Diabetes
More exercise may prevent diabetes in black women
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Taking a walk instead of turning on the TV may help African-American women lower their risk of type 2 diabetes, a large study suggests.
Researchers found that among more than 45,000 African-American women they followed for a decade, those who said they walked for exercise at least five hours per week were one-third less likely to develop type 2 diabetes than non-walkers.
Furthermore, women who watched five or more hours of television a day were 86 percent more likely to develop diabetes than those who watched less than one hour per day.
Diabetes may be linked to risk of lymphoma
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More cases of blood cancers classified as non-Hodgkin’s lymphoma, or NHL, seem to occur among people with diabetes than those without, researchers report.
“Although the relative risk is moderate, given the rapidly increasing incidence and prevalence of diabetes, the number of incident cases of NHL attributed to diabetes can potentially be very high,” Dr. Anastassios G. Pittas and colleagues point out in their report in the medical journal Diabetes Care.
Pittas, at Tufts University School of Medicine in Boston, and his team found 16 previous studies reporting an association between diabetes and NHL.
Fibrate drug does not cut heart risks in diabetics
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Long-term treatment with fenofibrate, a type of fibrate drug often used to lower cholesterol, does not reduce coronary plaques or signs of “atherosclerosis” in patients with type 2 diabetes, according to a report in the Journal of the American College of Cardiology.
Prior research has suggested that fibrate therapy can have beneficial cardiovascular effects. However, in the main analysis of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study, researchers found that treatment with fenofibrate did not reduce heart attacks in type 2 diabetics.
The focus of this FIELD substudy was to determine if fenofibrate therapy reduced atherosclerosis, a main risk factor for heart attacks, in patients with type 2 diabetes. Included were 170 patients randomly assigned to receive fenofibrate or inactive “placebo” for 5 years.
Discovery of new gene associated with diabetes risk suggests link with body clock
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A connection between the body clock and abnormalities in metabolism and diabetes has been suggested in new research by an international team involving the University of Oxford, the Wellcome Trust Sanger Institute and the MRC Epidemiology Unit in Cambridge.
The researchers have identified a gene involved in the way the body responds to the 24 hour day-night cycle that is strongly linked to high blood sugar levels and an increased risk of type 2 diabetes. The results of the genome-wide association scan are published in Nature Genetics.
“We have extremely strong, incontrovertible evidence that the gene encoding melatonin receptor 1B is associated with high fasting glucose levels and increased risk of type 2 diabetes,” says Professor Mark McCarthy of the Oxford Centre for Diabetes, Endocrinology and Metabolism at the University of Oxford.
Danish firm to give African children free insulin
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The world’s biggest maker of insulin on Wednesday pledged to provide diabetes care, including free medication, to 10,000 children in African countries to combat a hidden killer.
Danish pharmaceutical firm Novo Nordisk said it had a moral obligation to save lives in places where insulin was too expensive for families and aid efforts have focused on more prominent diseases such as AIDS or malaria.
“Lots of children in the developing world are dying of diabetes when we have had a life-saving drug for 85 years,” said Jean-Claude Mbanya, president-elect of the International Diabetes Federation, at an event in Paris to launch the Novo Nordisk project.
Diabetic women more likely to die after heart attack
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Women younger than age 65 with diabetes tend to have worse cardiovascular risk profiles than diabetic men of the same age, leading to higher death rates following a heart attack, research shows.
“The female advantage with fewer cardiovascular events than in men at younger ages is attenuated once a woman has the diagnosis of diabetes,” Dr. Anna Norhammar and associates report.
They sought to identify gender-related differences in prognosis, risk factors, or treatment among 25,555 patients younger than age of 65 treated for heart attack between 1995 and 2002. In this cohort, 23 percent were women and 21 percent of women and 16 percent of men were previously diagnosed with diabetes.
Heart problems often worse in diabetic women
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Women younger than 65 with diabetes tend to have worse heart problems than diabetic men of the same age, leading to higher death rates following a heart attack, the results of a Swedish study indicate.
