June 21, 2009, 8:42 PM CT

How obesity increases the risk for diabetes

Obesity is probably the most important factor in the development of insulin resistance, but science's understanding of the chain of events is still spotty. Now, scientists at the Salk Institute for Biological Studies have filled in the gap and identified the missing link between the two. Their findings, to be reported in the June 21, 2009 advance online edition of the journal Nature, explain how obesity sets the stage for diabetes and why thin people can become insulin-resistant.

The Salk team, led by Marc Montminy, Ph.D., a professor in the Clayton Foundation Laboratories for Peptide Biology, discovered how a condition known as ER (endoplasmic reticulum) stress, which is induced by a high fat diet and is overly activated in obese people, triggers aberrant glucose production in the liver, an important step on the path to insulin resistance.

In healthy people, a "fasting switch" only flips on glucose production when blood glucose levels run low during fasting. "The existence of a second cellular signaling cascadelike an alternate route from A to Bthat can modulate glucose production, presents the potential to identify new classes of drugs that might help to lower blood sugar by disrupting this alternative pathway," says Montminy.

It had been well established that obesity promotes insulin resistance through the inappropriate inactivation of a process called gluconeogenesis, where the liver creates glucose for fuel and which ordinarily occurs only in times of fasting. Yet, not all obese people become insulin resistant, and insulin resistance occurs in non-obese individuals, leading Montminy and colleagues to suspect that fasting-induced glucose production was only half the story......... Posted by: JoAnn      Read more         Source

June 11, 2009, 5:03 AM CT

Snoring pregnant women

If you are pregnant and your mate complains your frequent snoring is rattling the bedroom windows, you may have bigger problems than an annoyed, sleep-deprived partner.

A newly released study from scientists at the Northwestern University Feinberg School of Medicine has observed that women who reported frequent snoring during their pregnancy were more likely to develop gestational diabetes -- a condition than can cause health problems for the mother and baby. The study also found pregnancy increases the likelihood that a woman will snore.

This is the first study to report a link between snoring and gestational diabetes.

For the study, 189 healthy women completed a sleep survey at the time of enrollment (six to 20 weeks gestation) and in the third trimester.

Pregnant women who were frequent snorers had a 14.3 percent chance of developing gestational diabetes, while women who did not snore had a 3.3 percent chance. Even when scientists controlled for other factors that could contribute to gestational diabetes such as body mass index, age, race and ethnicity, frequent snoring was still.

linked to the disease.

Principal investigator Francesca Facco, M.D., a fellow at Northwestern's Feinberg School, will present her findings at the SLEEP 2009 23rd Annual Meeting of the Associated Professional Sleep Societies June 11......... Posted by: Emily      Read more         Source

June 9, 2009, 5:14 AM CT

Diabetes patients should have regular exercise

To reduce their cardiovascular risk, people with type 2 diabetes should do at least two-and-a-half hours per week of moderate-intensity or one-and-a-half hours per week of vigorous-intensity aerobic exercises, plus some weight training, as per an American Heart Association scientific statement published in Circulation: Journal of the American Heart Association.

The global increase in overweight and obesity has led to an "unprecedented epidemic" in type 2 diabetes (when the body is unable to use insulin efficiently to help turn glucose, or blood sugar, into energy for the body's cells). In 2007, type 2 diabetes in the United States cost an estimated $174 billion in direct medical costs and indirect costs such as disability, lost productivity and premature death. That amount represents a 30 percent increase from the $132 billion estimated in 2002, as per the statement.

Furthermore, heart and blood vessel disease is responsible for nearly 70 percent of deaths in people with type 2 diabetes.

"Given the observed increases in type 2 diabetes in adults over the last few decades in developed countries, and the increasing numbers of overweight and obese individuals throughout the world, we must look at ways to reduce the cardiovascular complications of diabetes, and exercise is one of those ways," said Thomas H. Marwick, M.D., Ph.D., chair of the writing group and professor of medicine and director of the Centre of Clinical Research Excellence in Cardiovascular and Metabolic Disease at the University of Queensland School of Medicine in Brisbane, Australia......... Posted by: JoAnn      Read more         Source

June 1, 2009, 5:10 AM CT

Obesity and diabetes double risk of HF

The twin epidemics of obesity and type 2 diabetes will continue to fuel an explosion in heart failure, already the world's most prevalent chronic cardiovascular disease, as per John McMurray, professor of cardiology at the Western Infirmary, Glasgow, and President of the Heart Failure Association. He reported that around one-third of patients with heart failure have evidence of diabetes, and for them the outlook is very serious. For doctors, he added, effective therapy is "very difficult".

