Vegan Diet May Help Fight Diabetes

Around 30% of children born in the year 2000 will develop Diabetes later in life if significant changes in lifestyle do not appear, commented Caroline Trapp, Director of Diabetes Education and care for the Physicians Committee for Responsible Medicine, Washington, D.C., in her article published in Juneau Empire.

Citing a recent study published in Diabetes Care, Caroline said that people who consume more protein from meat and other animal products are at higher risk for Type 2 Diabetes. According to Caroline, researchers analyzed the diets of nearly 40,000 participants and found that for every 5% of calories consumed from protein instead of carbohydrate or fat, the risk of developing Diabetes increased 30%. Increased animal protein intake was also related to increased weight and blood pressure. Vegetable protein was not associated with Diabetes risk.

The Director of Diabetes Education and care for the Physicians Committee for Responsible Medicine further added that meat-heavy diets are contributing to the Diabetes epidemic, but plant-based diets could help fight it. Recent studies find that a low-fat vegan diet is as effective as oral medications at lowering blood sugar. However, Caroline suggested that changes in diet or medication should be made in consultation with a health care professional.

Knowledge of Family History Helps Prevent or Delay Diabetes

Many people who develop Type 2 Diabetes in the later life have one or more family members with the disease. Hence, it is very important to share about your family history of Diabetes with your doctor. People with a family history of Diabetes can take steps to prevent or delay the development of the disease.

What is more advantageous of taking the steps to prevent Diabetes is that it is also good for your overall health. You can prevent or delay Type 2 Diabetes even by losing a small amount of weight  5% to 7% or 10-14 pounds for a 200-pound person and becoming more active. It is recommended that everyone should be active at least 30 minutes a day, five days a week. Keeping a log of what you eat and when you exercise can help when speaking with your healthcare provider and it will help you track your progress. 

The New Hampshire Department of Health and Human Services (DHHS), Division of Public Health Services is partnering with the National Diabetes Education Program  (NDEP) in recognizing National Diabetes Awareness Month in November 2010  by encouraging people to know their family history.  

DHHS Commissioner Nicholas Toumpas says, "I am encouraging all state employees as part of my affiliation with the State Wellness Advisory Group to increase their awareness of the health risks of diabetes, including their family history, and how to reduce their chances of developing this serious illness."

Dr. José Montero, Director of Public Health at DHHS, says, "You can’t change your family history, but knowing about it can help you work with your healthcare team to take actions on the things you can change, such as losing weight, exercising more, and eating better. So speak with your family to find out if you have any close relatives who have or had diabetes. If any woman in your family had gestational diabetes while pregnant, she is also at increased risk for diabetes in the future and so is that child."

Study: Diabetes May Not Increase Risk of Eye Disease

It may not be obvious that Diabetes patients will have an increased risk of developing eye disease, revealed a new study led by Dr Jennifer Sun, at the Beetham Eye Institute at Joslin Diabetes Center. However, this claim is against general medical opinion.

The research claims that Diabetes patients may even be protected against proliferative diabetic retinopathy.

Study

97 patients who had lived with Diabetes for over 50 years were analyzed.

Results

The majority of them escaped vision loss despite the extremely long duration of the disease.

Dr Jennifer Sun said that this data may help identify other factors that protect against retinopathy complications.

For those who opt for eye therapies like intravitreous injection and chemotherapy drugs, another study revealed that the therapies do not open risk for heart disease. This study was led by Dr Lesley Curtis and colleagues at the Duke University School of Medicine in North Carolina.

Rise in Magnesium Intake Lowers Risk of Diabetes

According to a 20 year study undertaken by Dr. Ka He of the University of North Carolina, USA, and his colleagues, the risk of diabetes is 47% less in people who consumed magnesium and vitamin supplements in their food. However, he mentioned that large clinical trials should be carried out to validate the relationship between magnesium and diabetes.

The study explains the association of whole grains, a rich source of magnesium, with lower risk of diabetes. The other options for rich content of magnesium include green leafy vegetables like spinach; the chlorophyll molecule in the leafy vegetable contains magnesium. In legumes, beans and peas, nuts and seeds, and whole, unrefined grains also contain magnesium. In addition, tap water is a good source of magnesium as it contains natural minerals.

