February 3, 2010, 2:21 PM CT

Reducing complications of obesity

Eventhough obesity is a risk factor for diabetes and coronary heart disease worldwide, only some obese individuals go on to develop these metabolic complications, while others are relatively protected. Defining these protective factors could help researchers prevent disease in the wider population.

To this end, a research team at the Gladstone Institute of Cardiovascular Disease, led by Suneil Koliwad, MD, PhD, recently added new details that link obesity to diabetes and heart disease.

When individuals become obese from overeating, cells called adipocytes located in the fat tissue fill up with dietary fats and begin to die. Immune cells called macrophages move out of the blood stream and into this tissue, where they accumulate around dying adipocytes. As the macrophages work to clear away the dead cells, they are exposed to large amounts of dietary fat that can result in unwanted consequences. Exposure to saturated fats, in particular, causes the macrophages to enter an inflammatory state. In this state, the macrophages secrete cytokines, such as tumor necrosis factor (TNF) alpha, that encourage the development of insulin resistance, diabetes, and heart disease.

The Gladstone team hypothesized that enhancing the capacity of macrophages to store dietary fats might alter this process. To do this, they focused on an enzyme called DGAT1, which makes triglycerides from dietary fats for storage as cellular energy reserves......... Posted by: JoAnn      Read more         Source

December 1, 2009, 8:14 AM CT

Glucose intolerance in pregnancy

Women who have gestational glucose intolerance (a condition less severe than gestational diabetes) exhibit multiple cardiovascular risk factors as early as three months after birth, as per a newly released study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

Scientists in this study sought to evaluate the relationship between gestational glucose intolerance and postpartum risk of metabolic syndrome (defined as the clustering of several cardiometabolic risk factors including obesity, high blood pressure and low HDL cholesterol). Metabolic syndrome, like gestational diabetes itself, is linked to increased risk of developing type 2 diabetes and cardiovascular disease.

Scientists followed 487 women who underwent oral glucose tolerance testing during pregnancy. Each subject was classified as either having normal glucose tolerance, gestational glucose intolerance or gestational diabetes. At three months postpartum, scientists reviewed each subject's cardiometabolic characteristics, such as blood pressure, weight, waist measurement and lipid levels.

Findings support that even mild glucose intolerance during pregnancy predicts an increased likelihood of the metabolic syndrome at 3 months postpartum. The presence of cardiovascular risk factors as early as three months postpartum indicates that these risk factors appears to be longstanding and contribute to the long-term risk of cardiovascular disease in this patient population......... Posted by: Emily      Read more         Source

November 24, 2009, 11:22 AM CT

What makes obese people develop diabetes?

A number of people who are overweight or obese develop insulin resistance and type 2 diabetes at some stage in their lives. A European research team has now discovered that obese people have large amounts of the molecule CXCL5, produced by certain cells in fatty tissue.

The main risk factors for type 2 diabetes are obesity and a sedentary lifestyle. The biomedical community has known for a number of years that substances produced by fatty tissue are responsible for the link between obesity and diabetes. "Chronic inflammation of the adipose tissue, which is characteristic of obese people, is a crucial stage in the development of insulin resistence and type 2 diabetes", Lluis Fajas, main author of the study and a researcher at the Institute of Health and Medical Research (Inserm) in France, told SINC.

The results of this newly released study show that serum levels of a chemokine molecule called CXCL5, produced by certain adipose tissue cells, appear at much high levels in the tissues of obese people than in those of individuals with normal weight. This has helped Lluis Fajas's research team to come to a biomedically relevant conclusion: "The CXCL5 molecule helps cause insulin resistance and type 2 diabetes".

The most important part of this study, reported in the journal Cell Metabolism, is the discovery that an experimental therapy aimed at inhibiting the action of CXCL5 can help to protect obese mice from develping type 2 diabetes. "If these studies can be confirmed in humans, this therapy would represent a fundamental improvement in the quality of life of obese individuals", the researcher concludes......... Posted by: JoAnn      Read more         Source

November 2, 2009, 11:52 PM CT

Fruit Fly Model toUnderstand Diabetes

As rates of obesity, diabetes, and related disorders have reached epidemic proportions in the US in recent years, researchers are working from a number of angles to pinpoint the causes and contributing factors involved in this public health crisis. While sedentary lifestyles and diets high in sugar and fat contribute significantly to the rise in diabetes rates, genetic factors may make some people more vulnerable than others to developing diabetes.