Obesity, like diabetes, is increasing in prevalence. The latest report from Euroaspire, Europe's largest survey of cardiovascular risk factors in coronary patients, observed that the prevalence of obesity had increased from 25 per cent in 1997 to 38 per cent in just ten years and this in people who had already had at least one heart attack.

Now, a session at Heart Failure 2009 emphasises that obesity is not just linked to an increased risk of heart attack, but also and particularly - with an increased risk of heart failure.1,2 "Obesity is at least as great a risk factor for heart failure as it is for heart attack or stroke," says Professor McMurray. "Obesity more than doubles the risk".

The pathways by which obesity plays such a role in heart failure are still not fully understood, but have been shown to have an indirect effect via hypertension, or heart attack, or diabetes and a direct effect on the heart muscle itself. "We know that the underlying changes in the structure and function of the heart appears to be different in obese and non-obese patients with heart failure," says Professor McMurray. An even more "intriguing" suggestion, he added, is that adipose cells might act as an endocrine tissue, secreting substances which may have a harmful effect on heart tissue and blood vessels......... Posted by: JoAnn      Read more         Source

May 21, 2009, 6:04 AM CT

More than a bad night's sleep

Sleep apnea has long been known to be linked to obesity. But a newly released study reported in the recent issue of Diabetes Care finds that the disorder is widely undiagnosed among obese individuals with type 2 diabetes nearly 87 percent of participants reported symptoms, but were never diagnosed.

For those with untreated sleep apnea, it doesn't just mean their sleep is disrupted; existing research shows that it can also mean an increased risk of heart disease and stroke.

"The high prevalence of undiagnosed, and therefore, untreated sleep apnea among obese patients with diabetes constitutes a serious public health problem," said Gary Foster, PhD, main author and director of the Center for Obesity Research and Education at Temple University.

The newly released study, called Sleep AHEAD, looked at 306 obese patients with type 2 diabetes already enrolled in the Look AHEAD trial, a 16-site study investigating the long-term health impact of an intensive lifestyle intervention in 5, 145 overweight or obese adults with type 2 diabetes.

Each participant had a sleep study (polysomnogram) that measures various breathing and brain activity during sleep. Participants also filled out a series of questions about symptoms correlation to sleep (snoring, sleepiness during the day), and had their weight, height, waist and neck circumferences measured......... Posted by: JoAnn      Read more         Source

May 20, 2009, 6:54 PM CT

Risk of Gestational diabetes

Gestational diabetes happens in more than three per cent of pregnancies in Ontario. Commonly the condition resolves itself after delivery, but a number of studies have shown that these women are at a very high risk for developing "regular" type 2 diabetes during the later part of life. New research out of the Institute for Clinical Evaluative Sciences (ICES) has observed that even women with mild abnormalities in their blood sugar during pregnancy, previously thought not to have any clinical significance, are 2.5 times more likely to develop type 2 diabetes in comparison to those who had completely normal glucose testing.

• To test for gestational diabetes, women receive a glucose challenge test (GCT) in the late second trimester of pregnancy. If the result of this test is abnormal, they go on to have a diagnostic test, called the oral glucose tolerance test (OGTT). If this test does not show gestational diabetes, women are reassured their glucose levels are normal and that no further testing is needed.
• However, recent studies have suggested that women who have even mild abnormalities on either the GCT or the OGTT do actually have subtle differences in their metabolism after pregnancy.
• The study examined 15,000 pregnant women aged 20-49 in Ontario who had a mild abnormality on their GCT but did not ultimately get diagnosed with gestational diabetes. They were in comparison to about 60,000 pregnant women who did not have abnormalities on their GCT. The women were followed for 6.4 years after delivery, and those who had had an abnormal GCT were 2.5 times more likely to develop type 2 diabetes in comparison to those who had not had an abnormal GCT.

