damage to the eyes or feet due to diabetes.
The study showed that 53% of patients with Type 2 diabetes and 32% with Type 1 received all nine tests.
Audit lead clinician, Dr Bob Young, consultant diabetologist and clinical lead for the National Diabetes Information Service, said: "These results ring alarm bells.
"They show that younger people make up a quarter of all those with diabetes yet have the highest risks of potentially preventable complications.
"If these risks could be reduced, much future disability and shortened life expectancy could be prevented."
Dr Rowan Hillson, National Clinical Director for Diabetes, said: "I am very concerned that the National Diabetes Audit shows that we still have a long way to go in delivering basic standards of diabetes care for everyone.
"In particular, young and middle-aged people with diabetes are not getting the regular checks they need to manage their condition and improve outcomes.
"These checks are vital to reduce serious but avoidable complications. All health care professionals should follow NICE's clear recommendations. There is no excuse for not doing the basics well."
Barbara Young, Chief Executive at Diabetes UK, said: "This highlights the need for urgent action to ensure that people with diabetes start to receive all the basic care processes otherwise there will be more amputations, more people going blind, and more cases of kidney failure, heart disease and stroke."
A white sweet potato extract from the Ipomoea batatas plant may cure diabetes, adding to other recent research showing blood sugar reducing benefits from coffee, the gingko tree, and nuts. Diabetes is at epidemic proportions but traditional medicine has used plants to treat this condition worldwide.
Sweet Potato Diabetes Research Researchers are now studying the Ipomoea batatas plant, a traditional sweet potato remedy from the mountains of Japan. The white sweet potato has been used for centuries in Japan to treat high blood pressure, anemia and diabetes. The raw potatoes come from the Kagawa region of Japan, a mountainous region between Osaka and Hiroshima.
Recent research with the sweet potato extract has shown promise in stabilizing blood sugar in type 2 diabetes. A study in Austria and Italy enlisted 60 participants who consumed 4 g of an extract of the white sweet potato, called caiapo. After three months, many reported reduced blood sugar of 15 points.
When participants consumed 2 grams of the extract, their results were not curative, but those on the 4 gram a day diet showed at least a 13 percent reduction in fasting blood sugar, as well as a 30 percent drop in cholesterol and a 13 percent drop in LDL cholesterol.
The caiapo extract seems to have an effect by decreasing insulin resistance; however, further tests are needed to confirm these findings. Sweet potatoes join the ranks of other foods thought to help reduce insulin resistance and prevent the onset of diabetes, such as coffee and nuts.
Coffee Reduces Risk of Diabetes
The coffee research showed that one cup of coffee reduced diabetes risk by seven percent. These findings, published in the Archives of Internal Medicine, collected data from numerous studies that totaled over a half million participants.
Nuts Lower Blood Sugar
Nuts have been shown to lower blood sugar by slowing the digestion of carbohydrates, according to the American Diabetes Association. Nuts also contain important nutrients such as magnesium, as well as fiber and omega-3 fatty acids, which also benefit a diabetic diet.
Ginkgo Biloba Herb Treats Diabetes
The herb Ginkgo biloba has long been used in Japan and China as a treatment for high blood sugar. The tree is one of the oldest known in the world and contains a powerful antioxidant. A ginkgo tree withstood the nuclear blast in Hiroshima during World War Two. Ginkgo has been used to treat diabetic retinopathy because it helps increase blood flow to the eyes and also the limbs.
Scientists in the United States have revealed that some treatments for rheumatoid arthritis could help to reduce the risk of developing diabetes. The research, which examined data on almost 14,000 patients with rheumatoid arthritis or psoriasis, found that TNF-inhibitor biologic agents were able to reduce the diabetes risk in patients with the inflammatory conditions.
The study, which was published in the Journal of the American Medical Association, showed that drugs taken for treating inflammatory diseases such as rheumatoid arthritis and psoriasis could work to prevent patients suffering from these conditions from developing type 2 diabetes.
Previous studies suggesting that people with rheumatoid arthritis and similar ailments brought on by inflammation could face a higher risk of heart disease, insulin resistance and diabetes.
Researcher Daniel H. Solomon commented "We are not at the point where we can make clinical leaps and say that these are the drugs to choose for high-risk patients. But if future studies support the conclusion that these drugs do decrease insulin resistance and diabetes risk, one could imagine a day when we make treatment decisions based on these comorbidities."
He added "Understanding how these drugs affect comorbidities like diabetes could help us make more informed treatment choices."
A study by scientists in Spain has found that taking medicine for hypertension at bedtime helps people suffering from type 2 diabetes to better manage their blood pressure, as well as lowering the risk of a major cardiovascular event, as compared to taking it in the morning.
The research, involving 448 patients with an average age of 62.5 years who have both hypertension and type 2 diabetes, and which was published in the journal Diabetes Care, showed that people who have diabetes who take one or more types of hypertension medication at bedtime exerted better blood pressure control and cardiovascular risk reduction than those who took their medication in the morning.
For the study, over an average of 5.4 years, ambulatory blood pressure was recorded for 48 hours at baseline, and annually or quarterly after adjustments in treatment. It was revealed that patients taking medications at bedtime had a significantly lower cardiovascular risk, while both groups had a statistically significant difference in the adjusted risk of cardiovascular death, myocardial infarction and stroke.
The research report pointed out "Among patients with diabetes, treatment with ¡Ý1 hypertension medications at bedtime, compared with all medications upon waking, resulted in improved ambulatory blood pressure control and significantly reduced cardiovascular morbidity and mortality."
Watching TV is the most commonly reported activity in the U.S. after working and sleeping, but a new study suggests that overindulging in television viewing may be associated with a higher risk of developing type 2 diabetes and cardiovascular complications.
The University of Southern Denmark and Harvard School of Public Health researchers who conducted the study said that their findings are important because sedentary lifestyles are becoming more common throughout the Western world. This lack of physical activity is often associated with long hours spent in front of the TV. The association they uncovered between television viewing and type 2 diabetes may help explain the rising rates of the metabolic condition.
For the study, the researchers analyzed data collected by eight previous investigations that looked into the possible connection between TV viewing and health problems. They identified four studies that looked at the link to type 2 diabetes involving a total of nearly 176,000 participants, and four studies into heart disease risk factors involving more than 34,000 individuals.
The results, which were published in the Journal of the American Medical Association, revealed a strong connection between watching excessive television and cardio-metabolic risk. Those who watched TV for two hours per day or more were 20 percent more likely to develop type 2 diabetes, 15 percent more likely to develop heart disease and 13 percent more likely to die from any cause.
The researchers said that there is nothing inherent to watching television that causes poorer health. Rather, excessive time in front of the TV encourages unhealthy lifestyle habits, like avoiding physical activity, eating junk food and smoking, all factors that increase the risk of type 2 diabetes and heart disease.
"Beyond altering energy expenditure by displacing time spent on physical activities, TV viewing is associated with unhealthy eating in both children and adults," the researchers wrote in their report. "Physical inactivity, various dietary factors and smoking are well-established independent risk factors of type 2 diabetes, cardiovascular disease, and all-cause mortality.”
The findings underscore the importance of adopting healthy lifestyle habits for those who are at risk for type 2 diabetes and cardiovascular health complications.
Diabetes UK’s Diabetes Week campaign ‘Let’s talk diabetes’ – aimed at encouraging people with diabetes to talk about their condition – was mentioned during Wednesday’s Prime Minister Questions (PMQs) in the House of Commons.
'Let's talk diabetes'
Adrian Sanders, MP for Torbay, asked Prime Minister David Cameron: “This week is national Diabetes Week and the theme this year is ‘Let’s Talk Diabetes’ - to encourage people with the condition to speak out and not feel stigmatised or worried about being discriminated against or joked against in school, or in the workplace. Would the Prime Minister please support this campaign?”