Scientists at the University of Maryland are using the fruit fly, Drosophila melanogaster, as a model system to unravel what genes and gene pathways are involved in the metabolic changes that lead to insulin resistance and full-blown diabetes in humans. In research reported in the Proceedings of the National Academy of Sciences (November 2, 2009), Leslie Pick, an associate professor in the department of entomology, and his colleagues describe how they altered genes in fruit flies to model the loss of insulin production, as seen in human Type 1 diabetes.

"These mutant flies show symptoms that look very similar to human diabetes," explains Dr. Pick. "They have the hallmark characteristic which is elevated blood sugar levels. They are also lethargic and appear to be breaking down their fat tissue to get energy, even while they are eating -- a situation in which normal animals would be storing fat, not breaking it down"......... Posted by: JoAnn      Read more         Source

October 29, 2009, 11:19 PM CT

Smartphone Games For Elderly Diabetics

Cellular phones - once a luxury used strictly for talking - have taken on a number of new roles in recent years. Now scientists at Saint Louis University and Old Dominion University in Virginia say smartphones can be used to help elderly diabetics manage their health and learn more about their condition.

A team of scientists from business, engineering, medicine and public health, as well as practitioners and scientists in China, designed the smartphone technology, which includes interactive games and easy-to-use logging features, particularly for elderly Chinese diabetics. They will present their research on Thursday, Oct. 29 in Washington, D.C. at the mHealth Summit, a public-private partnership of the Foundation for the National Institutes of Health.

Initial studies of the interactive diabetes self-management system, called the Chinese Aged Diabetic Assistant (CADA), are promising, scientists found. The system enables diabetics to track their blood glucose, weight, diet, exercise, mood and blood pressure - valuable information that will assist their doctors in providing the best care possible.

"We know that patients with chronic illnesses who are actively involved in their health care have better outcomes, yet this can be a challenging task. Mobile technologies can empower elderly people to better understand diabetes, track their health indicators more closely and follow a healthier lifestyle," said Maggie Jiao Ma, Ph.D., assistant professor at SLU's Parks College of Engineering, Aviation and Technology......... Posted by: JoAnn      Read more         Source

October 20, 2009, 8:38 AM CT

285 million people worldwide have diabetes

The International Diabetes Federation (IDF) released new data today showing that a staggering 285 million people worldwide have diabetes. The latest figures from the IDF Diabetes Atlas indicate that people in low and middle-income countries (LMCs) are bearing the brunt of the epidemic, and that the disease is affecting far more people of working age than previously believed.

In 1985, the best data available suggested that 30 million people had diabetes worldwide. Fast-forward 15 years and the numbers were revised to just over 150 million. Today, less than 10 years on, the new figures - launched at the 20th World Diabetes Congress in Montreal, Canada - put the number closer to 300 million, with more than half aged between 20 and 60. IDF predicts that, if the current rate of growth continues unchecked, the total number will exceed 435 million in 2030 - a number of more people than the current population of North America.

Professor Jean Claude Mbanya, President of the International Diabetes Federation, voiced concern: "The data from the latest edition of the IDF Diabetes Atlas show that the epidemic is out of control. We are losing ground in the struggle to contain diabetes. No country is immune and no country is fully equipped to repel this common enemy".

Type 1 diabetes cannot be prevented. It is an autoimmune disease in which the body destroys its own insulin-producing cells. People with type 1 diabetes require daily injections of insulin to survive. The majority of all diabetes is type 2 diabetes (85%-95%), which in a number of cases can be prevented. People with type 2 diabetes cannot use the insulin they produce effectively, but can often manage their condition through exercise and diet, eventhough a number of go on to require medication, including insulin, to properly control blood glucose levels. It is estimated 60% or more of type 2 diabetes could be prevented......... Posted by: JoAnn      Read more         Source

October 6, 2009, 7:16 AM CT

Resveratrol, brain and diabetes

Resveratrol, a molecule found in red grapes, has been shown to improve diabetes when delivered orally to rodents. Until now, however, little has been known about how these beneficial changes are mediated in the body. A newly released study accepted for publication in Endocrinology, a journal of The Endocrine Society, shows that the brain plays a key role in mediating resveratrol's anti-diabetic actions, potentially paving the way for future orally-delivered diabetes medications that target the brain.

Resveratrol activates sirtuins, a class of proteins that are thought to underlie a number of of the beneficial effects of calorie restriction. Prior studies in mice have provided compelling evidence that when sirtuins are activated by resveratrol, diabetes is improved. Sirtuin activators are now being tested in humans as anti-diabetic compounds.

Sirtuins are expressed virtually everywhere throughout the body and until now, little has been known about what tissues mediate resveratrol's beneficial effects. Knowing where in the body the beneficial effects of activated sirtuins are mediated could help in the development of more effective targeted diabetes medications.