Supporting this study, the National Institutes of Health, said, “Magnesium plays an important role in carbohydrate metabolism. It may influence the release and activity of insulin, the hormone that helps control blood glucose (sugar) levels. Low blood levels of magnesium (hypomagnesemia) are frequently seen in individuals with type 2 diabetes. Hypomagnesemia may worsen insulin resistance, a condition that often precedes diabetes, or may be a consequence of insulin resistance. Individuals with insulin resistance do not use insulin efficiently and require greater amounts of insulin to maintain blood sugar within normal levels. The kidneys possibly lose their ability to retain magnesium during periods of severe hyperglycemia (significantly elevated blood glucose). The increased loss of magnesium in urine may then result in lower blood levels of magnesium. In older adults, correcting magnesium depletion may improve insulin response and action.”

FDA Yet to Approve Diabetes Drug “Bydureon”

United States Food and Drug Administration (FDA) has declined to approve Amylin’s Diabetes drug “Bydureon” as more tests were expected to be run on the drug, revealed the drugs company Amylin Pharmaceuticals in a statement. The FDA has decided that it would like to run a QT test to know how the drug affects patients’ heart rate.

The Food and Drug Administration has requested the results of a study which would evaluate the efficiency and safety of the drug. According to the company that has produced the Diabetes drug, it is aiming to respond to the FDA’s requests by the end of next year. Hence, only when the company’s response comes, it can be said that whether the drug will be approved or not.

Type 2 Diabetes Mellitus Linked with Colorectal Cancer among Men

Type 2 Diabetes Mellitus is linked with increased risk of incident colorectal cancer (CRC) among men, revealed a study. The risk was higher for those participants with Type 2 Diabetes regardless of whether or not they used insulin. Though the linkage between the two conditions is evident, it is not clear if this association varies by gender or other factors.

Hyperglycemia and hyperinsulinemia, which are especially prominent during the early stages of Type 2 Diabetes, have been proposed as mediators for the association between the two diseases.

However, as far as women are concerned, the study revealed that Type 2 Diabetes and insulin use were not associated with CRC risk among them.

Peter T. Campbell, lead author of this study, said, "While our study supports an association of Type 2 Diabetes with colorectal cancer incidence among men, our results also suggest that insulin use is associated with a slight, but not a substantially increased, risk of colorectal cancer among men with Type 2 Diabetes.”

The author added, "Prevention strategies should emphasize adherence to guidelines intended for the general population such as smoking cessation, weight management, exercise and regular early detection exams.”

Study: Phone Communication with Peer Helps Diabetes Patients

Phone calls with a peer who is going through the same self-management challenges helped Diabetes patients manage their conditions, revealed a new research from the University of Michigan Health System which was based on a peer partnership established by the Veterans Affairs Ann Arbor Health System and the University of Michigan Medical School.

Study

Each peer pair received initial brief training in peer communication skills. They were expected to communicate by telephone at least once a week about their mutual efforts to improve Diabetes control.

Results

The peer partner program produced lower glycated hemoglobin (HbA1c) levels after six months among men with uncontrolled Diabetes. Results also showed that the activity improved blood sugar levels in Diabetes patients better than those who used traditional nurse care management services alone.

Comments from Study Lead Author Michele Heisler

"Our model was testing the hypothesis that a good way to activate patients was to give them some skills and encouragement to both help and be helped. Just as in education they say that the best way to learn something is to try to teach it."

"Our programme hoped to mobilize patients themselves to realize how much they themselves had to offer another person with Diabetes and enjoy the sense of meaning and pleasure that being needed and helping another can provide. That's why I think people did well – they were very motivated when they felt they were helping someone else."

The findings of the study are published in the October 19 issue of the Annals of Internal Medicine.

Study: Traditional Mediterranean Diet May Cut Risk for Diabetes in Older People

A traditional Mediterranean diet, heavy in olive oil and vegetables, may help older people lower their risk for adult onset Diabetes - that too without being worried about calories and weight, revealed a study by Spanish researchers led by Jordi Salas-Salvado of the University of Rovira i Virgili in Reus, Spain. A traditional Mediterranean diet, which comprises lot of vegetables, fibre-rich grains, legumes, fish and plant-based sources of unsaturated fat  (particularly olive oil and nuts), is basically low in red meat and high-fat dairy.

