Diabetes Watch Blog: From Medicineworld.org
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Medicineworld.org publishes a diabetes watch blog and this blog is run by JoAnn other bloggers. This diabetes watch blog brings you the latest in the field of diabetes. This includes personal stories, advances in diagnosis and treatment, and other observations about diabetes. Improving awareness about diabetes is an important mission of this group.
PCRM initiated development of the assay in 2002 after launching a clinical trial examining the effects of a low-fat vegan diet on diabetes. The only insulin test kits on the market at the time used two cruelly derived animal ingredients-fetal calf serum, a slaughterhouse byproduct that can harbor bacteria and viruses, and cells incubated in the abdomens of live mice, a painful procedure banned in several European countries but still legal in the United States. No one had ever manufactured an insulin assay kit without the animal serum, and numerous laboratories told PCRM it couldn't be done.
The resulting alternative, one grown in a synthetic medium, proved to be as accurate as the existing insulin testing method, and costs the same. Linco has begun manufacturing the animal-serum-free kit and offers it to researchers in the United States and abroad. The cruelty-free kit is expected to sell particularly well in Europe, where laboratories are concerned about bovine spongiform encephalopathy (mad cow disease) being transmitted in animal serum.
Type-1 diabetes is an autoimmune disease. For unknown reasons, at some point in childhood or adolescence, the body's own immune system starts attacking and destroying the insulin-producing islet cells in the pancreas. Once the majority of islet cells are destroyed, patients can no longer produce insulin to regulate their blood sugar and depend on strict diets and insulin injections.
Scientists are trying to understand the early events during the development of the disease. John Corbett and colleagues at St. Louis University have found that the early in the disease the islet cells die by a process called necrosis. Moreover, their study suggests some of the key factors involved. These are important results that will inform future studies toward the goal of understanding autoimmune diabetes well enough to prevent or stop its development.
Various studies are ongoing to find a solution to this auto-destruction of islet cells. It these attempts succeed, we may see a preventive strategy for type-1 diabetes in the future.
These findings are published in the latest issue of the New England Journal of Medicine. The study says that complications due to diabetes, such as eye, nerve and kidney damage that can be prevented by careful glucose control in people with Type 1 diabetes.
"Much to our delight, it appears that this intensive therapy introduced years and years ago seems to have this long-term benefit on heart disease and stroke," author David Nathan of Massachusetts General Hospital told Reuters.
It shows that aggressive diabetes treatment "should begin as early as possible and be maintained as long as possible," said co-author Saul Genuth of Case Western Reserve University.
The new discovery is an offshoot of a study begun in 1983 involving 1,441 people age 13 to 39 with Type 1 diabetes, which was once known as juvenile diabetes.
Half of the diabetics on this study were given intensive treatment using an insulin pump or at least three insulin injections a day, combined with careful monitoring, for an average of 6-1/2 years. The remainder received conventional treatment of one or two shots daily.
Most of the patients who got conventional treatment had more than one serious health event, so the Nathan team calculated that aggressive treatment cut the risk of heart attack, stroke or death from any cardiovascular problem by 57 percent.
Investigators in Boston report that for an overweight person secreting high levels of insulin, a low sugar diet can lead to greater weight loss than a diet rich in sugar.
When you have insulin resistance, the body does not use the normal amount of insulin secreted by the pancreas properly, causing the pancreas to secrete more insulin.
Because both resistance to insulin and insulin secretion are involved in the regulation of body weight, Dr. Anastassios G. Pittas, from Tufts-New England Medical Center, and associates theorized that dietary sugar load could counter the efforts designed to lose weight.
High-sugar load diets increase post-meal "hyperinsulinemia, which favors fatty acid uptake, inhibition of fat mobilization, and energy storage leading to weight gain," they note.
They also propose that an elevated sugar load may also boost hunger and thus increase eating during the post-absorptive period.
Researchers from University Hospital in Zurich studied 20 male smokers, who are at greater risk of hardening arteries characteristic of coronary heart disease, to see the effects of dark and white chocolate on arterial blood flow.
Diabetics can always find dark chocolate that does not contain sugar. Sugar-free chocolates are freely available in the market.
The group, who were asked to abstain from eating foods rich in antioxidants for 24 hours, were given 40 grams (2 ounces) of chocolate to eat.
After two hours, ultrasound scans revealed that dark chocolate which is made up of 74 percent cocoa solids, significantly improved the smoothness of arterial flow, whilst white chocolate, with four percent cocoa, had no effect, the study published in Heart magazine said.