“The female advantage with fewer cardiovascular events than in men at younger ages is attenuated once a woman has the diagnosis of diabetes,” Dr. Anna Norhammar and associates write in the journal Heart. In fact, they add, “the risk is increased about twofold in men and up to four times in women.”
Their goal in the current study was to identify gender-related differences in prognosis, risk factors, or treatment among 25,555 patients younger than 65 years old who were treated between 1995 and 2002 for a heart attack.
Sealing off portion of intestinal lining treats obesity, resolves diabetes in animal model
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Lining the upper portion of the small intestine with an impermeable sleeve led to both weight loss and restoration of normal glucose metabolism in an animal model of obesity-induced diabetes. Investigators from the Massachusetts General Hospital (MGH) Weight Center and Gastrointestinal Unit report in the journal Obesity that the procedure reproducing several aspects of gastric bypass surgery led to a significant reduction in the animals’ food intake and a resolution of diabetes symptoms. The study, which has received early online release, is the first controlled test of a new procedural approach to treating obesity.
“This is a clear proof of principle that the human version of this device may be an effective treatment for obesity and diabetes. The clinical device would be placed endoscopically, making it far less invasive than surgical therapies,” says Lee Kaplan, MD, PhD, director of the MGH Weight Center, who led the study. “The next step will be to complete large-scale controlled trials of this procedure in human patients. We also need to learn more about how this device affects the complex interplay between receptors that line the stomach and intestine – which are stimulated by ingested food – and the brain, pancreas, liver and other organs involved in metabolism and in eating behavior.”
Several surgical procedures have been developed to treat obesity and its complications, such as type 2 diabetes. The most common operation – Roux-en-Y gastric bypass – has five key components: isolation and reduction in size of the upper portion of the stomach, exclusion of the rest of the stomach from the flow of ingested food, exclusion of the upper portion of the small intestine (the duodenum and upper jejunum) from the flow of food, delivery of undigested nutrients to the middle portion of the small intestine, and partial severing of the vagus nerve, a key conduit between the gastrointestinal system and the brain in the control of appetite, digestion and glucose metabolism.
Study Sheds Light on Participants in National SEARCH for Diabetes in Youth Study
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University of South Carolina public health researchers have examined the SEARCH for Diabetes in Youth Study to characterize its participants. The findings could help other scientists understand how to recruit children and teens into future studies.
The results, published in the November issue of Contemporary Clinical Trials, found that children up to age 14 were more likely to participate in SEARCH than youths 15 - 19. White and Hispanic youths had the highest participation rates. African-American youths had the lowest participation rates.
Dr. Angela Liese, an associate professor at the university’s Arnold School of Public Health, said SEARCH participants are helping researchers understand the prevalence and incidence of diabetes in the United States and what factors lead to complications.
Pregnancy diabetes doubles the risk of language delay in children
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Children born to mothers with pregnancy-related diabetes run twice the risk of language development problems, according to a research team directed by Professor Ginette Dionne of Université Laval’s School of Psychology. Details of this discovery are published in the most recent issue of the scientific journal Pediatrics.
Researchers compared the vocabulary and grammar skills of 221 children whose mothers were diagnosed with gestational diabetes to those of 2,612 children from a control group. These tests were conducted at different intervals between ages 18 months and 7 years.
Results showed that children born to mothers with gestational diabetes achieve poorer scores on tests of spoken vocabulary and grammar than children of healthy mothers. The differences between the two groups are probably due to the effects of gestational diabetes on the brain development of babies. The study shows that these effects persist even after the children start school.
Clinical Guideline on Prevention of Cardiovascular Disease and Diabetes in Patients at Highest Risk
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Clinical Guideline on Prevention of Cardiovascular Disease and Diabetes in Patients at Highest Risk Released
The Endocrine Society has released a new clinical practice guideline for the primary prevention of cardiovascular disease and type 2 diabetes in patients at metabolic risk. The guideline appears in the Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of The Endocrine Society.
There is growing evidence that many patients who develop cardiovascular disease or diabetes have a pre-existing metabolic risk. This risk includes conditions such as enlarged waist circumference, hypertension, and elevated plasma glucose levels. The presence of three of more such conditions should alert a clinician to a patient at metabolic risk, said Dr. James Rosenzweig, director of diabetes services in the Section of Endocrinology, Diabetes and Nutrition at Boston Medical Center, and chair of the task force that developed this guideline.
