Diabetes Pharmacist : Diabetes Pharmacist Blog : Focus Express Mail Pharmacy : Insulin Pumps, Diabetes Supplies and Information

 

 

According to researcher Marie L. Misso, PhD, of the Australasian Cochrane Center at Monash University, Clayton, Australia, "good evidence is now available to support the use of continuous subcutaneous insulin infusion in the appropriate patient."

To assess and compare the effects of continuous subcutaneous insulin infusion with multiple insulin injections, researchers studied 23 randomized controlled trials which included a total of 973 patients who used one of the two interventions for their type 1 diabetes. Results showed that  the continuous subcutaneous insulin infusion users (users of insulin pumps)  had significantly lower HbA1c levels compared with multiple insulin injection users.

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A published report out of Australia says that every hour viewers spend watching television increases the risk of premature death.  The study was undertaken by the Baker IDI Heart and Diabetes Institute in Melbourne.The report involving more than 8,000 adults in Australia over a six-year period revealed that those adults who watched television the most died younger.

Professor David Dunstan, who led the study, says the elevated risk of an early death was independent of other risk factors, including high blood pressure or cholesterol levels as well as diet, exercise and smoking. The research showed that too much sitting on the couch/sofa can be detrimental to our health.

"What this study provides is the first compelling evidence linking television viewing to an increased risk of early death," Dunstan said. "People who watch four or more hours of television a day have a 46 percent higher risk of death from all causes and an 80 percent increased risk of death from cardiovascular disease."  There is a difference between not doing enough exercise and sitting down too much, which scientists  believe upsets the body's rhythms and regulatory processes, such as breaking down and using glucose.

So, you want to watch that 4 hour movie? Or you want to see those television shows that you taped or DVR'd while you were away? Watch them while walking/running on a treadmill or peddling a stationary bicycle. You'll live longer and feel better!


 

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A new European study has shown that obese people have large amounts of the chemokine molecule CXCL5, produced by certain cells in fatty tissue, and it is this molecule that  researchers feel will cause an obese person to develop Type II Diabetes.

'Chronic inflammation of the adipose tissue, which is characteristic of obese people, is a crucial stage in the development of insulin resistance and Type II Diabetes", Lluis Fajas, lead author of the study and a researcher at the Institute of Health and Medical Research (Inserm) in France, said.

 Serum levels of 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. An experimental treatment aimed at inhibiting the action of CXCL5 has protected obese mice from developing Type II Diabetes. If this can be shown in humans, an important step to prevent diabetes in obese people will have been taken.

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Using noninvasive imaging (Magnetic Resonance Imaging  (MRI) ) for the first time in diabetes research, physicians at Massachusetts General Hospital and Harvard Medical School have discovered how it may aid in the early diagnosis, staging, and treatment of diabetes.

"With noninvasive MRI we have the ability to evaluate beta cell mass, a major factor of insulin secretion that is significantly reduced in type two diabetes and almost gone in type one,” said Anna Moore, MD, lead author of the study. “Knowing the number of functional beta cells left would allow physicians to develop the most appropriate treatment plans for their patients. It would also allow them to respond, change or manipulate those treatment plans at any time,” she said.

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Researchers from Brigham and Women's Hospital as well as from Harvard Medical School are reporting that two medications that treat allergies, Cromolyn and Zaditor, helped mice lose weight and controlled their blood sugar. Test results showed that a group of diabetic and obese mice that  only used these drugs saw almost a complete reversal of their health problems. Monkeys will be tested next to see if, in fact, obesity and diabetes may be connected to immune system changes.

 

 

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A new standard, called the A1C assay, is being recommended by the American Diabetes Association (ADA), to help doctors test for and diagnose diabetes.

Instead of the 12-14 hour fasting glucose test and the glucose tolerance test currently in use, a simple blood test will be taken to measure how much protein in the blood has been fused with excess glucose that is not able to be used by the body because of diabetes.This is a process called called Glycation. Because it is such a simple test to do, the ADA recommends that everyone 45 or over has it regardless of lack of symptoms or family history.

 

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A recent  study from the Center for Disease Control and Prevention is warning that over the next 4 decades,  the number of adults 40 and older with diabetic retinopathy— the leading cause of blindness among working-age adults — will reach 16 million in 2050, up from 5.5 million in 2005. People with diabetic retinopathy ,which is damage to the small blood vessels in the retina, usually do not have symptoms until they actually start to lose vision. As a result, many skip the recommended annual eye exams.The study further states that elderly Hispanics and blacks will be hit hardest because of their higher rates of Type 2 Diabetes.

Dr. Jinan B. Saaddine, an epidemiologist at the disease centers and an author of the study. said that “This calls for more awareness and more action, not just to do something about the condition before it develops but to do more to PREVENT DIABETES to start with.”