........ Posted by: Emily      Read more         Source

April 22, 2009, 5:26 AM CT

Sleep pattern and risk of diabetes

Scientists at Universit Laval's Faculty of Medicine have observed that people who sleep too much or not enough are at greater risk of developing type 2 diabetes or impaired glucose tolerance. The risk is 2 times higher for people who sleep less than 7 hours or more than 8 hours a night. The findings were published recently on the website of the journal Sleep Medicine

The scientists arrived at this conclusion after analyzing the life habits of 276 subjects over a 6-year period. They determined that over this timespan, approximately 20% of those with long and short sleep duration developed type 2 diabetes or impaired glucose tolerance versus only 7% among subjects who were average duration sleepers. Even after taking into account the effect attributable to differences in body mass among the subjects, the risk of diabetes and insulin resistance was still twice as high among those with longer and shorter sleep duration than average sleepers.

The scientists also point out that diabetes is not the only risk linked to sleep duration. A growing number of studies have shed light on a similar relationship between sleep and obesity, cardiovascular disease, and overall mortality. The authors observe that among adults, between 7 and 8 hours of nighttime sleep may be the optimum duration to protect against common diseases and premature death......... Posted by: JoAnn      Read more         Source

April 17, 2009, 5:03 AM CT

Laughter Coupled With Standard Diabetic Treatment

The correlation between the body, mind and spirit has been the subject of conventional scientific inquiry for some 20 years. The notion that psychosocial and societal considerations have a role in maintaining health and preventing disease became crystallized as a result of the experiences of a layman, Norman Cousins. In the 1970s, Cousins, then a writer and magazine editor of the popular Saturday Review, was diagnosed with an autoimmune disease. He theorized that if stress could worsen his condition, as some evidence suggested at the time, then positive emotions could improve his health. As a result, he prescribed himself, with the approval of his doctor, a regimen of humorous videos and shows like Candid Camera©. Ultimately, the disease went into remission and Cousins wrote a paper that was reported in the New England Journal (NEJM) and a book about his experience, Anatomy of an Illness: A Patient's Perspective, which was published in 1979. The book became a best seller and led to the investigation of a new field, known then as whole-person care or integrative medicine and now, lifestyle medicine.

Background

The unscientific foundation that was laid down by Cousins was taken up by a number of medical scientists including the academic medical researcher Dr. Lee Berk in the l980s. In earlier work, Berk and colleagues discovered that the anticipation of "mirthful laughter" had surprising and significant effects. Two hormones - beta-endorphins (the family of chemicals that elevates mood state) and human growth hormone (HGH; which helps with optimizing immunity) - increased by 27% and 87 % respectively in study subjects who anticipated watching a humorous video. There was no such increase among the control group who did not anticipate watching the humorous film. In another study, they observed that the same anticipation of mirthful laughter reduced the levels of three detrimental stress hormones. Cortisol (termed "the steroid stress hormone"), epinephrine (also known as adrenaline) and dopac, (the major catabolite of dopamine), were reduced 39, 70 and 38%, respectively (statistically significant in comparison to the control group). Chronically released high levels of these stress hormones can be detremential to the immune system......... Posted by: JoAnn      Read more         Source

March 31, 2009, 5:21 AM CT

Link Between Schizophrenia And Diabetes

People with schizophrenia are at increased risk for type 2 diabetes, Medical College of Georgia scientists have found.

In a study of 50 people newly-diagnosed with schizophrenia or a related psychotic disorder with no other known risk factors, 16 percent had either diabetes or an abnormal rate of glucose metabolism, says Dr. Brian Kirkpatrick, vice chair of the MCG Department of Psychiatry and Health Behavior. In a similar size control group of people without schizophrenia, none had signs of or had developed the disease.

People with diabetes cannot produce or properly use insulin, a hormone that converts glucose, starches and other food into energy.

"These findings point toward there being some shared environmental factors or genetic factors between the development of schizophrenia and diabetes," he says.

Dr. Kirkpatrick presented his findings at the International Congress on Schizophrenia Research in San Diego March 28-April 1.