“The dramatic increase in the incidence of patients at risk for cardiovascular disease and diabetes throughout the developed and developing world requires physicians and other care providers to be aware of the risk factors for these conditions and identify patients at risk in order to initiate treatment,” said Dr. Rosenzweig. “This guideline was developed for just this purpose.”
Obesity, other health problems delay MS diagnosis
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People with pre-existing medical conditions, such as obesity, and vascular problems such as diabetes, high blood pressure or high cholesterol, may experience a delay in being diagnosed with multiple sclerosis (MS), or experience an increase in severity of the disease at diagnosis, according to a study published in the October 29, 2008, online issue of Neurology®, the medical journal of the American Academy of Neurology.
“Our study suggests that doctors who treat people with chronic diseases should not attribute new neurological symptoms such as numbness and tingling to existing conditions without careful consideration,” said study author Ruth Ann Marrie, MD, PhD, of the University of Manitoba in Winnipeg, Canada, and member of the American Academy of Neurology.
For the study, researchers examined the records of 8,983 people who had been diagnosed with MS. Of those, 2,375 were further classified as having mild, moderate or severe disability within two years of diagnosis. This well-characterized group was asked about pre-existing health conditions, their smoking status and weight history.
If the diabetes has a direct carcinogenetic effect?
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The association of DM2 with solid tumors, and particularly with HCC, has been long suspected and several studies have reported increased mortality rates for neoplastic diseases in patients with DM2. However, the temporal relationship between onset of diabetes and development of HCC, and the clinical and metabolic characteristics of patients with DM2 and HCC have not been well examined.
A research article to be published on October 7, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Dr. Valter Donadon from Pordenone Hospital of Italy investigated the relationships between DM2 and risk of HCC in a large population based case-control study. They enrolled 465 consecutive patients with HCC compared with an age and sex matched control group of 490 subjects.
Their results confirm that patients with DM2 have a significantly increased risk of HCC, independent of cofactors such as HBV and HCV infection and alcohol intake, and demonstrate that DM2 pre-exists to the development of HCC in most cases, suggesting that DM2 is more likely a concourse rather than merely a consequence of the liver tumor. This conclusion is also supported by the finding of a similar frequency and severity of DM2 in patients with small HCC detected during follow-up of cirrhosis and in those with more advanced and diffuse cancers detected outside of a surveillance program.
Cost of diabetes treatment escalating in US
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More expensive medications and an increasing number of patients is driving up the cost of treating type 2 diabetes in the US, researchers reported Monday.
“Although increasing costs of therapy are partly attributable to more patients with diabetes and more medications per patient, the greatest contributor to increasing costs is the substantially greater use of newer, more costly medications,” Dr. G. Caleb Alexander, at The University of Chicago, and colleagues wrote in the Archives of Internal Medicine.
They found, based on an analysis of information from US databases, that the number of patient visits for diabetes rose from 25 million in 1994 to 36 million in 2007 and the average number of diabetes medications per patient rose from 1.14 to 1.63.
Moderate Use Averts Failure of Type 2 Diabetes Drugs in Animal Model
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Drugs widely used to treat type 2 diabetes may be more likely to keep working if they are used in moderation, researchers at Washington University School of Medicine in St. Louis have found in a study using an animal model.
The drugs, sulfonylureas, help type 2 diabetics make more insulin, improving control of blood sugar levels. But in most patients the effects of sulfonylureas are lost after several years of use, causing insulin secretion to shut down. This typically forces patients to switch to regular insulin injections.
“Why this happens isn’t clear yet, but we’ve found what may be cause for hope,” says senior author Colin G. Nichols, Ph.D., the Carl F. Cori Professor and professor of cell biology and physiology. “We’ve shown in a mouse model that whatever causes this shutdown doesn’t kill the insulin-making beta cells of the pancreas or stop them from making insulin. Instead, it somehow stops them from secreting insulin.”