"We know that sirtuins are expressed in parts of the brain known to govern glucose metabolism, so we hypothesized that the brain could be mediating resveratrol's anti-diabetic actions," said Roberto Coppari, PhD, of the University of Texas Southwestern Medical Center and co-author of the study. "To test the hypothesis, we assessed the metabolic consequences of delivering resveratrol directly into the brain of diabetic mice. We observed that resveratrol did activate sirtuins in the brain of these mice which resulted in improving their high levels of blood sugar and insulin"......... Posted by: JoAnn      Read more         Source

October 6, 2009, 7:12 AM CT

How your ethnicity and diabetic risk are related?

Fat and muscle mass, as potentially determined by a person's ethnic background, may contribute to diabetes risk, as per a newly released study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

Obesity, a worldwide health concern, is linked to increased insulin resistance, type 2 diabetes and cardiovascular disease. The prevalence of obesity is increasing in all populations across the globe, yet past research has observed that body fat distribution varies widely among different ethnic groups. Scientists in this study investigated which ethnic groups were most likely to be at increased risk for diabetes due to higher total body fat and lower muscle mass.

"We know certain ethnic backgrounds show significant differences in amounts of body fat and lean mass," said Scott Lear, PhD, of Simon Fraser University in Vancouver, Canada and main author of the study. "What we didn't know, until now, is if these differences are correlation to insulin levels and insulin resistance, and therefore lead to an increased risk for diabetes. Our findings indicate they are".

In this study, scientists measured insulin levels and compared the amount of total body fat to lean mass in 828 men and women of Aboriginal, Chinese, European and South Asian origin to determine how differences in fat mass and lean mass appears to be correlation to insulin levels and insulin resistance in each group. Of the four ethnic groups studied, South Asians were found to have both higher fat mass, lower muscle mass and greater insulin levels, placing them at increased risk for insulin resistance and diabetes......... Posted by: JoAnn      Read more         Source

September 29, 2009, 10:39 PM CT

Metabolic syndrome, liver disease and obese teenaged boy

Scientists studying a large sample of adolescent American boys have found an association between metabolic syndrome, which is a complication of obesity, and elevated liver enzymes that mark potentially serious liver disease.

The link between metabolic syndrome and the suspected liver disease did not appear in adolescent girls, said study leader Rose C. Graham, M.D., a pediatric gastroenterologist at The Children's Hospital of Philadelphia. There were ethnic differences among the boys as well, she added, between Hispanic and non-Hispanic males.

The study appears in the October 2009 print edition of the Journal of Pediatric Gastroenterology and Nutrition

Metabolic syndrome is of concern as a risk factor for cardiovascular disease and type 2 diabetes, and is estimated to occur in 22 percent of U.S. adults and 4 percent of U.S. adolescents. It is defined by insulin resistance, increased waist circumference, high blood pressure, and abnormal measures of high density lipoprotein ("good cholesterol") and triglycerides in the blood. The criteria are similar for pediatric metabolic syndrome, eventhough there is some dispute over details of the definition.

In adults, scientists have shown an association between metabolic syndrome and a group of diseases called nonalcoholic fatty liver disease (NAFLD), which at its most severe, may progress to irreversible liver damage. The purpose of the current study was to investigate to what extent metabolic syndrome in adolescents was linked to elevated levels of the liver enzyme alanine aminotransferase (ALT), a marker of NAFLD......... Posted by: JoAnn      Read more         Source

September 28, 2009, 7:23 AM CT

Diabetic women at higher risk of irregular heart beat

Diabetes increases by 26 percent the likelihood that women will develop atrial fibrillation (AF), a potentially dangerous irregular heart rhythm that can lead to stroke, heart failure, and chronic fatigue. These are the findings of a new Kaiser Permanente study, reported in the recent issue of Diabetes Care, a journal of the American Diabetes Association.

While other studies have observed that patients with diabetes are more likely to have AF, this is the first large studyinvolving nearly 35,000 Kaiser Permanente patients over the course of seven yearsto isolate the effect of diabetes and determine that it is an independent risk factor for women.

The most important finding from our study is that women with diabetes have an increased risk of developing this abnormal heart rhythm, said the studys main author, Greg Nichols, PhD, investigator at the Kaiser Permanente Center for Health Research in Portland, Ore. Men with diabetes are also at higher risk, but the association between the two conditions is not as strong. For men, obesity and hypertension are bigger risk factors from diabetes.