Scientists have long suspected that schizophrenia led to an increased risk of diabetes, Dr. Kirkpatrick says.

To find out whether there was a link, he and his colleagues at the University of Barcelona in Spain and the University of Maryland administered a two-hour oral glucose test to patients who had still not been placed on anti-psychotic medication. Catching them before prescriptive therapy was important because scientists already knew that some of the most effective schizophrenia drugs also cause rapid weight gain - a risk factor for type 2 diabetes......... Posted by: JoAnn      Read more         Source

March 24, 2009, 6:18 AM CT

Intensive insulin therapy has its own risks

Intensive insulin treatment increases significantly the risk of hypoglycemia in critically ill patients, found a newly released study in CMAJ (http://www.cmaj.ca/press/cmaj.090206.pdf).

Intensive insulin treatment is used in a number of intensive care units around the world as a means to tightly regulate blood sugar. Eventhough labour intensive, it has been recommended as a standard of care for critically ill patients by a number of organizations including the American Diabetes Association and the American Association of Clinical Endocrinologists.

A randomized trial in 2001 reported that intensive insulin treatment significantly reduced hospital mortality, eventhough subsequent trials have reported inconsistent effects on mortality and higher rates of severe hypoglycemia.

The CMAJ study includes data from 26 trials, including the NICE-SUGAR Study on intensive insulin treatment, an international, multicentre randomized trial that is the largest intensive insulin treatment trial to date. The NICE-SUGAR study is published online in the New England Journal (NEJM) March 24, 2009 and March 26 for the print edition.

"By including the largest trial on intensive insulin treatment published to date, we provide the most current and precise estimate of the effect of intensive insulin treatment on vital status and hypoglycemia in the ICU setting," write Dr. Donald Griesdale, anesthesiologist and critical care doctor at Vancouver General Hospital and clinical instructor at the University of British Columbia, and coauthors......... Posted by: JoAnn      Read more         Source

March 3, 2009, 6:04 AM CT

Can we cure type 2 diabetes with bariatric surgery?

As the occurence rate of obesity-induced type 2 diabetes mellitus continues to increase worldwide, medical research indicates that surgery to reduce obesity can completely eliminate all manifestations of diabetes. As per a research findings reported in the March 2009 issue of The American Journal of Medicine, researchers analyzed 621 studies from 1990 to April of 2006, which showed that 78.1% of diabetic patients had complete resolution and diabetes was improved or resolved in 86.6% of patients as the result of bariatric surgery. The primary risk factor for type 2 diabetes is obesity, and 90% of all patients with type 2 diabetes are overweight or obese.

The dataset included 135,246 patients where 3188 patients reported resolution of the clinical and laboratory manifestations of type 2 diabetes. Nineteen studies with 11,175 patients reported both weight loss and diabetes resolution outcomes separately for the 4070 diabetic patients in those studies. Clinical findings were substantiated by the laboratory parameters of serum insulin, HbA1c, and glucose.

Scientists observed a progressive relationship of diabetes resolution and weight loss as a function of the operation performed: laparoscopic adjustable gastric banding, gastroplasty, gastric bypass, and biliopancreatic diversion/duodenal switch (BPD/DS). Gastric banding yielded 56.7% resolution, gastroplasty 79.7%, gastric bypass 80.3% and BPD/DS 95.1%. After more than 2 year post-operative, the corresponding resolutions were 58.3%, 77.5%, 70.9%, and 95.9%. In addition, the percent excess weight loss was 46.2%, 55.5%, 59.7% and 63.6%, for the type of surgery performed, respectively......... Posted by: JoAnn      Read more         Source

February 27, 2009, 6:22 AM CT

Taking care of muscles in type 2 diabetes

Research by kinesiology investigator Dustin Hittel, PhD, has proven that muscle in extremely obese individuals produces large amounts of a protein called myostatin, which normally inhibits muscle growth suggesting that for Type 2 diabetics, and the very obese, the task of getting healthy appears to be more difficult than initially thought.

It has been known for some years that naturally occurring mutations in the gene which controls myostatin results in doublemuscling in cattle, dogs and even humans. A number of in the body building community think that blocking myostatin is a shortcut to the Arnold Schwarzenegger body.