Cameron: "There's nothing abnormal or wrong"
Prime Minister David Cameron replied: “I will certainly support this campaign. I think my honourable friend makes an extremely good point which is that many people with diabetes find it an embarrassing illness and something they don’t want to talk about, and yet it’s affecting more and more people. I think we have to find a way of encouraging more people to come forward and say there’s nothing abnormal or wrong about this.
"We just need to help people manage their diabetes"
“We just need to help people manage their diabetes, particularly because we want to see them have control over their healthcare and spend less time in hospitals if at all possible.
"So I fully support the campaign and I think we’ve got to look at the long-term costs of people getting diabetes and recognise there’s a big public health agenda, particularly about exercise and other things, that we need to get a hold of.”
Diabetes Week campaign
Diabetes UK is raising awareness of the importance of talking about diabetes during Diabetes Week this year (12 to 18 June) and we are encouraging anyone having difficulty opening up about their condition to call our Careline service for help. A Diabetes UK survey has found that nearly one million people in the UK could be risking their health and experiencing emotional distress by keeping their diabetes a secret.
They say life begins at 40 - but according to health campaigners, that is just when everything starts to go rapidly downhill.
Researchers have found that 41 is the age when most Brits ‘let themselves go’.
Many over-40s begin to eat too much, put on weight and cut down on the amount of daily exercise they take, according to a new study.
And in a survey to mark the start of Diabetes Week, thousands of people said they wish they could turn back the clock.
More than 40 per cent of over-40s questioned felt they had let themselves go, with more than one third saying that if they could go back in time they wouldn’t allow themselves to become overweight.
More than 100,000 people are diagnosed with Type 2 diabetes every year in the UK - around 275 new cases every day or one every five minutes.
Despite diabetes being one of the biggest threats to the health of the nation, 42 per cent of those questioned said they didn’t understand what Type 2 diabetes was and a quarter couldn’t even name one complication associated with the disease, such as limb amputations, cardiovascular disease or blindness.
The survery was commissioned by Lloydspharmacy which today launched its ‘Diabetes - are you at risk?’ campaign to help people recognise the risk factors for Type 2, diabetes which include being overweight.
Alison Freemantle, diabetes expert at Lloydspharmacy, said: ‘Our research shows that many over-40s feel they’ve let themselves go and have regrets about putting on weight over the years - but they’re not necessarily making the link between being overweight and the risks of developing diabetes.
‘Type 2 diabetes is an incredibly serious condition with nasty complications that can arise if it’s not diagnosed early enough. The good news is that for many people, it is possible to turn back the clock on their risk.
‘Adopting a healthier diet and lifestyle, losing weight and staying physically active can delay the onset of diabetes – or even prevent it completely.
‘Today we are urging people to have a diabetes check-up so that they understand their risk and can take steps to reduce it if necessary.’
Of all the regions where people were questioned, the West Midlands ranked highest with half (51 per cent) of people admitting they had let themselves go.
Last year a study found that a though mid-life crisis was seen as the preserve of 50-something men desperate to regain their youth, it is in fact a condition striking people in their mid-30s.
The research found people who were in their 30s and 40s were unhappier than any other age group.
A change in work culture has been blamed for people suffering from anxieties about their age far younger than previously thought.
With the average age of a chief executive going down from 59 to 48 in a generation, success is now expected much younger than ever before.
More than 2,000 people of a variety of ages were surveyed for the study, which was carried out last month by Relate and the broadband company TalkTalk.
The National Institute for Health and Clinical Excellence (NICE) has issued draft guidelines recommending a drug-infused eye implant for some patients that suffer from vision loss caused by macular oedema. The findings, which were praised by the Royal National Institute of Blind People (RNIB), could benefit patients who have problems with diabetic retinopathy and central retinal vein occlusion.
The macula is a part of the retina responsible for colour and fine detail in our seeing. Macula oedemas result from the retina becoming blocked and becoming inflamed and having a build-up of fluid, which sometimes leads to severe visual impairment.
The health watchdog has approved the treatment, a biodegradeable implant called Ozurdex, which is injected into the eye every six months, releasing a drug, dexamethasone, which controls the inflammation and helps to restore vision.
Peter Littlejohns, clinical and public health director at NICE, commented "We are pleased to be able to recommend dexamethasone intravitreal implant for this condition. Retinal vein occlusion can be very debilitating and have a very profound effect on everyday life so this draft decision will be welcome news to all those affected."
Barbara McLaughlan, eye health campaigns manager at the RNIB, also said "We would urge PCTs not to force patients to wait for final guidance to be published on treatment with Ozurdex, but to start providing this sight-saving treatment immediately."
People who receive high amounts of omega-3 fatty acids through their daily diet are less likely to develop type 2 diabetes in the long run.
Two new studies have further suggested that eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) -- two omega-3s found in fatty fish -- have protective effects against type 2 diabetes.
The study of 3,088 US elderly showed that those with the highest levels of the two omega-3 fatty acids are about one-third less likely to develop diabetes over the next decade, Reuters reported.
About 5 percent of the participants with the highest blood levels of EPA/DHA developed diabetes while the rate was as high as 6.5 percent in those with the lowest blood levels of the fatty acids, Dr. Luc Djousse of Harvard University and his colleagues found.
Furthermore, another study looking at 43,000 Singaporean adults suggested that taking more amounts of omega-3 fats, particularly alpha-linolenic acid (ALA), lowers the risk of diabetes.
Neither of the two studies published in the American Journal of Clinical Nutrition, however, confirmed the direct protective role of omega-3s against diabetes.
The findings just suggest and association and not a cause and effect relation, the scientists noted, adding that individuals are not urged to take Omega-3-containing supplements to protect themselves against diabetes.
People often hope there is a dietary "magic bullet" against disease, noted Andrew Odegaard of the University of Minnesota, who was involved in Singapore study.
"Approaching your dietary intake with this 'big picture' approach should take care of the small things, like essential nutrients such as omega-3 fatty acids," he added.
Before people develop type 2 diabetes, they almost always have "prediabetes," defined as blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. There are 79 million people in the United States who have prediabetes. Recent research has shown that even during prediabetes both heart and circulatory long-term damage to the body may already be occurring.
Both pre-diabetics and diabetics are sometimes concerned about eating fruit due to its reported “high sugar content.” Are fruits wrongly lumped into the catch-all phrase “carbohydrate” and incorrectly classified as a sugar food?
Regardless of which stage of diabetes one might be experiencing or not, all of us would fare far better by including more fruit consumption in our daily diets while reducing grains, breads, meal replacement bars and the plethora of refined manufactured carbohydrates that are consumed instead, according to Dian Griesel, Ph.D. and Tom Griesel, co-authors of the new book, TurboCharged: Accelerate Your Fat Burning Metabolism, Get Lean Fast and Leave Diet and Exercise Rules in the Dust (BSH, 2011).
There is considerable research supporting their claims. Researchers from the Centers for Disease Control and Prevention in Atlanta completed a 20-year study that involved closely watching the diets of a group of individuals between the ages of 25 and 74. The study named the first National Health and Nutrition Examination Survey concluded that fruits and vegetables had a demonstratively positive, protective effect against diabetes.
As reported in Preventive Medicine, "A healthy diet including fruits and vegetables could help prevent diabetes from ever occurring. The higher levels of fruit and vegetable consumption might decrease the risk of diabetes in adults, particularly women.”
The average daily intake of fruits
and vegetables as well as the number of participants consuming five or more fruits and vegetables per day was lower among the participants who developed diabetes than among the participants in the study who remained free of this disease. The investigators determined that these results suggest that fruit and vegetable consumption may decrease the risk for diabetes."
“Lumping fruit into the broad category of carbohydrates is confusing to us as consumers—diabetic or not. Fruits are loaded with vitamins, minerals, fiber and perfectly filled with water that allows better absorption of their natural nutritive properties,” says Tom Griesel.