Study

More than 400 adults found that those following the traditional diet were less likely to develop Diabetes over four years than those instructed to follow a low-fat diet, according to findings published in the journal "Diabetes Care." 418 adults between the ages of 55 and 80 were followed; each of the subjects had at least three risk factors for heart disease such as high blood pressure or smoking. They were randomly assigned to one of three diets - a Mediterranean diet with emphasis on more consumption of olive oil, the same diet with a focus on getting unsaturated fats from nuts, and a diet cutting all types of fat. The groups were not asked to limit calories or get more exercise.

Results

After four years, 10 to 11 % of those in the two Mediterranean groups had developed Diabetes, compared to 18% of those in the low-fat diet group. When researchers accounted for a number of other factors, such as the participants' weight, smoking history and reported exercise levels, the Mediterranean diet itself was linked to 52% reduction in Diabetes risk compared to the low-fat diet.

According to Constance Brown- Riggs, a spokeswoman for the American Dietetic Association, the results did not indicate that exercise is not needed. She said, “Sometimes individuals can get hung up on one item, like olive oil. But what we're talking about here is an overall eating pattern, and an overall lifestyle."

How Does Physical Exercise Help Diabetes Patients?

Physical activities have many more benefits than just to help you lose weight. For Diabetes patients, it is no less than a boon, and has long-term and static advantages. 


Being active, you improve your cholesterol, reduce stress, prevent osteoporosis, lower your blood pressure and help youself sleep. This, in turn, boosts your immune system and gives you more energy. In addition, when you engage in physical activities, your muscles use the glucose for energy, reducing your blood glucose for energy, reducing your blood glucose levels. Exercise also increases your insulin sensitivity, which means you will need less insulin to get glucose for your cells. This way physical exercise helps Diabetes patients. 

Higher Type 2 Diabetes Rates in US than UK might be Attributed to Greater Level of Mid-section Fat

According to a study, excess fat around the mid-section is a health risk. The American and British researchers advised that studies of Type 2 Diabetes to concentrate on waist size along with traditional risk factors.

The study revealed that 16% and 14% of American men and women have Diabetes, respectively as compared 11% and 7% of men and women in England, respectively. To know the reason behind the difference, researchers analyzed studies about the health and lifestyles of people in the US and England. However, they found no association between higher Diabetes rates in the United States and conventional risk factors such as age, smoking, socioeconomic status, or BMI.

But, they observed that American men's waists were an average of 3 centimeters (1.5 inches) larger than those of men in England. And American women's waists were an average of 5 centimeters (2 inches) larger than those of women in England.

In addition, women in America were much more likely than women in England to have a higher risk of Diabetes because of their waist size (69% versus 56%), while American men had only a slightly higher waist size-related Diabetes risk than their counterparts in England.

The study co-author James P. Smith concluded, “Americans carry more fat around their middle sections than the English, and that was the single factor that explained most of the higher rates of diabetes seen in the United States, especially among American women. Waist size is the missing new risk factor we should be studying.”

Study: Intensive Lifestyle Intervention More Effective in Type 2 Diabetes than Diabetes Support and Education

Intensive lifestyle intervention (ILI) produces greater improvements in weight, fitness, glycemic control, and cardiovascular (CV) risk factors in patients with Type 2 Diabetes than Diabetes support and education (DSE), revealed the Look AHEAD study. Main objective of the study was to compare the effects of ILI with DSE on lifestyle factors in Type 2 Diabetes patients.

Study

Conducted by Rena Wing from Brown Medical School, Providence, Rhode Island, USA, and her team. Rena said, “The critical question is whether the differences between groups in risk factors will translate into differences in the development of cardiovascular disease. These results will not be available for several additional years. However, effects of the magnitude that we observed for fitness, high-density lipoprotein (HDL) cholesterol and glycated hemoglobin (HbA1c) levels, and blood pressure have been associated with decreased CV events and mortality in previous medication trials and observational studies."