The flipside is that producing too much myostatin has been linked with muscle wasting conditions such as HIV-AIDS, starvation and now, Type 2 diabetes.

Hittel believes this appears to be due to a pre-diabetic condition known as insulin resistance that "tricks" the muscles into thinking the body is starving despite the fact that blood sugar levels are skyrocketing.

"When that happens, the body reverses muscle production using myostatin," says Hittel. "This is especially worrisome because losing muscle mass further erodes your ability to control your blood sugar with exercise".

One of the tell-tale signs of the transition between insulin resistance and full-blown Type 2 diabetes is a loss of muscle mass......... Posted by: JoAnn      Read more         Source

February 25, 2009, 6:19 AM CT

Diabetes can lead to postpartum depression

BOSTON, Mass. (Feb 23, 2009) Postpartum depression is a seriousand often undiagnosedcondition affecting about 10 to 12 percent of new mothers. Some of the causes might include personal history of depression, stressful life events, and lack of social, financial or emotional support. Left untreated, it can have lasting negative effects not only on the mother but on her child's development.

In the first study of its kind, researchers at Harvard Medical School and the University of Minnesota School of Public Health report that low-income women with diabetes have a more than 50% increased risk of experiencing this serious illness.

"While prior studies have linked diabetes and depression in the general population, this is the first time, to our knowledge, that the relationship has been studied specifically in pregnant women and new mothers," says Katy Backes Kozhimannil, research fellow in the Department of Ambulatory Care and Prevention at Harvard Medical School and Harvard Pilgrim Health Care. "We believe these findings may help clinicians better identify and treat depression in new mothers".

These findings are published in the February 25 edition of JAMA, the Journal of the American Medical Association

For over 25 years, clinicians have been aware that new mothers are at risk for postpartum depression. However, the condition is difficult to identify. A number of symptoms are attributed to the every-day struggles of being a new mother. Others, such as irrational thoughts about harming the baby or, on the other hand, obsessing over the baby's health, are simply difficult for new mothers to admit......... Posted by: JoAnn      Read more         Source

February 12, 2009, 5:36 AM CT

Elevated blood sugar level leads to decreased brain funciton

Results of a recent study conducted by scientists at Wake Forest University Baptist Medical Center and his colleagues show that cognitive functioning abilities drop as average blood sugar levels rise in people with type 2 diabetes.

The study appears in this month's issue of Diabetes Care

The ongoing Memory in Diabetes (MIND) study, a sub-study of the Action to Control Cardiovascular Risk in Diabetes Trial (ACCORD), found a statistically significant inverse relationship between A1C levels (average blood glucose levels over a period of two to three months) and subjects' scores on four cognitive tests. No association, however, was found between daily blood glucose levels (measured by the fasting plasma glucose test) and test scores.

For the study, scientists at 52 of the 77 ACCORD sites throughout the United States and Canada administered a 30-minute battery of cognitive tests to nearly 3,000 individuals ages 55 years and older.

"The tests used in the study measured several aspects of memory function," said Jeff Williamson, M.D., M.H.S., principal investigator for the study at the Wake Forest clinical site. "For example, we tested one's ability to switch back and forth between memory tasks or to 'multitask,' an important skill for people needing to manage their diabetes"......... Posted by: JoAnn      Read more         Source

January 27, 2009, 6:23 AM CT

Huge burden of diabetes

In the United States, nearly 13 percent of adults age 20 and older have diabetes, but 40 percent of them have not been diagnosed, as per epidemiologists from the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), whose study includes newly available data from an Oral Glucose Tolerance Test (OGTT). Diabetes is particularly common in the elderly: nearly one-third of those age 65 and older have the disease. An additional 30 percent of adults have pre-diabetes, a condition marked by elevated blood sugar that is still not in the diabetic range. The scientists report these findings in the February 2009 issue of Diabetes Care, which posted a pre-print version of the article online at http://diabetes.org/diabetescare.