The confusion with fruit eating by diabetics at any stage may have arisen because according to the Glycemic Index, some fruits, like bananas, considered by many “Nature’s Perfect Food,” are rated with a high glycemic index.
“Glycemic index is significantly altered by the type of food, its ripeness, processing, the length of storage, cooking methods, and its variety. Watermelon has a glycemic score of 100—which is identical to heavily processed and nutrient poor white bread,” says Dian Griesel, Ph.D.
The misconceptions for prediabetics and diabetics concerning fruit is two-fold: Since fruit is very high in both water and naturally occurring fiber, the digestion time of any naturally contained sugars is slowed significantly. “The natural water and fiber content of fruit actually causes a slow release of sugar into the bloodstream. This is quite unlike the instant sugar impact of no-fiber, high-chemical, heavily processed white bread that is also quite dehydrating,” say the Griesels.
Fruit is an excellent food. It satisfies our natural urges for something sweet. Prediabetics and diabetics would benefit from eating more fresh, raw fruits and vegetables and less refined carbohydrates, in any form.
Recent research by scientists at the University of Warwick into cholesterol has found a new type of ultrabad cholesterol that is believed to raise the risk of heart disease . The cholesterol is more sticky than the usual, so-called, bad cholesterol, which means it is much more likely to become attached to the walls of arteries.
The cholesterol, called MGmin-LDL and which is involved in the arterial plaque deposits that can lead to heart attacks and strokes, is more common in patients suffering from type 2 diabetes, as well as the elderly.
The fatty material contains sugary molecules that are smaller and denser than the regular type, and can more easily adhere to artery walls, helping the build-up of plaques. It is thought the breakthrough, which was published in the journal Diabetes, could offer an explanation of why the diabetes drug metformin seems to lower the risk of heart attacks.
Naila Rabbani, lead researcher on the study, commented "We're excited to see our research leading to a greater understanding of this type of cholesterol, which seems to cause heart disease in diabetics and elderly people."
She added "The next challenge is to tackle this more dangerous type of cholesterol with treatments that could help neutralise its harmful effects on patients' arteries."
A new study has revealed that women who gain weight between their first and second pregnancies have a heightened risk for developing pregnancy-related diabetes in their second pregnancy.
However, losing weight between the two pregnancies appeared to reduce gestational diabetes mellitus (GDM) risk during the second pregnancy.
According to researchers, GDM is associated with an increased risk of adverse perinatal outcomes as well as subsequent diabetes in women and their offspring.
An examination of 22,351 women from Kaiser Permanente in Northern California over a 10-year period further supports the study.
The examination showed that women who gained 12 to 17 pounds between the first and second pregnancy were almost two times more likely to develop GDM compared to their peers whose weight remained stable (plus or minus 6 pounds between pregnancies).
On the other hand, women who lost more than 6 pounds between the first and second pregnancy reduced their risk of developing GDM by approximately 50 pc compared with women whose weight remained stable.
It also emerged that the association between losing weight and reduced GDM risk was strongest in women who were overweight or obese in their first pregnancy.
"Taken together, the results support the avoidance of gestational weight retention and postpartum weight gain to decrease the risk of GDM in a second pregnancy, as well as the promotion of postpartum weight loss in overweight or obese women, particularly those with a history of GDM," said Samantha Ehrlich, project manager at the Kaiser Permanente Division of Research in Oakland.
The study appears online in the journal Obstetrics and Gynecology.
A research has indicated that small differences in diet – even without weight loss – can significantly affect risk for diabetes.
In this study, 69 healthy, overweight people who did not have diabetes — but were at risk for it — were placed on diets with modest reductions in either fat or carbohydrate for eight weeks.
"At eight weeks, the group on the lower fat diet had significantly higher insulin secretion and better glucose tolerance and tended to have higher insulin sensitivity," said Barbara Gower, professor in the Department of Nutrition Sciences at UAB and lead author of the study.
"These improvements indicate a decreased risk for diabetes," added Gower.
Gower says, "The unique aspect of this study is that the results were independent of weight loss."
"People find it hard to lose weight. What is important about our study is that the results suggest that attention to diet quality, not quantity, can make a difference in risk for type 2 diabetes," she added.
The study is detailed in the American Journal of Clinical Nutrition.
“Minister for Health and Family Welfare Gulam Nabi Azad intends to come out with a affordable kits which could be used in the screening of diabetes and saliva rather than using expensive kits as the whole countryuses it for screening diabetes”, the BBMP chief said.
BANGALORE: The Indian Council of Medical Research (ICMR) has proposed an initiative to introduce affordable diabetes diagnostic kit using blood and saliva. Patients will not have to pay more than Rs. 2 to 5 for this new kit.
Speaking to TNIE, Dr Vishwamohan Katoch, secretary, Department of health research and Director General, ICMR said: “We have already flouted the tenders and three pharmaceutical companies have already been shortlisted to design and develop these quick diagnostic kits. These diagnostic kits, which are expected to be available in two years will be boon for economically weaker section who shell out nearly Rs. 25 to 30 for the tests.”
Boon for NUHM
These affordable diagnostic kits will also help the Union health ministry to successfully launch the National Urban Health Mission (NUHM)in a grand way across the country.
As a part of pilot project, the screening of diabetes and blood pressure in the urban slum which was started in the BBMP areas in month of October has been put on hold.
Dr L T Gyathri, BBMP chief health officer (CHO), told TNIE that the screening for diabetes and hypertension in the urban slums could not be continued as the fund were not released to continue the camps.
Bangalore city has 327 notified slums with a population of 9,52,911 of which 47,655 are above 30 years of age.
“Minister for Health and Family Welfare Gulam Nabi Azad intends to come out with a affordable kits which could be used in the screening of diabetes and saliva rather than using expensive kits as the whole countryuses it for screening diabetes”, the BBMP chief said.
A gene that is thought to be crucial in controlling a person's fat levels has been identified by scientists.
It is hoped the discovery could lead to new treatments for obesity and related diseases such as heart disease and diabetes .
Researchers analysed more than 20,000 genes in fat samples taken from under the skin of 800 British female twin volunteers.
They found that a gene called KLF14 is linked to levels of many other distant genes found in fat tissue, suggesting KLF14 is a ‘master switch’.
The team then confirmed their findings using 600 fat samples from a separate group of people from Iceland.
"This is the first major study that shows how small changes in one master regulator gene can cause a cascade of other metabolic effects in other genes," said Tim Spector of King's College London, who led the research .
The study was published in the journal Nature Genetics .
More than half a billion people worldwide are thought to be obese.
A new study in the United States has revealed that the health benefits of apples is not just an old wives’ tale, but rooted in scientific reality. Apart from the benefits of fibre, they have also been shown to lower the levels of bad cholesterol and contain pectin and polyphenols that help improve lipid metabolism and reduce the production of pro-inflammatory molecules.
The research, led by Bahram H. Arjmandi of the Department of Nutrition, Food and Exercise Sciences at Florida State University, focused on assessing the long-term cardioprotective benefits for postmenopausal women of eating an apple every day. It involved monitoring 160 women aged between 45 and 65 in two groups, one of which consumed dried apples each day for one year, while the other received dried prunes daily for a year, with blood samples taken regularly.
Dr. Arjmandi commented that "incredible changes in the apple-eating women happened by 6 months – they experienced a 23 per cent decrease in LDL cholesterol ." The group that ate the apples also showed a reduction in lipid hydroperoxide levels and C-reactive protein .
Arjmandi added "I never expected apple consumption to reduce bad cholesterol to this extent while increasing HDL cholesterol or good cholesterol by about 4 per cent." The apple consumption also produced no weight gain in the women studied, but rather a loss of 3.3lbs on average over the period, offering another benefit from eating an apple a day.
Researchers have found that a gene linked to type 2 diabetes and cholesterol levels is in fact a 'master regulator' gene, which controls the behaviour of other genes found within fat in the body.