 

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A study recently published in the New England Journal of Medicine, followed 3,277 newly diagnosed Type 2 diabetes patients who were asked to tightly manage their blood sugar either through diet restrictions or drugs.

The results show that the group taking insulin had a 15 percent lower risk of heart attack and a 13 percent lower risk of death compared with the group who used diet. The early, intensive approach to blood sugar control amounted to a head start. The researchers call this the "Legacy Effect."

 "These results emphasize the importance of detecting and treating diabetes at the earliest opportunity and the major benefits that can be obtained with good blood glucose control."  said Professor Rury Holman, of Oxford University, who led the study.

Intensive and not-so-intensive approaches to blood pressure were also compared among the diabetes patients in the study. When the study ended, the patients who took the intensive approach were less likely to have died from diabetes, had a stroke or developed diabetes-related complications.

It's not news that controlling blood sugar and blood pressure are musts for managing type 2 diabetes. But the new findings show that doing so promptly and intensively will lead to a lower likelihood of a heart attack as well as a healthier cardiovascular system.

 

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 High arsenic levels in drinking water has been linked to diabetes according to research done over the years. It is known that impaired insulin secretion in pancreas cells occurs when those cells are treated with an arsenic compound.

Here's the Bad News: a recent analysis of government data has linked Low-level arsenic exposure, possibly from drinking water, with Type 2 diabetes.

Molly Kile, an environmental health research scientist at the Harvard School of Public Health says in an editorial in the journal JAMA. “Urinary arsenic reflects exposures from all routes—air, water, and food—which makes it difficult to track the actual source of arsenic exposure, let alone use the results from this study to establish drinking water standards,” . Kile also said the findings raise a sort of “chicken-and-egg problem,” since it’s unknown whether diabetes changes the way people metabolize arsenic. It is also possible that people with diabetes actually excrete more arsenic.

 

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Researchers at the Joslin Diabetes Center have determined that insulin resistance is likely the reason why gallstones are more common in obese people. Sudha Biddinger, M.D., Ph.D., lead author of the study and a researcher in the Joslin Section on Obesity and Hormone Action, said:

"Obesity is associated with increased secretion of cholesterol into the bile. The excess cholesterol accumulates in the gallbladder which can lead to the formation of painful gallstones. This study shows that insulin resistance is key to this process, as the lack of insulin receptors in the livers (of research mice) was sufficient to promote gallstones".

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In important research, scientists in Michigan have discovered  that signs of metabolic stress in the retina caused by diabetes can be detected by capturing a snapshot of the eye.They say that new imaging technology may offer a quick, noninvasive way of detecting diabetes early and monitoring its progress
Although the study focused on patients with diabetes, the researchers feel that  the screening technology should be able to identify people with prediabetes--a condition in which blood glucose levels are higher than normal and that often progresses to full-blown diabetes.  Clinical trials begin this fall (2008), using the system on diabetics and prediabetics.

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Which came first? The chicken or the egg? Does a diagnosis of diabetes lead to depression or does depression lead to diabetes? Probably both according to new research reported on Newsday.com.

People with diabetes are more likely to become depressed as they face a lifetime of keeping their disease in check, researchers said. About 21 million Americans have diabetes, which requires patients to adhere to a strict diet and exercise routine and to monitor their blood sugar levels regularly. People being treated for Type 2 diabetes, the most common form, were 52 percent more likely to develop depression than those without the disease, according to a paper published in a recent Journal of the American Medical Association. John Buse, the American Diabetes Association's president of medicine and science, said. "It's a very tough business to take care of diabetes."

On the flip side, depression may cause patients to develop behaviors that cause diabetes or make it worse. For example, research has shown that many people who are depressed don't exercise, smoke, and/or overeat. "It's important that doctors be attuned to look for both conditions in patients at risk for either diabetes or depression," lead author Sherita Hill Golden, an associate professor of medicine and epidemiology at Johns Hopkins University in Baltimore, said in a statement. "We may want to develop interventions for both treatments, instead of just one or the other."

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Researchers at the University of Virginia were able to reverse Type 1 diabetes in 70% of the diabetic mice tested  by using a combination of 2 drugs, Lisofylline and INGAP,  according to reporter Mark Tenia.

This may be the only type of medication for people with existing Type 1 Diabetes," said Dr. Jerry Nadler, director of Endocrinology and Metabolism at the University of Virginia. "We're very excited about the findings and these mice simulate what happens in people with type 1 diabetes," he added.

 Lisofylline, stops the body from destroying insulin producing cells while  INGAP, helps the body regenerate new cells that create insulin. 
"The most exciting part to us is that this combination therapy approach could actually go to the clinic in a reasonably short period of time," said Nadler. 

Both drugs have already been tested in humans in clinical trials separately. Safety testing that usually takes years and years, has already been passed."Even if it works partially well and helps the body regenerate some insulin producing cells that stay functional, that's a major advance. There's no other therapy like that out there," said Nadler. If all goes well, Dr. Nadler says that the drugs could be available to the public within three to five years.