The study compared the results of two national surveys that included a fasting blood glucose (FBG) test and 2-hour glucose reading from an OGTT. The OGTT gives more information about blood glucose abnormalities than the FBG test, which measures blood glucose after an overnight fast. The FBG test is easier and less costly than the OGTT, but the 2-hour test is more sensitive in identifying diabetes and pre-diabetes, particularly in older people. Two-hour glucose readings that are high but still not diabetic indicate a greater risk of cardiovascular disease and of developing diabetes than a high, but still not diabetic, fasting glucose level......... Posted by: JoAnn      Read more         Source

January 23, 2009, 6:09 AM CT

Sleep Apnea may lead to diabetes

In a study that addressed the issue of insulin sensitivity with respect to sleep disordered breathing (SDB), Naresh Punjabi, M.D., Ph.D. sought to examine the relationship between SDB and insulin resistance using the best tools at his disposal to do so.

The results definitively link SDB to pre-diabetic changes in insulin production and glucose metabolism. It was reported in the first issue for February of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

"In the past scientists have used body mass index, or BMI, as a proxy measure for body fat, but we know this to be a variable and crude tool to assess the true percentage of body fat," said Dr. Punjabi. "In addition, prior studies have used surrogate measurements to assess the body's response to insulin without investigating the interaction that occurs between reduced insulin sensitivity and increased insulin production in the body".

To address the shortcomings of prior studies, Dr. Punjabi and his colleagues used two tools in their investigation into the link between SDB and insulin resistance: dual-energy x-ray absorptiometry (DEXA), a highly precise technique for assessing body fat, and frequently sampled intravenous glucose tolerance test (FSIVGTT), which provides a detailed picture of the subject's insulin sensitivity over time, rather than a simple snapshot at a specific moment......... Posted by: JoAnn      Read more         Source

October 16, 2008, 10:49 PM CT

Aspirin does not prevent heart attacks in patients with diabetes

Taking regular aspirin and antioxidant supplements does not prevent heart attacks even in high risk groups with diabetes and asymptomatic arterial disease, and aspirin should only be given to patients with established heart disease, stroke or limb arterial disease, as per a research studypublished recently on bmj.com.

In light of these findings, and the evidence from six other well controlled trials, the prescribing practice of doctors and international guidelines should be evaluated so that aspirin is only prescribed to patients with established heart and stroke disease, argues the author of an accompanying editorial.

Patients with diabetes are two to five times more likely to suffer from heart disease than the general population and heart disease is a major cause of death in patients with type 1 and 2 diabetes. Eventhough there is considerable evidence showing no protective benefit of aspirin in high risk patients without heart disease, guidelines are inconsistent and aspirin is usually prescribed for the primary prevention of heart disease in patients with diabetes and with peripheral arterial disease.

But aspirin is one of the top 10 causes of adverse drug events reported to the Commission on Human Medicines. It causes gastrointestinal bleeding and the risk of bleeding increases with age and prolonged use......... Posted by: Daniel      Read more         Source

September 25, 2008, 11:06 PM CT

Continuous glucose monitoring in diabetic pregnant women

Continuous glucose monitoring as part of antenatal care for women with diabetes improves maternal blood glucose control and lowers birth weight and risk of macrosomia* (excessive birth weight in babies), as per a research studypublished on bmj.com today.

During pregnancy it is important that women with diabetes keep their blood glucose under control. If not, there may be an increase in the amount of glucose reaching the baby, which makes the baby grow faster than normal, and may cause difficulties at birth as well as an increased longer term risk of insulin resistance, obesity and type 2 diabetes.

Evidence suggests that measuring glucose more often improves outcomes, but the optimum frequency of blood glucose testing is not known.

Dr Helen Murphy and his colleagues examined whether continuous glucose monitoring during pregnancy can improve maternal glucose control and reduce birth weight and risk of macrosomia in babies of mothers with diabetes.

They recruited 71 pregnant women with type 1 and type 2 diabetes from antenatal clinics in the UK.

The women were randomly assigned to standard antenatal care (intermittent self monitoring of glucose levels using the finger prick technique) or intermittent monitoring plus continuous glucose monitoring (using glucose values from subcutaneous tissues measured electronically every 10 seconds, giving up to 288 measurements a day)......... Posted by: Emily      Read more         Source

August 27, 2008, 9:02 PM CT

Young Type-2 Diabetic Men Suffer Low Testosterone Levels

Young men with type 2 diabetes have significantly low levels of testosterone, endocrinologists at the University at Buffalo have found -- a condition that could have a critical effect on their quality of life and on their ability to father children.

