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August 28, 2006, 10:06 PM CT

Lowering Diabetes Risk In Youth

Lowering Diabetes Risk In Youth
As schools across the country reopen their doors this fall, hundreds of sixth graders in 42 middle schools will begin taking part in a study sponsored by the National Institutes of Health (NIH). The HEALTHY study will determine if changes in school food services and physical education (PE) classes, along with activities that encourage healthy behaviors, lower risk factors for type 2 diabetes, an increasingly common disease in youth.

"The alarming rise in obesity and type 2 diabetes in all age groups poses a major public health crisis for this country. This important study is one component of a multi-faceted research agenda to address this dual epidemic, which threatens the health of our youth and the vitality of our health care system," said NIH Director Elias A. Zerhouni, M.D.

Participating schools will be randomly assigned to a program group, which implements the changes, or to a comparison group, which continues to offer food choices and PE programs typically seen in middle schools across the country. Students in the program group will have .
  • healthier choices from the cafeteria and vending machines (e.g., lower fat foods, more fruits and vegetables, and drinks with no added sugar)
  • longer, more intense periods of physical activity, and
........

Posted by: JoAnn      Permalink         Source


August 28, 2006, 4:25 AM CT

Diabetes Control Poorer In Blacks Compared To Whites

Diabetes Control Poorer In Blacks Compared To Whites
A recently performed meta-analysis (a systematic analysis of several studies) combining 11 separate research studies observed that blacks with diabetes have poorer control of blood sugar than whites. These research findings come from Wake Forest University School of Medicine and his colleagues.

"This lower level of control may partly explain why blacks have disproportionately higher rates of death and complications from diabetes," said Julienne Kirk, PharmD, lead author of the study published online today (Aug. 25) in Diabetes Care.

Kirk said the findings point to the need to determine why the difference in control exists and to identify ways to prevent or reduce the resulting health problems. Poor blood sugar control can result in long-term complications such as blindness, amputation and end-stage kidney failure.

The scientists analyzed studies that measured sugar control among blacks and whites using a blood test for glycosylated hemoglobin hemoglobin that has linked with glucose, or blood sugar. The lower the amounts of glycosylated hemoglobin, also called A1C, in the blood, the better the body is controlling blood sugar.

By combining the data from the 11 studies into a "meta-analysis" involving a total of 42,273 white and 14,670 black patients, they were able to detect differences that may not have shown up in each individual study. This was the first meta-analysis of racial and ethnic differences in blood sugar control among patients with diabetes.........

Posted by: JoAnn      Permalink         Source


August 24, 2006, 9:54 PM CT

Chemical Compounds Restore Normal Glucose Levels In Obese Mous

Chemical Compounds Restore Normal Glucose Levels In Obese Mous
Treatment of obese and diabetic mice with compounds that act as chemical chaperones called PBA and TUDCA restored healthy glucose levels and normal insulin action - and reduced the presence of fatty liver disease - according to a study published in the August 25 issue of Science. The work was conducted by a team of researchers from the Harvard School of Public Health (HSPH).

Type 2 diabetes - 90 to 95 percent of all diabetes cases - affects an estimated 18 million people in the United States, and causes some 200,000 deaths a year. Obesity is closely associated with insulin resistance and is one of the leading risk factors for type 2 diabetes. The molecular mechanisms that link these two metabolic diseases remain under investigation, and current therapeutic options are limited.

Gokhan S. Hotamisligil, chair of the HSPH Department of Genetics and Complex Diseases, is the senior author of the Science paper. In 2004, he led a team that identified a major molecular pathway that causes diabetes. A cornerstone of that discovery was a hypothesis that the key to the obesity-diabetes connection might be found in the endoplasmic reticulum, or ER - a system of folded membranes and tubules in the cytoplasm of cells where proteins and lipids are manufactured, processed, and shipped around the cell. When unusual demands - such as excess fat - are put on the ER's capacity, the organelle starts failing, and the cell enters an emergency mode, emitting stress signals. The condition is called ER stress. Cellular inflammation, insulin resistance and diabetes result. (http://www.hsph.harvard.edu/press/releases/press10142004.htm).........

Posted by: JoAnn      Permalink         Source


August 22, 2006, 5:10 AM CT

Schizophrenics At Risk For Type 2 Diabetes

Schizophrenics At Risk For Type 2 Diabetes
Dissecting the relationship between schizophrenia and an increased risk of type 2 diabetes has physician-researchers reaching across the Atlantic Ocean.

They are looking at newly diagnosed schizophrenics in an upper-middle-class Spanish community to find whether the disease that causes patients to hear voices and smell, feel and even taste unreal objects also increases their risk of diabetes.