The study involved researchers from King's College London, University of Oxford, The Wellcome Trust Sanger Institute, and the University of Geneva. DeCODE Genetics also contributed to the results reported in this paper.
It was already known that the KLF14 gene is linked to type 2 diabetes and cholesterol levels but, until now, how it did this and the role it played in controlling other genes located further away on the genome was unknown.
The researchers examined over 20,000 genes in subcutaneous fat biopsies from 800 UK female twin volunteers. They found an association between the KLF14 gene and the expression levels of multiple distant genes found in fat tissue, which means it acts as a master switch to control these genes. This was then confirmed in a further independent sample of 600 subcutaneous fat biopsies from Icelandic subjects.
These other genes found to be controlled by KLF14 are in fact linked to a range of metabolic traits, including body-mass index (obesity), cholesterol, insulin and glucose levels, highlighting the interconnectedness of metabolic traits.
The KLF14 gene is special in that its activity is inherited from the mother. Each person inherits a set of all genes from both parents. But in this case, the copy of KLF14 from the father is switched off, meaning that the copy from the mother is the active gene - a process called imprinting. Moreover, the ability of KLF14 to control other genes was entirely dependent on the copy of KLF14 inherited from the mother - the copy inherited from the father had no effect.
Professor Mark McCarthy from the University of Oxford, who co-led the study, said, "KLF14 seems to act as a master switch controlling processes that connect changes in the behaviour of subcutaneous fat to disturbances in muscle and liver that contribute to diabetes and other conditions. We are working hard right now to understand these processes and how we can use this information to improve treatment of these conditions."
The study has been published in Nature Genetics.
Taking a hot bath on a cold day could increase the chances of having a heart attack, new research suggests.
A study led by Chika Nishiyama at Kyoto Prefectural University of Medicine School of Nursing in Japan has found that the rate of cardiac arrests following a hot bath increases dramatically from summer to winter, Reuters reports.
The team studied data from nearly 11,000 cardiac arrests in the western prefecture of Osaka between 2005 and 2007.
They found that the rate of heart attacks was 54 per ten million people for those who had been bathing prior to going into cardiac arrest.
This was the highest rate for any activity, followed by exercising with a rate of ten cardiac arrests per ten million.
The risk increased for bathers who had a hot bath on a cold day.
It is thought this because the change in temperature results in a rapid blood pressure drop which stresses the heart.
Earlier this month, new research suggested that heart function is better for those recovering from a cardiac arrest if they start physical activity soon after the event than if they delay it for a few weeks.
People with type 2 diabetes can make a significant improvement to their glucose control by getting just over 20 minutes of exercise a day.
It’s long been known that a healthy diet and exercise regimen is an important part of diabetes treatment. Yet most studies of exercise and diabetes have been small, so it’s been hard to see how much exercise people need, and which types of exercise are best.
In a new summary of the research, doctors pooled the data to get a better overall picture. The results were encouraging. Taking part in any exercise program that lasted at least 12 weeks improved glucose control.
Aerobic exercise (where you get out of breath and push your heart rate up) worked best, but resistance exercise (such as using weights) also worked well. More important than the type of exercise was the amount. Those people who exercised for at least two and a half hours a week (just over 20 minutes a day) showed the most impressive results.
The researchers said that the improvement in glucose control was about what you might see if you added a second glucose-control drug to someone’s medication.
Bottom line. Getting plenty of exercise makes a real difference to how well you can control your diabetes. If you take insulin, be sure you know how to adjust your dose before exercising, to avoid getting a hypoglycemic attack.
Source
Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes [Journal of the American Medical Association (JAMA)]
Diabetes and dementia have a connection, and what we can do to delay it will be on the table during a diabetes education event in Sidney.
“I am clarifying the ties between dementia and diabetes,” said Dr. Dorothy (Sam) Williams, of her speaking engagement on May 14 at the Mary Winspear Centre.
Williams is vice-chief of Geriatric Medicine for the Vancouver Island Health Authority (VIHA), chief of staff for the VIHA South Island region, and acting chief of staff for Vancouver Island. She is a full-time clinician in geriatrics, a clinical instructor with the Department of Internal Medicine at UBC, a past president of the Medical Staff Association for South Island, and a member of the provincial Physician Health Program’s “Physicians Advocating Wellness” groups.
She’ll speak on Brain Function and Diabetes … What is the connection? during the Canadian Diabetic Association Vancouver Island regional annual meeting.
“Given that those high prevalence rates for both diabetes and dementia it really is increasing the awareness in the research world that this association has to be looked at and has enormous public impact,” she said. “We know that if you have diabetes you are more likely to develop a dementia. What we don’t yet know is if you have diabetes and you’re treated, will that decrease your chance of dementia?”
It’s unknown if treatment for diabetes has an ongoing effect on dementia
“That’s where the research world is now turning to,” she explained. In 25 years of research into dementia there’s nothing to treat the illness; treatments are symptomatic only, Williams noted.
“If treating diabetes can slow down the dementing process that would be the first time that has ever been shown.”
She feels the world is paying attention because of the pandemic in diabetes primarily caused by change in diet and obesity.
“At the end of the day it’s everybody that needs to hear this,” she said. The common sense treatments suggested, losing weight, eating healthier and changing lifestyle are still the best options. “We keep coming back full circle. At the very base of it is lifestyle modification.”
Williams speaks during the diabetes education event and annual general meeting Saturday, May 14 at 8:45 a.m.
For more information on changing lifestyles visit the Canadian Diabetes Association web site at www.diabetes.ca
FRIDAY, May 6 (HealthDay News) -- People with diabetes who sleep poorly have higher blood glucose levels and a more difficult time controlling their disease, a new study shows.
Researchers compared 40 people with type 2 diabetes to 531 people without the blood sugar disease. The investigators looked at potential links between sleep quality, blood glucose levels and other measures of diabetes control.
"We found that in those with diabetes, there was an association between poor sleep quality and worse glucose measures," said study leader Kristen Knutson, an assistant professor of medicine at the University of Chicago.
"We did not see a relationship in people without diabetes," she said.
The study is published in the May issue of Diabetes Care.
Previous research has found some linkage between diabetes and poor sleep. Knutson said it is just an association, not cause-and-effect. "It may be that people with diabetes are more vulnerable to the effects of impaired sleep," she said. "But it could go either way." Those who don't control their diabetes could have worse sleep than those who do, she said.
"We need to look more closely at the role of sleep in diabetes," she added.
For the study, Knutson monitored sleep by having people wear wrist activity monitors. "If you are moving your wrist a lot, you are probably awake," she said.
The participants also reported on their sleep quality.
The researchers found that those with diabetes who had trouble sleeping had a 23 percent higher fasting blood glucose level, a 48 percent higher fasting insulin level and an 82 percent higher insulin resistance than the normal sleepers with diabetes.
The findings tend to reflect what is seen in clinical practice, said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.
He, too, pointed out that the results beg the "chicken-egg" question. "They cannot tell us if the higher sugars were caused by the poor sleep or if the patients who have higher sugars don't sleep well or there are other factors causing that," Zonszein said.
Often, he noted, those with type 2 diabetes are overweight and that excess weight may impair sleep quality. Obesity is linked with sleep apnea, in which the patient often stops breathing during the night and is then awakened, for instance.
The take-home message for those with diabetes is to pay attention to their sleep quality, agreed Zonszein and Knutson. "If no sleep studies have been done, they might want to ask their doctor [about doing some],'" Zonszein said.
Reducing stress, which is easier said than done, should be another goal for those with diabetes and poor sleep, he added. "A lot of people are stressed, and they don't sleep well," Zonszein said.
"Don't wait for your doctor to ask you about sleep," said Knutson. "People with diabetes need to take their sleep seriously and talk to their doctor about it."
Researchers in Canada and the United States have uncovered a link between type 2 diabetes and problems with the body’s immune system, a breakthrough that it is hoped could lead to new immune system therapies for type 2 diabetes .