This study follows research published earlier by these researchers reporting that one-third of middle-aged men with type 2 diabetes have low testosterone levels, requiring therapy for erectile dysfunction.

"These new findings have several clinical implications besides the impairment of sexual function in these young men," said Paresh Dandona, Ph.D., UB Distinguished Professor in the Department of Medicine and senior author on both studies.

"The lack of testosterone during these critical years may lead to diminished bone mass and the lack of development or lose of skeletal muscle. In addition, these patients may gain more weight (with an average body mass index of 38 they already were obese) and become more insulin resistant.

"Also, patients with low testosterone and type 2 diabetes have been shown to have very high concentrations of C reactive protein," he added, "which increases their risk of developing atherosclerosis and heart disease above and beyond the risk linked to diabetes".

Results of the new study appear in the online edition of Diabetes Care and will be published in an upcoming edition of the journal......... Posted by: JoAnn      Read more         Source

July 1, 2008, 8:50 PM CT

A step towards better diabetes treatment

In today's issue of the prestigious journal Cell Metabolism Uppsala researchers are presenting new findings that shed light on the processes that determine the release of the blood sugar-lowering hormone insulin. The discovery is based on the development of image analysis methods that make possible the detailed study of events immediately inside the plasma membrane of the insulin-secreting cells.

Cyclic AMP (cAMP) is a universal messenger molecule that controls many different functions inside the cell. For example, it plays a role in the release of insulin from the beta cells in the pancreas (see Facts). It is well-known that the production of cAMP explains how certain hormones can amplify insulin secretion. Conversely, it has been unclear to what extent cAMP also contributes to the major release of insulin triggered by an increase in blood sugar (glucose).

Anders Tengholms research team at Uppsala University has developed methods that make it possible for the first time to measure both the secretion of insulin and the cAMP concentration in individual beta cells. The results show that ATP, the energy-rich molecule that is produced when glucose is metabolized, causes an increase in cAMP concentration right at the cell membrane where the release of insulin takes place. This increase varies rhythmically and coincides with similarly regular variations in another stimulant messenger, the calcium ion, resulting in pulsatile secretion of insulin......... Posted by: Scott      Read more         Source

June 5, 2008, 10:28 PM CT

Vitamin D and type 1 diabetes

Sun exposure and vitamin D levels may play a strong role in risk of type 1 diabetes in children, as per new findings by scientists at the Moores Cancer Center at University of California, San Diego (UCSD) and the Department of Family and Preventive Medicine. This association comes on the heels of similar research findings by this same group regarding vitamin D levels and several major cancers.

In this new study, the scientists observed that populations living at or near the equator, where there is abundant sunshine (and ultraviolet B irradiance) have low incidence rates of type 1 diabetes. On the other hand, populations at higher latitudes, where available sunlight is scarcer, have higher incidence rates. These findings add new support to the concept of a role of vitamin D in reducing risk of this disease.

Ultraviolet B (UVB) exposure triggers photosynthesis of vitamin D3 in the skin. This form of vitamin D also is available through diet and supplements.

"This is the first study, to our knowledge, to show that higher serum levels of vitamin D are linked to reduced incidence rates of type 1 diabetes worldwide," said Cedric F. Garland, Dr. P.H., professor of Family and Preventive Medicine in the UCSD School of Medicine, and member of the Moores UCSD Cancer Center......... Posted by: JoAnn      Read more         Source

May 8, 2008, 9:14 PM CT

How slow growth as a fetus can cause diabetes as an adult

Intrauterine growth retardation (IUGR), which results in a baby having a low weight at birth, has been associated with the development of type 2 diabetes in adulthood. It has been suggested that this is because the expression of key genes is altered during fetal development and that this affects disease susceptibility during the later part of life. Evidence to support this hypothesis and indicating that the changes in gene expression might be permanent has now been provided by Rebecca Simmons and his colleagues, at the University of Pennsylvania, Philadelphia, using a rat model of IUGR.