Findings: 

• Over the period of 4 years, the mean percentage of weight loss was greater at 6.15% in ILI group as compared to 0.88% in DSE group
• Treadmill fitness: A significant improvement in ILI group was seen at 12.74% as compared to 1.96% of the DSE group 
• HbA1c: A significant improvement in ILI group was seen at 0.36% as compared to 0.09% of the DSE group
• ILI group witnessed a significant decrease in systolic and diastolic blood pressure than DSE patients, by 5.33 versus 2.97 mmHg and 2.92 versus 2.48 mmHg, respectively
• HDL cholesterol increased and triglycerides decreased to a greater extent in ILI than DSE patients, by 3.67 versus 1.97 mg/dl and 25.56 versus 19.75 mg/dl, respectively
• Low-density lipoprotein cholesterol reductions were greater in DSE than ILI patients, by 12.84 versus 11.27 mg/dl.

Rena concluded, “Longer follow-up will allow us to determine whether the differences between groups in CV disease risk factors can be maintained and whether the ILI has positive effects on CV morbidity and mortality.”

The DSE group is given dietary advice and recommendations to increase physical activity while the ILI group has to attend weekly group sessions and monthly individual sessions with a lifestyle counselor.

Finnish Study: Risk of Developing Type 2 Diabetes Reduces with Moderate Weight Loss

Risk of developing Type 2 Diabetes reduces with moderate weight loss in at-risk individuals, revealed the one-year results of The Finnish National Diabetes Prevention Program (FIN-D2D). The program was conducted to examine effects of weight loss on 2,798 individuals with a high risk of Diabetes.

Study

The study was undertaken by Leena Moilanen from Kuopio University Hospital, Finland, and her colleagues on participants who had a history of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), cardiovascular disease, or gestational Diabetes mellitus.

Findings after a year

• Incidence of Type 2 Diabetes with normal glucose tolerance at baseline

• In men: 2.0%
• In women: 1.2%

• Incidence of Type 2 Diabetes with IFG

•  In men: 13.5%
•  In women: 7.4%

• Incidence of Type 2 Diabetes with IGT

• In men: 16.1%
• In women: 11.3%

• 17.5% of participants lost 5% or more of their body weight, with no significant differences noted between men and women. Simultaneously, these individuals also had a significant 69% reduction in relative risk for Type 2 Diabetes as compared to those who maintained their baseline weight.

It was also noted that participants who lost less weight in the range of 2.5-4.9% had a 28% reduction in relative risk for Type 2 Diabetes compared to those who maintained their weight. On the contrary, participants who gained 2.5% or more of their body weight had a nonsignificant 10% increase in relative risk for Type 2 Diabetes compared with those who maintained their baseline weight.

According to authors in the journal Diabetes Care, “Despite some weaknesses, this is the largest study so far on implementation of screening and prevention of Diabetes among high-risk individuals in the primary health care setting.”

Study: Children and Adolescents with Metabolic Syndrome at Higher Risk of Type 2 Diabetes

Children and adolescents with the metabolic syndrome are at increased risk for developing Type 2 Diabetes and subclinical atherosclerosis in adulthood, according to study by Costan Magnussen (University of Turku, Finland) and team. However, the study also revealed that screening for high body mass index (BMI) alone in this age group is a simpler and equally accurate predictor of later cardiometabolic outcomes compared with the metabolic syndrome as a whole.

Study:

The researchers used data from the Bogalusa Heart Study and Cardiovascular Risk in Young Finns Study to assess whether the metabolic syndrome and its associated components in childhood and adolescence predict Type 2 Diabetes and high carotid intima-media thickness (IMT) in later life. In all 1781 children aged 9-18 years were recruited during 1984-1988. They were then followed up between 2001 and 2007 when aged 24-41 years.

Result:

Children who had the metabolic syndrome had a 2-3 times higher risk for developing Type 2 Diabetes or having increased carotid IMT (at or above 90th percentile for population) than those without the metabolic syndrome. However, they also stated that use of pediatric BMI alone to predict adult Type 2 Diabetes or high carotid IMT was the most significant component of the pediatric metabolic syndrome for predicting adult outcomes.

Comments from the researchers:

"Our findings have direct clinical relevance because they suggest that in the clinical setting, efforts to identify youth with heightened future risk of meaningful outcomes can be minimally achieved with the use of BMI only.”