Researchers know the drugs that best control the psychosis increase the risk. "We know it's the medicine; I'm asking whether it's the disease as well," says Dr. Brian Kirkpatrick, vice chair of the Medical College of Georgia Department of Psychiatry and Health Behavior and principal investigator on the National Institute of Diabetes & Digestive & Kidney Diseases-funded study.

Dr. Kirkpatrick and his colleagues at Hospital Clinic at the University of Barcelona in Spain and the University of Maryland note mounting evidence that developmental problems, resulting from significant maternal stress in the second or early third trimester of pregnancy, may cause schizophrenia and related problems.

"The brain has this incredibly complex development where cells are born here and march over here and send communication over here; that goes wrong from the very beginning probably," says Dr. Kirkpatrick of the complex process of laying down normal communication pathways that apparently go awry in about 1 percent of people.........

Posted by: JoAnn      Permalink         Source


August 21, 2006, 10:09 PM CT

Insulin Resistance May Predict Diabetes

Insulin Resistance May Predict Diabetes
The body's decreased response to insulin beginning as early as age 13 may mean increased cardiovascular disease risk by age 19, as per research reported in Hypertension: Journal of the American Heart Association.

The finding indicates that the prevalence of atherosclerotic cardiovascular disease risk factors and type 2 diabetes (both of which are correlation to obesity and are increasing as today's children reach adulthood) also are correlation to insulin resistance independent from obesity, said Alan R. Sinaiko, M.D., lead author of the study and professor of pediatrics at the University of Minnesota Medical School in Minneapolis.

After screening blood pressure, height and weight in more than 12,000 5th through 8th grade students in Minneapolis public schools, 357 students (average age 13) were recruited for the study. Two-hundred twenty-four participants completed the study. The participants were 58 percent male and 83 percent white.

At baseline the children underwent a complete physical examination including measurements of blood pressure, height, weight, percentage of body fat, high density lipoprotein cholesterol (HDL-C), triglycerides and fasting insulin levels. The students were also categorized by stage of sexual development.

Sinaiko and his colleagues tracked insulin resistance with a series of insulin clamp studies first at age 13, then 15 and again at 19.........

Posted by: JoAnn      Permalink         Source


August 9, 2006, 11:18 PM CT

High Blood Sugar May Cause Cognitive Impairment

High Blood Sugar May Cause Cognitive Impairment
A four-year study of elderly women has observed that chronically elevated blood sugar is linked to an increased risk of developing either mild cognitive impairment (MCI) or dementia.

The study was the first to investigate the association over time between glycosylated hemoglobin - a long-term measure of blood sugar - and the risk of cognitive difficulties, and the first to investigate that association in people without diabetes. It appears in the Volume 10, Number 4 issue of the Journal of Nutrition, Health, and Aging.

"We already know there's a correlation between diabetes and cognitive problems," says lead author Kristine Yaffe, MD, a staff doctor at the San Francisco VA Medical Center and a professor of psychiatry, neurology, and epidemiology at the University of California, San Francisco. "We were interested in what this measurement would tell us about a group of women with and without diabetes who were followed for four years. Nobody has really looked at that before."

The glycosylated hemoglobin test measures the percentage of hemoglobin - the oxygen-bearing protein in red blood cells - that is bound to glucose. Unlike the standard diabetic blood sugar test, which measures blood sugar at the moment of testing, glycosylated hemoglobin is considered an accurate measure of blood sugar levels over the course of two to four months preceding the test. A result of seven percent or less indicates good long-term blood sugar control.........

Posted by: JoAnn      Permalink         Source


August 3, 2006, 11:58 PM CT

Race Affects Type 2 Diabetes Treatment

Race Affects Type 2 Diabetes Treatment Rajesh Balkrishnan
African Americans may be less likely than whites to take their medicine for Type 2 diabetes as it is prescribed, a new study suggests.

The scientists observed that adherence rates were as much as 12 percent lower among black people when in comparison to whites.

"That's an unacceptable difference, especially because African Americans tend to have higher rates of diabetes and disease-related complications," said Rajesh Balkrishnan, a co-author of study and the Merrell Dow professor of pharmacy at Ohio State University.

Each of the nearly 2,700 study participants were covered by Medicaid, which provided prescription medicine coverage to all enrollees. Still, more than a third of the African Americans and whites in this study failed to take their anti-diabetic medications properly.

"Adherence rates for these types of medications should be better than 90 percent, regardless of who takes them," Balkrishnan said. "Such low rates of adherence may be correlation to lower socioeconomic status and to lower levels of education.

"A number of commercial insurers pay for educators to teach patients the importance of taking their medications as prescribed," he continued. "Medicaid needs to do the same thing. While it invests a lot of money in providing services, it does little to educate its recipients about those services and how to use them. People need to understand the importance of taking their medications".........

