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January 27, 2009, 6:23 AM CT

Huge burden of diabetes

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

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

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 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 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

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

Vitamin D and  type 1 diabetes
Food rich in vitamin-D
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

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

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

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



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Did you know?
Eventhough having diabetes can sometimes feel isolating to individuals, participation in an Internet-based discussion group offers hope, inspiration and encouragement as well as bolsters people's perceived ability to cope with diabetes, according to a new study from Joslin Diabetes Center. The study, which appears in the November/recent issue of The Diabetes Educator, examined the impact of Joslin's Online Discussion Boards - forums in which people with diabetes can find information and share thoughts and experiences on specific diabetes issues.

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