"However, clinicians who use high BMI to identify youth at increased future risk need to keep in mind that a large proportion of contemporary youth will be classified as at risk and that our analyses are unable to discount that youth metabolic syndrome may be useful in identifying and possibly treating other cardiometabolic disorders."

Self Monitoring of Blood Glucose (SMBG) – A Must for Diabetes Patients

As the main aim of Diabetes treatment is to keep your blood glucose levels in normal or near-normal range, monitoring blood glucose levels is one of the best ways of determining how well a Diabetes treatment plan is working.

With Self-blood glucose monitoring, you can know your blood glucose level at any time for e.g. fasting (before breakfast or 2 hours after meals). It helps prevent the immediate and potentially serious consequences of very high or very low blood glucose.

SMBG can be used by you to avoid acute complications and increase safety in the following situations: Hyperglycemia (high blood sugar), Hypoglycemia, Periods of illness or post-surgery, Exercise, Adjustment of Diabetes Medications, Evaluation of Effects of Other Medication Therapies, Preconception Planning, and Pregnancy.

SMBG not only improves glycemic control in individuals with Type 1 and Type 2 Diabetes but also improves their overall health. It is particularly important during pregnancy, where it has been shown that intensive glycemic control significantly benefits foetal outcomes. 

Aerobic Exercise Benefits Diabetes Patients

Aerobic exercise has proved to be beneficial for Diabetes patients. It is an activity that requires the use of large muscles and makes your heart beat faster. Doctors always suggest this to patients.  Doing aerobic exercise for 30 minutes a day, at least 5 days a week provides many benefits.

So see your doctor first to make sure if it is ok for you to increase your level of physical activity. Talk to them about how to warm up, stretch before you exercise and how to cool down after you exercise. Start slowly with 5 to 10 minutes a day.

Along with aerobics, the following exercises can also prove beneficial for you:

·         Walking briskly
·         Hiking
·         Climbing stairs
·         Swimming
·         Dancing
·         Playing basketball, volleyball or other sports

Study: Type 2 Diabetes Patients May Be Prone to Acute Pancreatitis

Type 2 Diabetes patients are more likely to develop acute pancreatitis compared to Diabetes-free people, reveals a study published in Diabetes Care on September 10. Dr. Antonio Gonzalez-Perez, of Centro Espanol de Investigacion Farmacoepidemiologica, Madrid, Spain, and colleagues, wrote, "The results of this study confirm the excess risk of acute pancreatitis associated with Type 2 Diabetes previously reported in other observational studies."

Study

Data from The Health Improvement Network database in the UK, between 1996 and 2006 were taken to study the risk of acute pancreatitis among patients with Type 2 Diabetes. The researchers performed a population-based case-control analysis in a cohort of 85,525 Type 2 Diabetes patients and 200,000 Diabetes-free subjects from the general population. They followed the patients for an average of 3.8 and 4.0 years, respectively.

Results

·         A total of 419 cases of acute pancreatitis were identified, including 243 in the general population and 176 in the Diabetes cohort.

·         The adjusted incidence rate ratio of acute pancreatitis in Diabetic patients compared to the general population was 1.77, but the magnitude of this association decreased when it was adjusted for multiple demographic and lifestyle factors (adjusted odds ratio 1.37).

·         The use of insulin (adjusted OR 0.35) and long-term use of metformin (adjusted OR 0.50) were associated with a decreased risk of pancreatitis. Past use of sulphonylureas was associated with a significant risk increase (adjusted OR 2.58).

Comments from researchers

"Overall, when we analyzed the risk of pancreatitis among treated and not treated diabetic patients separately, we observed that the greatest risk appeared among those without anti-diabetic pharmacotherapy, who represent a quarter of our diabetic population." 

Statins Reduces Stroke Risk in Type-1 or 2 Diabetes Patients over 40, says Dr John Betteridge from University College London

Diabetes patients (Type-1 or 2) over the age of 40 should take Statins to reduce the risk of stroke or coronary events, said Dr John Betteridge (University College London, UK) at the European Association for the Study of Diabetes (EASD) 2010 Meeting. According to Betteridge, Statins is safe if appropriately used and drug interactions are avoided.