Although it has long been known that people suffering from type 1 diabetes have malfunctions in their immune system which destroy the insulin -producing cells in the pancreas, the type 2 version of the condition has not previously been seen as an autoimmune disorder .
However, this new study by scientists at the University of Toronto and Stanford University, and published in the journal Nature Medicine, has shown that immune system abnormalities could be involved in type 2 diabetes. In laboratory experiments, it was revealed that a mouse could develop type 2 diabetes due to a manipulation of its immune system.
It was also shown that blood samples from type 2 diabetes patients contained antibodies against some of their own proteins, which was explained as being due to their immune systems turning on them.
Daniel Winer, one of the lead authors on the study, commented "This data is highly suggestive that there is an autoimmune component in type 2 diabetes."
Washington: Einstein researchers have found a molecule in the brain that may contribute to obesity and one of its major complications – type 2 diabetes.
Nerve cells in the brain's hypothalamus detect nutrients and hormones circulating in the blood and then coordinate a complex series of behavioral and physiological responses to maintain a balance between calories eaten and calories burned.
Obesity and diabetes can result when this regulatory mechanism goes awry.
Now, a research by postdoctoral fellow Clemence Blouet and Prof Gary Schwartz at the Albert Einstein College of Medicine of Yeshiva University has revealed a molecule in the brain that may contribute to those health problems.
Their study on mouse models has shown that excess nutrient availability leads to an overabundance of a protein found in nutrient-sensing nerve cells of the hypothalamus.
They concluded that increased levels of this protein, known as thioredoxin-interacting protein, or TXNIP, contribute to the onset of obesity and the impaired control of blood sugar levels that characterizes type 2 diabetes.
"Our study indicates that TXNIP in hypothalamic nerve cells provides a crucial link between brain nutrient sensing and the increases in body weight and fat mass that lead to obesity and diabetes," said Schwartz.
"Hyperglycemia—pathologically elevated glucose levels—causes an excess of TXNIP in hypothalamic neurons, which in turn may contribute in several ways to a breakdown in energy homeostasis—the balance between calories taken in and calories burned.
“For example, we''ve found that elevated TXNIP in nerve cells contributes to obesity by decreasing energy expenditure, as evidenced by decreased physical activity, and by reducing the rate at which fat is burned to produce energy. In addition to increasing fat mass, hypothalamic TXNIP overabundance also impairs glucose tolerance and insulin sensitivity—two of the hallmarks of diabetes," said Schwartz.
Their findings were published in the April 20 online edition of the Journal of Neuroscience.
A report by scientists in the US has claimed that parents support the introduction of genetic testing on children, as they believe it is preferable to the negative consequences of not testing . The research, published in the journal Pediatrics, found that many parents that were offered genetic testing felt their children should also be tested in this way.
The research involved 219 parents being tested for 15 genetic variants linked to heart disease, type 2 diabetes, high cholesterol, osteoporosis, high blood pressure, as well as skin, colon and lung cancer . The parents were also questioned about the benefits of reassurance, knowledge and prevention, against risks such as psychological discomfort and the invasion of privacy.
The study state that "parents offered the genetic susceptibility test for common preventable conditions tended to consider that the potential benefits of this test for their own child could outweigh its risks."
However, non-profit lobby group Genewatch UK have stated that children should never be genetically tested for adult conditions. Helen Wallace, a director of Genewatch UK, commented "Online gene tests frequently give misleading results because most common conditions such as cancer, obesity or diabetes are not predicable from a person's genes, except in special circumstances."
She added "Children should not be tested for risk of adult-onset conditions, full stop. They should be allowed to decide for themselves, with medical advice, when they are grown up."
(Reuters Health) - Diet soda and other artificially-sweetened drinks - previously implicated in raising the chance of developing diabetes - are not guilty, suggests a new study from Harvard University researchers.
In a large group of men followed for 20 years, drinking regular soda and other sugary drinks often meant a person was more likely to get diabetes, but that was not true of artificially-sweetened soft drinks, or coffee or tea.
Replacing sugary drinks with diet versions seems to be a safe and healthy alternative, the authors said in The American Journal of Clinical Nutrition.
"There are multiple alternatives to regular soda," Dr. Frank Hu, one of the study's authors, told Reuters Health.
"Diet soda is perhaps not the best alternative, but moderate consumption is not going to have appreciable harmful effects," he said.
Prior studies have suggested that people who drink diet soda regularly might be more likely to get diabetes than those who stay away from artificially-sweetened drinks.
But this study indicates that the link is a result of other factors common to both diet soda drinkers and people with diabetes, including that they are more likely to be overweight.
In other words, people who are already diabetic or overweight are drinking more diet soda for those very reasons.
Hu and his colleagues analyzed data from more than 40,000 men who were followed between 1986 and 2006. During that time, participants regularly filled out questionnaires on their medical status and dietary habits, including how many servings of regular and diet sodas and other drinks they consumed every week.
About 7 percent of men reported that they were diagnosed with diabetes at some point during the study.
The researchers found that men who drank the most sugar-sweetened beverages - about one serving a day on average - were 16 percent more likely to be diagnosed with diabetes than men who never drank those beverages.
The link was mostly due to soda and other carbonated beverages, and drinking non-carbonated sugar-sweetened fruit drinks such as lemonade was not linked with a higher risk of diabetes.
When nothing else was accounted for, men who drank a lot of diet soda and other diet drinks were also more likely to get diabetes. But once researchers took into account men's weight, blood pressure, and cholesterol, those drinks were not related to diabetes risk.
That finding is "confirming the idea that it's really these differences between people who choose to, versus don't choose to, drink artificially-sweetened beverages" that is related to diabetes, Dr. Rebecca Brown, an endocrinologist at the National Institutes of Health, told Reuters Health.
"People who are at risk for diabetes or obesity ... those may be the people who are more likely to choose artificial sweeteners because they may be more likely to be dieting," said Brown, who has studied artificial sweeteners but was not involved in the current research.
Scientists in the United States have found that a vegetarian diet could substantially lower the risk of conditions such as diabetes, heart disease and stroke compared to those people who eat meat. The research revealed that vegetarians had a 36 per cent lower risk of metabolic syndrome, a potential precursor to these conditions, than that of non-vegetarians .
The team from Loma Linda University, whose work is published in the journal Diabetes Care, said their work showed vegetarians could be at a reduced risk of developing these conditions.
They reviewed over 700 adults from a long-term study into the health and lifestyle of nearly 1,000 Seventh-day Adventist Christians, finding that when factors such as age, race, gender, physical activity, calories consumption, smoking and alcohol intake were taken into account, although 25 per cent of vegetarians had metabolic syndrome, this increases to 37 per cent for semi-vegetarians and 39 per cent for non-vegetarians.
Even though the vegetarians on the study were slightly older, they exhibited lower glucose levels, triglycerides, blood pressure, waist circumference and body mass index (BMI). Semi-vegetarians, on the other hand, also showed substantially lower BMI and waist circumference as compared with the patients who ate meat more regularly.
A new study has clarified the link between high-fat diet and type 2 diabetes.
A diet high in saturated fat is a key contributor to type 2 diabetes, a major health threat worldwide. Several decades ago, scientists noticed that people with type 2 diabetes have overly active immune responses, leaving their bodies rife with inflammatory chemicals.
In addition, people who acquire the disease are typically obese and are resistant to insulin, the hormone that removes sugar from the blood and stores it as energy.
For years no one has known exactly how the three characteristics are related. But a handful of studies suggest that they are inextricably linked.
Now, researchers from the University of North Carolina at Chapel Hill School of Medicine found that saturated fatty acids but not the unsaturated type can activate immune cells to produce an inflammatory protein, called interleukin-1beta.
"The cellular path that mediates fatty acid metabolism is also the one that causes interleukin-1beta production," said senior study co-author Jenny Y. Ting, William Kenan Rand Professor in the Department of Microbiology and Immunology.