AF is the most common arrhythmia in the world, and diabetes is one of the most common and costly health conditions. Our study points out that there is a correlation between these two growing epidemicsone we should pay closer attention to, particularly among women, says Sumeet Chugh, MD, co-author and associate director of the Cedars-Sinai Heart Institute in Los Angeles. The gender differences need to be looked at more closely because they could have significant implications for how we treat diabetes in men and women......... Posted by: JoAnn      Read more         Source

September 28, 2009, 6:41 AM CT

Diabetes weakens your bones

Boston, MA and Newark, NJ Current research suggests that the inflammatory molecule TNF-α may contribute to delayed bone fracture healing in diabetics. The related report by Alblowi et al, "High Levels of TNF-α Contribute to Accelerated Loss of Cartilage in Diabetic Fracture Healing" appears in the October 2009 issue of the American Journal of Pathology

Diabetes, a condition where the body either does not produce enough, or respond to, insulin, affects at least 171 million people worldwide, a figure that is likely to double by 2030. Long-term complications of diabetes include cardiovascular disease, chronic renal failure, retinal damage that may lead to blindness, nerve damage, and blood vessel damage, which may cause erectile dysfunction and poor wound healing.

Diabetic patients often experience low bone density, which is linked to increased risk of bone fractures and delayed fracture repair. To examine how diabetes affects bone, Dr. Dana Graves and his colleagues of the University of Medicine and Dentistry of New Jersey and the Boston University School of Medicine explored bone repair in a mouse model of diabetes. They observed increased levels of inflammatory molecules, including TNF-α during fracture healing. The diabetic animals had rapid loss of cartilage in the healing bones, which was due to increased numbers of osteoclasts, cells that remove bone and cartilage. Factors that stimulate osteoclast formation were regulated by both TNF-α and a downstream mediator, FOXO1. These results suggest that diabetes-mediated increases in TNF-α and FOXO1 may underlie the impaired healing of diabetic fractures......... Posted by: JoAnn      Read more         Source

September 23, 2009, 7:15 AM CT

Childbearing Increases Chance of Developing the Metabolic Syndrome

Childbearing is associated directly with future development of the metabolic syndrome - abdominal obesity, high triglycerides, insulin resistance and other cardiovascular disease risk factors - and for women who have had gestational diabetes, the risk is more than twice greater, as per a co-author of studyed by University of Alabama at Birmingham (UAB) scientists reported in the American Journal of Obstetrics and Gynecology.

UAB Professor of Preventive Medicine Cora E. Lewis, M.D., M.S.P.H., and his colleagues used data collected in the CARDIA (Coronary Artery Risk Development in Young Adults) study to determine the connection between a higher occurence rate of the metabolic syndrome among women ages 18-30 at the start of the study who bore at least one child during the 20-year period following.

"Pregnancy can have lasting, adverse physiological effects and may result in behavioral changes," Lewis said. "Some prior studies have shown an association between childbearing and the metabolic syndrome, and some have shown that a history of gestational diabetes is a strong predictor of Type 2 diabetes.

"However, these studies lacked the preconception measurements to establish a baseline with which to measure the changes brought on by pregnancy," she said. "A number of have not had control groups of women who had not had pregnancies, and thus they have rarely provided conclusive evidence linking pregnancy-related risk factor changes to disease onset. CARDIA began following participants ages 18-30 years in 1985-1986 and continues today, and we had the necessary information to track women both before and after pregnancy and to compare women with pregnancies to those without"......... Posted by: Emily      Read more         Source

September 10, 2009, 6:49 AM CT

Medicine wheel model for nutrition

American Indian populations experience significant nutrition-related health disparities in comparison to other racial and ethnic groups within the US. American Indian adults have the highest age-adjusted rates for cardiovascular disease, diabetes and obesity of any racial or ethnic group. Age-adjusted rates of diabetes among Native people vary from 14% to 72%, which are 2.4 to more than 6 times the rate of the general US population. As per a research findings reported in the September 2009 issue of the Journal of the American Dietetic Association, scientists from the South Dakota State University, Brookings, report that a culturally-sensitive educational program based on the Medicine Wheel Model for Nutrition shows promise in changing dietary patterns in an American Indian population and impacting glycemic control.

During a 6-month period from January 2005 through December 2005, participants from the Cheyenne River Sioux Reservation were randomized to an education intervention or to a usual care control group. The education group received six nutrition lessons based on the Medicine Wheel Model for Nutrition, a diet patterned after the traditional consumption of macronutrients for Northern Plains Indians: protein (25% of energy), moderate in carbohydrate (45% to 50% of energy) and low in fat (25% to 30% of energy). The usual care group received the usual dietary education from their personal providers......... Posted by: JoAnn      Read more         Source

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