Dr John Betteridge revealed that trials such as CARDS have proven the benefit of Statins in Type 2 Diabetes. He noted that 10mg of atorvastatin (Lipitor, Pfizer) reduced LDL cholesterol by 40% and was associated with a 37% reduction in cardiovascular events and a "dramatic" halving of the stroke rate over 4 years.

Citing the results from the Cholesterol Treatment Trialists' Collaboration, Betteridge said that women and Type 1 Diabetes also benefited equally from Statins. However, he warned that there is a little evidence to guide Statin therapy in people under 40 with Type 1 Diabetes.

About the non-affectivity of Statins, Betteridge said, "Statins only work if people take them." He adds that he has seen many patients in whom Statins have been stopped inappropriately, either by the patient or by their doctors. 

Study: Diabetic Patients with Coronary Artery Disease Have Reduced Platelet Response to Aspirin

A study by Stig Mortensen and colleagues from Aahus University Hospital Skejby in Denmark revealed that diabetic patients with coronary artery disease (CAD) have reduced platelet response to aspirin.

Study:

The researchers studied 85 diabetic and 92 nondiabetic CAD patients. All the 177 patients taking 75 mg/day non-enteric coated aspirin had platelet aggregation evaluated using arachidonic acid 0.5 and 1.0 mM and platelet activation assessed by soluble (s)P-selectin.

Result:

The study revealed that patients with diabetes had significantly higher levels of platelet aggregation and activation compared with nondiabetics.

The researchers claim that "these findings may partly explain the reduced cardiovascular protection from aspirin in diabetic patients."

The authors concluded: "Several mechanisms may explain the reduced response of diabetic platelets to aspirin. Hyperglycemia together with dyslipidemia and insulin resistance in diabetic patients may all affect the response to antiplatelet drugs.”

"Hyperglycemia may cause a competition between acetylation and glycation of platelet proteins… Diabetics might also have an increased platelet turnover and be hypersensitive to pro-aggregatory agonists causing an increased platelet activation and aggregation.”

Sanofi-aventis Unveils Blood Glucose Monitoring Devices BGStar and iBGStarTM

Sanofi-aventis and its partner AgaMatrix have developed blood glucose monitoring (BGM) devices BGStar and iBGStarTM. Both the products are expected to be available in the markets in early 2011.

iBGStarTM can be plugged into an iPhone® or iPod touch® and displays results on a full-color, touch screen. The product range allows users to access a full service telephone hotline and other support services.

                                                                            

BGStar, which is based on the patented Dynamic Electrochemistry® technology, has various feedback features including alerts, programmable reminder alarms and positive feedback to indicate meaning of the result.

Prof. Thomas Haak, chief physician at the diabetes clinic Bad Mergentheim Germany, said, "Blood glucose values recorded for immediate and future analysis, forming a complete record, are the basis of well-informed decision making. Specifically designed devices, which fit conveniently into a patient's daily lifestyle, resulting in blood glucose self-monitoring at the recommended level, will improve diabetes management.”

Study: High Particulate Matter Exposure May Increase Risk for Type 2 Diabetes

According to a research by John Brownstein (Harvard Medical School, Boston, Massachusetts) and colleagues, increased exposure to airborne particulate matter measuring less than 2.5 µm in diameter (PM2.5) may increase risk for Type 2 diabetes.

Study:

Since ambient air pollution adversely affects various aspects of human health, the researchers decided to study the influence of increasing levels of PM2.5 on risk for Type 2 Diabetes. The researchers gathered data from the Centers for Disease Control and Prevention and the US Environmental Protection Agency for 2004 and 2005 to assess levels of PM2.5 exposure and the county level prevalence of Diabetes.

Results:

After studying the data, the researchers realised that the prevalence of Diabetes increased with increasing PM2.5 concentrations. For instance, 1% increase in Diabetes prevalence was linked to a 10 µ/m3 increase in PM2.5 exposure.

               

They further found that despite EPA-based guidelines for PM2.5 exposure, individuals with the highest exposure to PM2.5 had a more than 20% increased prevalence of Diabetes compared with those with the lowest exposure.

The researchers said, "Our results, although associative, demonstrate that additional research is needed to understand the role that PM2.5 plays in the inflammatory pathway or other pollution-mediated mechanisms giving rise to Diabetes. They concluded, "Such research could lead to novel therapeutic approaches to reduce pollution-induced inflammation."