"Interleukin-1beta then acts on tissues and organs such as the liver, muscle and fat (adipose) to turn off their response to insulin, making them insulin resistant. As a result, activation of this pathway by fatty acid can lead to insulin resistance and type 2 diabetes symptoms," added Ting.
The study has been published in the journal Nature Immunology.
Scientists in Italy have identified a link between wrist size and a major risk factor for diabetes and heart disease in overweight children . They found that levels of insulin resistance were related to the size of the wrist bone, not the amount of fatty tissue around it. The scientists hope that measuring wrist size may offer an early warning sign for diabetes.
The study, published in the journal Circulation, examined 477 overweight and obese children with an average age of 10 years, and revealed that the circumference of the wrist could explain 12 per cent of the differences of blood insulin and levels of insulin resistance between children.
The team used the nuclear magnetic resonance imaging technique to show that the bigger the size of wrist, the more likely it was that the chid would exhibit signs of an underlying problem, and that the amount of bone in the wrist accounted for 17 per cent of the variation present.
Raffaella Buzzetti, lead researcher on the project, commented "Wrist circumference is easily measured and if our work is confirmed by future studies, wrist circumference could someday be used to predict insulin resistance and cardiovascular (heart and artery) disease risk."
Many commonly prescribed medications for patients with diabetes type 2 may be much less effective at preventing cardiovascular disease and death than oral metformin, Danish researchers revealed in the European Heart Journal this week. Diabetes drugs, such as glimepiride, glibenclamide (USA, Canada: glyburide), known as ISs (insulin secretagogues) have been commonly prescribed for many decades.
The authors explain that the long term risks linked to ISs have not been clearly studied. Neither has metformin been compared to ISs for long-term risk and comparative efficacy. Metformin is the first drug of choice for type 2 diabetes.
Dr. Tina Ken Schramm, Heart Centre at the Rigshospitalet Copenhagen University Hospital, and team tracked a large, unselected group of 107,806 people living in Denmark aged 20+ years, who had received either an IS or just metformin between 1997 and 2006.
They found that ISs monotherapy was linked to a higher risk of death from any cause, as well as a considerably greater risk of stroke, heart attack, and death from cardiovascular disease compared to metformin monotherapy. Examples of ISs included glimepiride, glibenclamide, glipizide and tolbutamide.
Monotherapy means treatment of an illness or disorder with just one drug.
They found the greater risk for those on ISs was for individuals who had already had a heart attack as well as those who hadn't. They added that "Two other ISs, gliclazide and repaglinide, showed no significant difference to metformin in their effectiveness in patients with and without a history of heart attacks."
Those on an IS had a fifth to one third greater risk of death from any cause than those on metformin. Among individuals who had already had a heart attack, the risk was about one third to one half greater.
The authors stress that their findings do not show that ISs cause harm. All they demonstrate is that metformin appears to be more effective.
Dr Schramm said:
"Previous studies have shown that ISs, in particular sulphonylureas, are associated with a reduction in long-term risk. Therefore, the increased risk from ISs shown in our study presumably has more to do with the beneficial effects of metformin, gliclazide and repaglinide, than the detrimental effect of the other ISs. This is the first study to compare all ISs with metformin despite a wide debate on the possible cardiovascular risk associated with ISs for about three decades. Our findings emphasise how important it is to conduct long-term follow up studies of glucose-lowering medications."
Researchers in the US have shown that the body mass index (BMI) of teenagers could help predict their future risk of diabetes and heart disease due to levels of obesity .
The study, published in the New England Journal of Medicine, found that a high BMI (but that still lies within the normal range) in a young adult is associated with type 2 diabetes and cardiovascular problems. However, those teenagers with a high BMI who then become thin as an adult can practically eliminate the predicted risk of developing diabetes because of obesity.
Amir Tirosh, lead author on the research, commented "Conversely, the risk of that person for heart disease will remain elevated compared to the lean teen who became a lean adult, though still will be lower than that of the heavier teen who became an obese adult."
The research monitored 37,000 teenage Israeli boys for an average of 17 years to examine how the BMI of adolescents can influence the chances of developing type 2 diabetes or cardiovascular disease in early to mid-adulthood.
The study advises that teenagers who are in the high but normal range should be doing something about their weight earlier despite not being recommended to do so by healthcare professionals . The team have still to explore whether the same results apply to teenage girls.
The National Institute for Clinical Excellence (NICE) has issued new foot care guidelines to hospitals for the treatment of people with diabetes .
Diabetic patients are significantly more at risk from foot problems than others with about 100 people with diabetes needing a lower leg or foot amputation every week. This is a high number of amputations and the guidelines from NICE sets out to reduce the incidence.
The guidelines state that hospitals should have a plan in place for how to manage foot problems. To support the plan, the hospital should have a team available who have been specifically trained in treating foot problems. Such a team should include a diabetologist, a diabetes specialist nurse, a surgeon and with expertise in diabetic foot problems, a podiatrist and a nurse specialised in wound care.
The new guidelines state that people with diabetic foot problems should be initially examined for a number of foot problems, including diabetic neuropathy, foot ulcers and charcot foot . Following this examination, they should then be referred to the specialist foot team within 24 hours.
The number of amputations for people with diabetes in the UK per week is high. However, with good control of blood glucose levels and regularly checking of your feet, particularly if you have reduced sensitivity in your feet, the chances of foot problems developing can be significantly reduced.
A new study has found that patients in their 50s with diabetes have nearly double the risk for developing ''geriatric'' ailments.
Regularly going a day without food may reduce your risk of heart disease and diabetes, research has suggested.
Doctors studied the health and habits of more than 200 residents in the state of Utah, where fasting for at least one day a month is a way of life for many Mormons.
X-ray scans revealed narrowing of the arteries in around 75 per cent of those who didn’t fast. In contrast, clogged arteries affected 63 per cent of those who said they often skipped meals.
Fasting also appeared to more than halve the odds of diabetes, the American College of Cardiology’s conference heard.
To ensure the results were not only due to those who fast having healthier lifestyles, the researchers carried out a second study on people who were not regular fasters.
They did not eat or drink anything other than water for 24 hours and underwent a series of health checks. They were also monitored while eating normally.
The tests revealed fasting triggers a significant surge in human growth hormone, a hormone credited with speeding up metabolism and burning off fat.
Levels rose 13-fold in women and 20-fold in men. Shedding fat is known to cut the risk of diabetes and related heart problems.
The fasting caused levels of cholesterol to rise but they returned to normal after the fast was over.
Doctors stressed that more research is needed before fasting can be prescribed to patients.
Nutritionist Dr Emma Williams said: ‘I wouldn’t be in a hurry to commence fasting, as the precise nature by which the body reacts to it remains relatively unknown.’
A new study has found that patients in their 50s with diabetes have nearly double the risk for developing ''geriatric'' ailments.
According to experts from the University of Michigan Health System and VA Ann Arbor Healthcare System, middle-aged adults with diabetes are much more likely to develop age-related conditions than their counterparts who don't have diabetes.
They found that adults between 51 and 70 with diabetes developed age-related ailments like cognitive impairment, incontinence, falls, dizziness, vision impairment and pain at a faster rate than those without diabetes.
"Our findings suggest that middle age adults with diabetes start to accumulate these age-related problems," said lead author Christine Cigolle.
"Because diabetes affects multiple organ systems, it has the potential to contribute significantly to the development of a number of issues that we associate with aging," she added.
The research was based on nationally representative data from the University of Michigan Health and Retirement Study.
The study has been published in the March issue of the Journal of General Internal Medicine.
People with diabetes account for 15 per cent of inpatients in England, according to an audit published today by NHS Diabetes.
Analysing clinical data of over 12,000 inpatients with diabetes from 206 hospitals as well as nearly 5,000 patient questionnaires, the 'National Diabetes Inpatient Audit (NaDIA) 2010 (England)' also found that at the time of the audit people with diabetes had been in hospital for an average of eight days, approximately three days longer than all inpatients. Nearly all (86.7 per cent) were admitted as an emergency.