Pervious studies using the rat model of IUGR have shown decreased fetal expression of the gene Pdx1, which is critical for the development and function of the cells that become defective in type 2 diabetes (pancreatic beta-cells), and adult onset of diabetes. In this study, expression of Pdx1 was found to be reduced in pancreatic beta-cells throughout life following IUGR. The molecular mechanisms (known as epigenetic mechanisms because they affect gene expression without altering the information in the gene) that reduced Pdx1 expression in pancreatic beta-cells were found to change during development. One mechanism was observed in the fetus, one following birth, and one after the onset of diabetes in adulthood. Of interest, the mechanisms reducing Pdx1 gene expression in the fetus and following birth could be reversed, whereas those reducing Pdx1 gene expression in the adult were irreversible. These data provide new insight into the mechanisms by which diabetes develops in adulthood following IUGR......... Posted by: Emily      Read more         Source

April 30, 2008, 5:55 PM CT

Salk study links diabetes and Alzheimer's disease

Diabetic individuals have a significantly higher risk of developing Alzheimers disease but the molecular correlation between the two remains unexplained. Now, scientists at the Salk Institute for Biological Studies identified the probable molecular basis for the diabetes Alzheimers interaction.

As per a research findings reported in the current online issue of Neurobiology of Aging, researchers led by David R. Schubert, Ph.D., professor in the Cellular Neurobiology Laboratory, report that the blood vessels in the brain of young diabetic mice are damaged by the interaction of elevated blood glucose levels characteristic of diabetes and low levels of beta amyloid, a peptide that clumps to form the senile plaques that riddle the brains of Alzheimers patients.

Eventhough the damage took place long before the first plaques appeared, the mice suffered from significant memory loss and an increase in inflammation in the brain. Eventhough the toxic beta amyloid peptide was first isolated from the brain blood vessels of Alzheimers patients, the contribution of pathological changes in brain vascular tissue to the disease has not been well studied, says Dave R. Schubert, Ph.D., professor and head of the Cellular Neurobiology Laboratory. Our data clearly describe a biochemical mechanism to explain the epidemiology, and identify targets for drug development......... Posted by: JoAnn      Read more         Source

April 8, 2008, 9:58 PM CT

Cholesterol, blood pressure control in diabetics

Aggressively lowering cholesterol and blood pressure levels below current targets in adults with type 2 diabetes may help to prevent and possibly reverse hardening of the arteries, as per new research supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. Hardening of the arteries, also known as atherosclerosis, is the number one cause of heart disease and can lead to heart attack, stroke, and death.

The three-year study of 499 participants is the first to compare two therapy targets for LDL (bad) cholesterol and systolic blood pressure levels, key risk factors for heart disease, in people with diabetes. Results are reported in the April 9 issue of the Journal of the American Medical Association.

This study provides good news for adults with type 2 diabetes, said Elizabeth G. Nabel, M.D., NHLBI director. These patients are two to four times more likely than people without diabetes to die from heart disease. For the first time, we have evidence that aggressively lowering LDL cholesterol and blood pressure can actually reverse damage to the arteries in middle-aged adults with diabetes.

In the Stop Atherosclerosis in Native Diabetics Study (SANDS), approximately one-half of the participants (247) were asked to lower to standard levels their LDL cholesterol (to 100 milligrams per deciliter) and blood pressure (systolic blood pressure of 130 mmHg or lower), while the other half (252) aimed for more aggressive lowering of LDL cholesterol to 70 mg/dL or lower and of systolic blood pressure to 115 mmHg or lower. All participants were American Indians 40 years or older (average age of 56) who had diabetes, high blood cholesterol, and hypertension but no history of heart attack or other evidence of heart disease. The study was conducted at four clinical centers in southwestern Oklahoma; Phoenix, Ariz.; northeastern Arizona; and South Dakota. All participants continued to receive their medical care, including diabetes management, dietary and exercise counseling, and smoking cessation, from their health care providers with the Indian Health Service. Like the NIH, the Indian Health Service is part of the U.S. Department of Health and Human Services......... Posted by: JoAnn      Read more         Source