The researchers, who said further studies were needed, suggested that the possible benefits arose from the antioxidants in dark chocolate.
"Only a small daily treat of dark chocolate may substantially increase the amount of antioxidant intake and beneficially affect vascular health," they said.
Fructose, the sugar found in fruit, honey and the corn-syrup sweeteners used in many processed foods, may trick the body into thinking it's hungrier than it really is, researchers report.
The findings could explain why sweet foods help boost obesity rates in the United States and elsewhere.
A word of caution in interpreting the study! The evidence comes from animal studies and not from human studies. Researchers at at the University of Florida identified fructose as part of a biochemical chain reaction that causes weight gain in rats.
Fructose can also cause an increase of uric acid levels in the blood, the Florida team found. This temporary rise in uric acid blocks the action of insulin, the hormone that regulates how body cells use and store the sugar they need for energy.
If increased uric acid levels occur frequently enough, features of metabolic syndrome may develop over time, the researchers said. These features include obesity, elevated blood cholesterol levels and high blood pressure.
This research paper is published in the December issue of the journal Nature Clinical Practice Nephrology and in the online edition of the American Journal of Physiology-Renal Physiology.
"If left untreated, overweight and poor diet among these children could have disastrous consequences for minority health and the health-care costs for future generations," Dr. Michael I. Goran, of the University of Southern California's Institute for Prevention Research said.
Previous research findings indicate that Latino children in the United States are more often overweight than are non-Latino white children. Latinos have also been shown to have a higher risk for diabetes than their white peers.
Goran and his colleagues studied 63 overweight children, ages 9 to 13 years, enrolled in the ongoing Study of Latinos at Risk Diabetes Project.
They found that children's sugar consumption was the only dietary component associated with insulin dynamics. Sugary foods and drinks accounted for more than 40 percent of the total carbohydrates consumed by these children, and almost half of their sugar consumption was in the form of sugary drinks. On average, children drank 2.5 daily servings of drinks with added sugar.
This high sugar intake was associated with lower beta cell function - a measure of the pancreas' ability to produce insulin - and a lower acute insulin response - how much insulin beta cells produce in response to glucose, study findings indicate.
These findings suggest that "high sugar levels may contribute to deterioration in beta cell function," Goran said.
"From a public health perspective, the aggregate effect of mental health conditions on medical care could prove to be quite substantial," Dr. Susan M. Frayne of the Veterans Administration Health Services Research and Development Centers of Excellence in Bedford, Massachusetts, told Reuters Health.
The investigation was not aimed at addressing the issue why such disparities in care might occur, however observations showed that this sub-optimal care may be the result of various factors including difficulty adhering to medication, or provider factors such as the nature of the interaction between providers and patients, or health care system factors such as difficulty with integration of mental and medical health services.
Frayne and her colleagues looked at data for 313,586 VA patients with diabetes, 25 percent of whom had some type of mental health condition.
Patients with a mental health condition were 24 percent more likely not to have had hemoglobin A1c testing, 24 percent more likely not to have had their low-density cholesterol tested, and 5 percent more likely not to have had an eye exam, the researchers found. Those with mental health conditions were also 32 percent more likely to have poor control over blood sugar levels.
The effect was more pronounced for psychosis, mania, substance use and personality disorders than for anxiety and depression, the researchers found. And the more mental health conditions a person had, the less likely he was to be receiving optimum care.
Researcher have long recognized the relationship between diabetes and pancreatic cancer, but it was not clear until now if diabetes was the cause or result of pancreatic cancer or merely represented a general risk factor that may increase the risk of both diabetes and pancreatic cancer.
To find answers, Dr. Rachael Z. Stolzenberg-Solomon and colleagues conducted a study that included data from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. The findings are reported in the Journal of the American Medical Association.
Within 5 years of follow-up, 169 patients developed pancreatic cancer. These subjects were compared with a random sample of 400 subjects without a cancer diagnosis. All of the subjects were male smokers between ages 50 of 69 years old, who were then followed for up to 16.7 years.
After the effects of age, years of smoking, and body mass index were considered, the researchers found that higher levels of glucose (blood sugar), insulin, and insulin resistance correlated with increasing risk of pancreatic cancer, the authors report.
Subjects diagnosed with diabetes and those with the highest insulin levels had twice the risk of developing pancreatic cancer. The length and the design of the study indicates that increased insulin levels and insulin resistance were the consequence of pancreatic cancer, Dr. Stolzenberg-Solomon and her colleagues add.