Posted by: JoAnn      Permalink         Source


July 25, 2006, 8:52 PM CT

Overweight Teens Reduce Risk Of Diabetes

Overweight Teens Reduce Risk Of Diabetes
Teens at risk of developing diabetes can prevent or delay its onset through strength training exercise, a University of Southern California study has observed.

Research led by Michael Goran, PhD, professor of preventive medicine in the Keck School of Medicine of USC, showed that overweight Latino teenage boys who lifted weights twice per week for 16 weeks significantly reduced their insulin resistance, a condition in which their bodies don't respond to insulin and can't process sugars properly. Insulin resistance is common in obese children and is a precursor of diabetes. The findings were reported in the recent issue of Medicine and Science of Sports Exercise.

Prior research has demonstrated that aerobic and resistance exercise is effective in improving insulin sensitivity in adults, but no controlled studies of resistance exercise had been done on overweight youth. Goran and his colleagues hypothesized that overweight teens would be more likely to stick with a resistance training regimen in comparison to aerobic exercise because it is less physically taxing and gives visible results quicker.

The scientists chose to focus on Latino teens because they are at particular risk for diabetes. As per the Centers for Disease Control, about half of all Latino children born in 2000 are expected to develop type 2 diabetes in their lifetime.........

Posted by: JoAnn      Permalink         Source


July 18, 2006, 8:34 PM CT

New diabetes drug may also cause weight reduction

New diabetes drug may also cause weight reduction Cris Welling
The Washington University Diabetes Center at Barnes-Jewish Hospital focuses on providing patients with the latest technology, therapys and clinical research. Some patients at the center are receiving a new diabetes drug that may give a welcome side effect - weight loss.

Byetta, developed by Amylin Pharmaceuticals and Eli Lilly and Co., is designed to help patients with type 2 diabetes get better control of their condition by helping the body make more of its own insulin. The drug, a twice-daily injection, tells the pancreas to make the right amount of insulin after meals to bring blood sugar closer to normal levels. It also helps stop the liver from producing too much sugar when the body doesn't need it, and helps slow down the rate at which sugar enters the bloodstream. It is typically used along with oral diabetes medications, and in some patients, it has led to weight loss.

One of the patients taking Byetta is Cris Welling, a research lab supervisor in the endocrinology/metabolism lab of M. Alan Permutt, M.D., professor of medicine and of cell biology and physiology. About five years ago, Welling volunteered to be a non-diabetic control in a University research study. When she went through the initial tests, she found out she had pre-diabetes.

Welling's physician, Garry Tobin, M.D., associate professor of medicine and medical director of the diabetes center, had prescribed several other oral medications to treat her diabetes, but none helped her to lose weight. Since she began taking Byetta for type 2 diabetes about 10 months ago, she has lost about 40 pounds. She no longer needs medicine for hypertension and has reduced the medicine she takes for high cholesterol.........

Posted by: JoAnn      Permalink         Source


July 11, 2006, 11:35 PM CT

Type 2 Diabetes Increases The Risk Of Glaucoma

Type 2 Diabetes Increases The Risk Of Glaucoma
A 20-year study of women in the Nurses' Health Study has shown that Type 2 diabetes is associated with primary open angle glaucoma (POAG), the most common form of glaucoma, accounting for about 60 to 70% of all glaucomas. The study is reported in the recent issue of the journal Ophthalmology.

Scientists at the Massachusetts Eye and Ear Infirmary, Brigham and Women's Hospital, Harvard School of Public Health and Harvard Medical School observed 76,3128 women who were enrolled in the Nurses' Health Study from 1980 to 2000. Eligible participants were at least 40 years old, did not have POAG at the beginning of the study, and reported receiving eye exams during follow-up. After controlling for age, race, hypertension, body mass index, physical activity, alcohol intake, smoking and family history of glaucoma, they found that type 2 diabetes was positively associated with POAG. However, the relation between type 2 diabetes and POAG did not increase with longer durations of type 2 diabetes.

"The study supports the notion that type 2 diabetes is associated with an increased risk of glaucoma," said Louis Pasquale, M.D., lead author of the study and co-director of the Glaucoma Service at the Massachusetts Eye and Ear Infirmary (MEEI) and an Assistant Professor of Ophthalmology at Harvard Medical School. "While obesity fuels the type 2 diabetes epidemic, it appears that factors uncorrelation to obesity contribute to the positive association between type 2 diabetes and glaucoma. We were surprised to find this. Our study had a large enough sample to allow us to focus on type 2 diabetes only and to study its relation to newly diagnosed POAG cases. We were also able to correct for other factors that could contribute to glaucoma. Our work suggests, but in now way proves, that factors other than lifestyle behavior contributing to insulin resistance could lead to elevated intraocular pressure and glaucoma".........

Posted by: JoAnn      Permalink         Source



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Type-2 Diabetes
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.

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