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News of bariatric surgery restoring high blood sugars to normal in grossly overweight people has made the rounds lately. Now, similar surgery on people who are NOT overweight has gotten similar results. According to the Washington Post News Service, this surgery is promising but the mechanism of action is uncertain.

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Researchers are now investigating the strong blood sugar reducing capability of Bitter Melon, a vegetable commonly used in Asia for medicinal use.

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It's a connection that wouldn't surprise Dr. Ulysses Magalang, a sleep expert with Ohio State University Medical Center. He says that depriving your body of oxygen often takes its toll.
"We do not know whether sleep apnea actually causes diabetes. What we do know is that patients with sleep apnea have an increased insulin resistance, which is a hallmark of patients with diabetes," says Magalang.

Dr. Magalang also says that  "obesity is a common risk factor for both diabetes and sleep apnea, and fat cells seem to function similarly in both. Studies have shown that wearing airflow masks at night can prevent problems with those fat cells. The problem is, getting patients to wear them."

Research will continue to see if, in fact, there is a direct link between sleep apnea and diabetes.

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At UC Irvine, researchers are working to develop a painless breath test to determine when a patient's blood sugar is high. Dr. Pietro Galassetti and colleagues tested the breath of ten children with type 1 diabetes. They took breath samples while blood sugar levels were high, then continued to gather samples as blood sugar levels dropped in response...MORE

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A new study shows that diabetes and Alzheimer s diseases are more related than everybody thought. According  to Suzanne M. de la Monte,a Rhode Island Hospital neuropathologist and professor of pathology at Brown University Medical School ,insulin disappears early and dramatically in Alzheimer's disease and many of the unexplained features of Alzheimer's, such as cell death and tangles in the brain, appear to be linked to abnormalities in insulin signaling. MORE......

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According to Larry Greenemeier in Scientific America,  researchers are experimenting with new ways of harvesting insulin-producing islet cells from pigs and transplanting them into diabetes sufferers in the hope of one day reducing the need for daily insulin shots and even replacing them with twice-yearly islet-cell treatments. MORE......

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Robert Langreth, in Forbes.com, writes about a new type of drug, called an anti-CD3 antibody, which aims for the first time to delay or prevent development of diabetes by arresting the immune system's attack on pancreatic islet cells. This new class of drugs, now entering final-stage human trials, are given to newly diagnosed patients for just a few days or weeks but appear to preserve some insulin-producing capacity for years. Ultimately the drugs may even be able to prevent the disease from striking people at high risk because of a family history of diabetes or bad genes. MORE.....

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 According to United Press International, Canadian researchers have discovered specialized T-cells lose their effectiveness over time in some people, leading to the onset of type 1 diabetes.

T-cells suppress and regulate the body's immune responses, but in diabetes mellitus, or type 1 diabetes, the body's own immune system attacks and destroys insulin-producing islet cells in the pancreas. Patients must thereafter inject insulin daily.

"The genetic and cellular mechanisms by which the immune system goes out of control and destroys the islets has been an enigma and an area of great interest over the last few decades," said Dr. Ciriaco Piccirillo of McGill University, one of the study's authors. "For the last several years, it's been postulated that non-functional regulatory T-cells are the critical mechanism, and this study proves it."

The research was conducted on mice that were genetically engineered to model human diabetes. Piccirillo and colleagues discovered the functional potency of T-cells in the mice declined with age, leaving autoimmune responses in the pancreas unchecked. Piccirillo said that finding could lead to the development of immune system-based therapies for a range of diseases.

The study appears in the journal Diabetes.

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 Natreon Inc., a nutraceutical industry’s leading supplier of botanical extract ingredients announced today the incorporation of Puredel Ltd., (Puredel), a company aimed at developing 
Ossulin™, an oral insulin which has shown promising results in preliminary animal and human studies.. More...

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 Smoking, already known to cause lung cancer, heart disease and stroke, also increases the risk  of developing type 2 diabetes by 44% when compared to nonsmokers, Swiss researchers found. More.....

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Takeda Pharmaceutical Co., Japan's biggest drugmaker, sought U.S. approval to sell alogliptin as a once-daily treatment for type-2 diabetes, it said in a statement today. If approved, it will be the Osaka- based company's first new medicine released in the U.S. in more than two years. More...

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Suppression of deep sleep in healthy young adults significantly increases their risk of type 2 diabetes, report researchers at the University of Chicago Medical Center. More...

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According to an article in ScienceAlert.com. and published in the October 4, 2007 issue of the well known medical journal, Cell Metabolism, scientists from The Garvan Institute of Medical Research, have identified an enzyme that is active during diabetes and also blocks the availability of insulin. Click here for more

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