"Lifestyle changes to decrease glucose and insulin concentrations through weight reduction, increasing physical activity, and diet, such as decreasing saturated fat intake, ....could possibly impact pancreatic cancer development," they suggest.
The report was prepared by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics from data gathered by state and federal health agencies and through ongoing national surveys.
The report features an in-depth look at the 55-64 age group, which includes the oldest of the baby boomers. In 2011, the oldest of the boomers will be eligible for Medicare, and by 2014, the ranks of Americans ages 55-64 will swell to 40 million, up from 29 million in 2004.
"Controlling hypertension and obesity is crucial for health, and especially for baby boomers as they grow older," said HHS Secretary Mike Leavitt. "It's time to act against both conditions so more Americans can live longer, healthier lives."
Dr. Julie Gerberding, CDC Director, urged 55-to-64-year-olds to take careful stock now of their health, including such vital measures as weight, cholesterol level, blood pressure, risk of heart attack and any signs of diabetes. "The late 50s and early 60s are a crucial time of life to focus on disease prevention. It's never too late to adopt a healthy lifestyle to enjoy a longer, healthier life," she said.
While a number of adults in their late 50s and early 60s enjoy good health, others are dealing with chronic and debilitating diseases and lack of health insurance. The report finds that minorities - primarily blacks and Hispanics - are more likely to fall into those categories.
The report also notes that 11 percent of Americans ages 55-64 lack health insurance-compared to the national average of Americans under age 65 without health insurance (16.5 percent). Eighty-three percent of married adults ages 55-64 had private health insurance, compared to 60 percent of widowed, separated, divorced or single adults in that age group.
A new study suggests that the excess mortality associated with diabetes is disproportionately concentrated among those diabetics who were singleton term infants with low or high birth weight.
These findings are observed by researchers Dr. Cynthia L. Leibson and colleagues from the Mayo. This finding emphasizes the importance of preventing low birth deliveries as per the researchers.
Their findings also suggest that monitoring and treatment of diabetic complications and co-morbid conditions, such as high blood pressure and lipid abnormalities, are especially important in people with diabetes whose weight at birth was outside the normal range, she said.
Leibson and colleagues estimated the risk of death associated with diabetes as a function of birth weight for 171 adults with diabetes and 342 nondiabetic controls.
According to the team's report in Diabetes Care, the proportion of deaths among diabetics was more than twice that for controls. The difference was less apparent for normal-birth-weight individuals than for high-birth-weight individuals and low-birth-weight individuals (20 percent Vs 2 percent).
The purported benefit of either ACE inhibitors or ARBs comes from placebo-controlled studies, Dr. Casas and his colleagues reported in the recent issue of The Lancet. But when these agents were compared with other antihypertensive drugs that also substantially reduce blood pressure "there was no evidence of a significant salutary effect of ACE inhibitors or ARBs on renal outcomes in patients with diabetes."
The authors wrote that their analysis found that in patients with diabetic nephropathy there was no benefit seen in comparative trials of ACE inhibitors or ARBs on the doubling of creatinine, end-stage renal disease, glomerular filtration rate, or creatinine amounts.
On balance, the authors contended that the reported renoprotective benefit of ACE inhibitors and ARBs comes from a handful of smaller studies while the impact of drugs on end-stage renal disease and doubling of creatinine "showed a reduced benefit in large studies."
They pointed out, for example, that in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, there was no evidence for a greater beneficial effect of ACE inhibitors in people with poor renal function.
The authors found some evidence of "small benefits of the drugs" in trials of patients with non-diabetic renal disease. But those studies were small, they wrote, so the findings are subject to bias.
The take home, the authors concluded, is that the evidence does not support use of ACE inhibitors or ARBs as "first-line choices for renoprotection on the basis of efficacy, and residual uncertainty still exists about the inherent value of these drugs in other renal disorders."
Type-2 diabetes is the most common form of diabetes, accounting for 90% of cases diabetes. This disease affects nearly 17 million Americans and is the seventh leading cause of death in the United States. Even though 17 million Americans have type-2 diabetes only half of these people are aware that they have diabetes. The death rate in patients with diabetes may be up to 11 times higher than in persons without the disease. The occurrence of diabetes in persons 45 to 64 years of age is 7 percent, but the proportion increases significantly in persons 65 years of age or older. Type-2 diabetes accounts for more than 90% of all diabetes worldwide.
Diabetes Watch Blog: From Medicineworld.org
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