The audit also discovered that over one third (37.1 per cent) of inpatients with diabetes experienced at least one medication error, a quarter (26.0 per cent) of their charts had prescription errors and a fifth (20.0 per cent) had one or more medication management errors. Insulin overdoses can result in potentially fatal hypoglycaemic episodes ('hypos')1 and insufficient insulin can lead to diabetic ketoacidosis (DKA)2 which, if left untreated, can also prove fatal. The audit found that patients with medication errors had twice the rate of severe hypoglycaemia (18.1 vs 7.9 per cent). Of further concern, whilst in hospital 44 people (0.4 per cent) developed DKA and 266 (2.4 per cent) had hypoglycaemia severe enough to require injectable treatment.
There is now a cure for a widespread disease that is sometimes deadly, diabetes.
26 million people in the United States have it and another 7 million have it but haven't been diagnosed.
Terri Adcock has suffered from Type 2 diabetes most of her life and she was also carrying a little extra weight. She had a surgery three years ago that left her diabetes free and full of life.
"Three years ago we went to Disney World and I had to be in a wheelchair," says Adcock.
I cannot wait to go back to Disney World and walk with everybody."
Three years after a Gastric Bypass surgery she is 110 pounds lighter, 12 sizes smaller and practically diabetes free.
"She was a great example of this she actually had 3-4 weight related health problems that were her big issues," says Dr. Steve Katsis of Saint Francis Hospital.
Adcock was diabetic, had asthma and high blood pressure. She use to take several pills and inhalers a day now she's down to half a blood pressure pill. Dr. Katsis says some patients are off insulin within hours after the surgery.
"That's really why we do the surgery I don't really care if somebody is 400 pounds if I can cure their diabetes and their blood pressure with a procedure," says Dr. Katsis.
He says he's glad that the International Diabetes Federation is now recognizing this cure for diabetes, but he's been doing weight loss surgeries benefiting diabetes for years. Dr. Katsis says this is more for patients with Type 2 diabetes.
He explains what exactly Gastric Bypass surgery is.
"Taking the top part of the stomach and creating a little pouch from that and that becomes the new reservoir for food," says Dr. Katsis.
It's practically cutting the stomach by 90%. So to fill the void of food, most patients turn to a vice. For Adcock it was shopping.
"I always wore the jeans that had elastic in them and you pulled them up well I have probably 50 pairs of jeans now that zip," says Adcock.
There can be risks with the surgery including blood clots and leaks. The Gastric Bypass surgery normally costs between $10,000 - $20,000.
Dr Katsis says there are some candidate requirements those include but are not limited to:
•BMI (Body Mass Index) above 40
•Tried to diet and exercise in past and did not work in losing weight
•Significant medical problems with a BMI over 30
A new report has found that an increasing number of children in the US are being diagnosed with type 2 diabetes, a condition that used to be known as adult-onset diabetes .
The study, by the Centers for Disease Control and Prevention, showed that around 3,700 people in the US under the age of 20 are diagnosed every year for type 2 diabetes, and that the trend has been growing over the last decade.
Another recent study of eighth-grade students in communities at high risk of diabetes in the US revealed that over half of the children were either overweight or obese, and that nearly a third of them had pre-diabetes . More work is being done to pinpoint problems earlier, with pediatricians checking children in an attempt to delay, or sometimes prevent, the onset of type 2 diabetes by prescribing lifestyle changes.
There are now reported to be over 25 million people in the US suffering from diabetes, more than 90 percent of which have the type 2 variety, and an additional 79 million who are thought to have pre-diabetes, where levels of blood sugar are high but not as much as in diabetes.
It is recommended that children with factors such as a neck rash, a family history of diabetes and whose weight is very high should be screened for diabetes.
Smoking is a health hazard for anyone, but for people with diabetes or a high risk of developing the disease, lighting up can contribute to serious health complications.
Researchers have long known that diabetes patients who smoke have higher blood sugar levels, making their disease more difficult to control and putting them at greater danger of developing complications such as blindness, nerve damage, kidney failure and heart problems. Now a new study offers the most definitive evidence why: the nicotine in cigarettes.
Xiao-Chuan Liu, a professor of chemistry at the California State Polytechnic University, presented results from his study of blood samples from diabetic smokers at the American Chemical Society national meeting and exposition. He found that nicotine, when added to human blood samples, raised levels of hemoglobin A1c (HbA1c) by as much as 34%.
Hemoglobin A1c — a combination of hemoglobin (which ferries oxygen) and glucose — is a standard indicator of blood sugar content in the body.
Doctors always knew smoking can make diabetes worse, but, Liu says, "now we know why. It's the nicotine. This study also implies that if you are a smoker, and not diabetic, that your chances of developing diabetes is higher."
The higher A1c levels rise in the blood, he says, the more likely it is that other protein complexes, which build up in various tissues of the body, from the eyes, heart and blood vessels, can form, leading to blockages in circulation and other complications.
But perhaps more importantly, the results also suggest that nicotine replacement products such as patches and nicotine-containing electronic cigarettes, aren't a safe option for diabetes patients either. Because they still contain nicotine, these products are just as likely to boost A1c levels as cigarettes are. "In order to minimize your chances of developing diabetes or diabetic complications, you need to quit smoking," says Liu. Even it means going cold turkey.
A new study shows that people who are high risk of developing Type 2 diabetes may be able to prevent the disease by taking pioglitazone (sold as Actos), a common drug for diabetes treatment. But experts say that doesn't mean everyone with high blood sugar levels should be taking the medication.
Diabetes often progresses from a condition of impaired insulin sensitivity to the full-blown disease. Doctors have long been eager to find medications or lifestyle changes that can slow this progression or stop it altogether. While 21 million Americans suffer from Type 2 diabetes, nearly four times as many have high blood sugar levels that put them at risk of developing the disease.
Now researchers led by Dr. Ralph DeFronzo at the Texas Diabetes Institute and University of Texas Health Science Center report in the New England Journal of Medicine that pioglitazone can be an effective tool in helping high-risk patients control their blood sugar and stop the onset of diabetes.
The drug helps diabetes patients become more sensitive to their body's insulin; in Type 2 diabetes, the amount of insulin patients make isn't sufficient to break down the sugar they consume in their diet.
Among more than 600 people with elevated blood sugar levels and at least one additional risk factor for diabetes — including a family history of diabetes, being overweight, high cholesterol levels or hypertension — 2% of those taking pioglitazone developed diabetes, compared with 7.6% of those in the placebo group, during the study's more than two year follow-up, amounting to a 72% reduction in risk for those taking pioglitazone. In addition, more of the volunteers who took pioglitazone were able to restore their glucose tolerance to normal levels than those who were on placebo.
The reduction in diabetes risk seen in the new study was greater than that of other interventions that doctors currently use to help people with pre-diabetes avoid the disease. Another drug used to treat diabetes and control blood sugar, metformin, can lower risk by 31%; other medications in pioglitazone's class have lowered risk by up to 62%; and lifestyle modifications such as diet and exercise have also reduced risk by 58%.
Research by scientists at the Mayo clinic and Olmsted Medical Center in Minnesota in the United States has found an apparent link between asthma and an increased risk of developing type 2 diabetes, as well as heart disease .
The study, involving data from a total of 2,392 asthma patients with age and gender factors taken into account, revealed that asthma was associated with an increased risk of developing diabetes and heart disease but not inflammatory bowel syndrome and rheumatoid arthritis . The incidence rate of diabetes for asthmatics was shown to be 138.4 per 100,000 people as compared with 104 per 100,000 people for non-asthmatics.
Study author Young J. Juhn commented "Asthmatics have a more allergy-prone immune environment called T-helper 2 (Th2) immune profile. This Th2 immune profile has a delicate balance with a counter-regulatory one called Th1 immune profile, which underlies proinflammatory conditions such as coronary artery disease, diabetes, rheumatoid arthritis and inflammatory bowel syndrome."
He added "While it's important for clinicians to be aware of the increased risks of coronary artery disease and diabetes in asthmatics, these findings should be interpreted cautiously given the preliminary nature."
The Centers for Disease Control and Prevention (CDC) in the US estimates that asthma affects about 24.6 million people in the country.
Daily intake of safflower oil over a 16 week period could be an effective way to reduce the risk of heart problems, and also can prevent type-2 diabetes According to the new study in United States. Safflower cooking oil can also help postmenopausal women who suffer from type 2 diabetes. It is said that women who add as little as one and two-third teaspoon of cooking oil to their diets can improve the blood sugar test score, cholesterol levels, inflammation and insulin sensitivity.
In the study, the researchers examined the result on the investigation that was previously done. They asked a group of diabetic postmenopausal women to add cooking oil on their diet. The researchers took a blood sample to the participants throughout the duration of the study.
The data on the study shows that there is an improvement to the condition in just 16 weeks of supplementation. The sensitivity of insulin rise up to 2.7 percent, C-reactive protein which is the marker of inflammation decreased by 17.5 percent. The blood sugar levels improved in between 11 to 19 points and the good cholesterol increased by 14 percent.
“The researchers said the safflower oil is rich in a polyunsaturated fatty acid (PUFA) known as linolec acid. This substance has been shown in previous investigations to support heart health. It is most likely behind the improvements in the condition of diabetics noted by the study.”
http://www.endocrineweb.com/news/type-2-diabetes/4880-changing-cooking-oil-may-benefit-postmenopausal-women-type-2-diabetes
Martha Belury, one who led the study said that, a small change in the eating manners to modify the content of fatty acid in the diet may improve the metabolic measure in people already consuming what it is considered as to be an adequate dietary linoleic acid amount. She added that we need DUFA in the diet to help with the cardiovascular diseases which is the number one killer of women in the country.
Studies have already shown that weight loss surgery, such as the gastric band, can reduce the symptoms of type 2 diabetes or even cure it altogether.
Now new research published in the Annals of Surgery has provided even more impressive figures monitoring obese patients with type 2 diabetes who had bariatric surgery – a massive 72% were cured of their diabetes with no symptoms a couple of years later.
ESCO (Experts in Severe and Complex Obesity), showed that all the gastric bypass patients monitored showed greater insulin production and better insulin resistance within just a week of the surgery.
The Hospital Group is the UK’s leading provider of bariatric surgery. CEO, David Ross, said “Many of our weight loss patients report that as they lose weight, associated conditions such as diabetes or hypertension literally disappear. Procedures like the gastric band are too often associated with celebrity slimmers. Yet the impact on the patients’ health, quality of life and even life expectancy are massive.
This new research is exciting, as it indicates that bariatric surgery itself offers specific benefits to diabetes sufferers; as the condition improves before any weight is even lost, due to the increase in insulin production and insulin resistance.
Our bariatric surgeons are very familiar with the full implications of being overweight and obese and can provide expert clinical advice not only on weight loss, but also on the impact of weight loss surgery on any other medical conditions.”
A new study by scientists in Boston has found that the more second-hand smoke that people are exposed to, the higher the risk of them getting type 2 diabetes . The research showed that smoke from cigarettes can increase the chances of type 2 diabetes, both for smokers and other people around them exposed to their smoke.
The study, which was published in Diabetes Care and shows the possible risk of second-hand smoke for the first time, examined submitted questionnaires regarding the amount of time spent around cigarette smoke from over 100,000 female nurses participating in a national study since 1982.
It was found that the women who smoked more than two packs of cigarettes per day were at the highest risk of developing diabetes, with around 30 of the heavy smokers getting diabetes every year for each 10,000 women in the study, as compared with around 25 women who did not smoke and spent no time with smokers.
It was also shown that the risk was highest for those who used to smoke and for women exposed to second-hand smoke. Once factors including age, weight, and family history of diabetes were taken into account, ex-smokers had a 12 per cent greater risk of diabetes compared to women who were regularly exposed to second-hand smoke. However, it is recommended that people don’t continue to smoke just because smokers had a lower risk of developing diabetes in this study.
A blood test that reveals if someone is at risk of diabetes at least a decade before symptoms appear has been developed.
By measuring levels of five markers in the blood, doctors are able to predict the onset of type 2 diabetes.
It could act as an early warning for those most at risk – giving them time to improve their diet or change their lifestyles.
Dr Thomas Wang, who developed the test, said: ‘These findings could provide insight into metabolic pathways that are altered very early in the process leading to diabetes.
‘They also raise the possibility that, in selected individuals, these measurements could identify those at greatest risk of developing diabetes so that early preventative measures could be instituted.’
Diabetes occurs when the pancreas is unable to produce enough insulin – the hormone that controls blood sugar – or when its insulin does not work properly.
Dr Wang and colleagues from the Massachusetts General Hospital looked at historic blood samples taken from 189 diabetics before they developed symptoms of the disease and compared them to blood from 189 healthy people.
After measuring levels of 61 metabolites – by-products of metabolism – they discovered five amino acids that were higher in the people who developed diabetes.
Some of these markers had previously been shown to be higher in people with obesity or insulin resistance.
When the researchers looked at people most likely to develop type 2 diabetes – such as those who are overweight or who have a family history – they found that those with the highest levels of the markers were up to five times more likely to get the disease than those with the lowest levels. The results are published in the journal Nature Medicine.
Victoria King, head of research at Diabetes UK, said early diagnosis and effective management was crucial to reduce the risk of complications such as heart disease, stroke, kidney failure and blindness.
‘This research could lead to ways to help us identify those at risk, as well as giving us new insights into how and why type 2 diabetes develops,’ she said.
Around two million Britons have type 2 diabetes, the kind linked to being overweight in middle age. Another 700,000 are thought to suffer without realising it.
What a woman eats while pregnant could increase her child’s risk of developing potentially life-threatening diseases in adulthood.
Research pinpointed how eating habits during the nine months of pregnancy affect a gene linked to diabetes, which is in turn associated with heart disease and kidney failure.It is thought these genetic changes could be inherited and passed on to future generations.
The study – in the emerging field of epigenetics – is the first to show how a poor diet during pregnancy increases children’s vulnerability to the effects of ageing.
The Royal College of Midwives said it was important women received “clear advice” about diet during pregnancy.
The study, by Cambridge University, which is published in the journal PNAS, reveals how the gene Hnf4a, which has been linked to type 2 diabetes, is regulated by maternal diet, through modifications to DNA.
Dr Susan Ozanne, the senior author on the paper and British Heart Foundation senior fellow from Cambridge’s Institute of Metabolic Science, said: “What is most exciting about these findings is that we are now starting to really understand how nutrition during the first nine months of life spent in the womb shapes our long-term health by influencing how the cells in our body age.”
“A healthy well-balanced diet is particularly important during pregnancy because of the impact on the baby long-term, and the potential impact on the grandchildren as well.”
Scientist have identified a gene variant present in some people of white European descent who have type 2 diabetes.
Although it's not yet clear how the gene works, it may prove a future target for treatments, among other benefits, say the authors of a study published March 2 in the Journal of the American Medical Association.
As with so many gene studies, however, these findings aren't likely to translate into anything clinically meaningful soon.
"This shows an association between this gene and an increased risk of diabetes compared to the general population," said Dr. Steven D. Wittlin, clinical director of the endocrine-metabolism division and director of the Diabetes Service at the University of Rochester Medical Center.
"If we can find out how this gene is associated with diabetes from a pathophysiological point of view, then we can figure out how to intervene, but that's a lot of ifs, and right now we have 92.5 percent of people with diabetes who don't have this gene," said Wittlin, who was not involved in the study.
Between 7 and 8 percent of the patients involved in this study had the gene variant, the researchers found.
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