Study: South Asians Living in the US are at Higher Risk of Diabetes than Other Asian Immigrants

South Asians (born in Bangladesh, India, Nepal, and Pakistan) living in the US are at a much higher risk of Type 2 Diabetes compared to the other Asian immigrants, revealed a study led study author, Swapnil Rajpathak, M.D., an assistant professor of epidemiology and population health at the Albert Einstein College of Medicine.

Study:

Data from the New York City Health and Nutrition Examination Survey, conducted in 2004, were studied to evaluate different racial and ethnic groups for risk factors relating to heart disease and metabolic disorders such as diabetes. The researchers studied the fasting glucose levels from 1,324 respondents.

Results:

The findings of the study appear in the latest issue of the journal Ethnicity & Disease. Swapnil Rajpathak said, "In addition to cultural and lifestyle factors, Asians subgroups are also different in terms of their genetic makeup. He added, "Immigrants may experience dramatic changes in their diet and physical activity after moving to this country. Given their higher genetic susceptibility, unfavorable changes in lifestyle factors may increase the risk of diabetes."

The variations found contribute to the inequality in Diabetes risk between whites and Asians overall, as well as between South Asians and Asians from other countries. 

                                                                                                                                                                                   

South Asians were found to have the highest prevalence of Diabetes at 35.4%, compared with 16.1% for all Asians and 10.8% for whites.

Vivian Fonseca, M.D., vice president of the American Diabetes Association and chief of endocrinology at Tulane University Health Sciences Center, said, in general, "Asians get insulin resistance and increased risk of diabetes and heart disease at a much lower level of obesity than Caucasians.”

Unilever Gathers Experts for a Diabetes Forum in Singapore

Unilever Research and Development and A Star, the Singapore agency for Science, Technology and Research, organized a symposium to discuss on the causes and prevention of Diabetes and Cardiovascular disease. A total of 250 delegates were expected to attend the meeting along with academic researchers and representatives from public health bodies, NGOs, and private companies.

During the meeting, it was found that developing countries constitute about 80% of Diabetes patients. It also came to light that India and China are the first two countries with the maximum count of diabetic persons. The situation is expected to worsen in the coming two decades. According to Sir Prof. Gluckman from the University of Auckland, “Asians appear to be particularly susceptible to these diseases and are becoming ill at a younger age and a lower body mass index than other ethnic groups.” The experts are still unable to find the reasons for this epidemic.

Jim Crilly (EVP Unilever Research) highlighted that the main purpose of the symposium extended beyond sharing information. He added, “Our aim was to seek opportunities for Unilever to partner and collaborate with the best international and local experts in this field. Unilever as a major manufacturer in the fast moving consumer goods sector seeks to use its brands, R&D and innovations to make Asian consumers lives healthier and happier everyday.”

AstraZeneca and Bristol-Myers Squibb Present Results on dapagliflozin at the 46th annual meeting of the European Association for the Study of Diabetes

AstraZeneca and Bristol-Myers Squibb presented results from the study on dapagliflozin at the 46th annual meeting of the European Association for the Study of Diabetes. As per the results of a late-stage clinical trial, dapagliflozin works as effective as a generic drug already present in the market.

According to the phase-3 trial results, AstraZeneca and Bristol-Myers Squibb’s investigational drug dapagliflozin in combination with a widely available generic metformin was as effective as a combination of combglipizide and metformin, or as compared with metformin alone. Patients who were prescribed dapagliflozin experienced weight loss, while patients prescribed with glipizide experienced weight gain and some patients experienced hypoglycaemia.

Takeda to Continue with ACTOS for Treatment of Type 2 Diabetes

Takeda Pharmaceuticals North America, a part of Takeda, has reiterated its commitment to ACTOS (pioglitazone HCl) and medications having ACTOS for the treatment of type 2 diabetes following suspension announcement of rosiglitazone in the US and Europe by the FDA and the European Medicines Agency (EMA). ACTOS has same use and class as other diabetes drugs but its chemical structure is unqiue having different therapeutic effects. The drug works very well with proper diet and exercise that further improve blood sugar (glucose) control in many adults suffering from the condition.

Clinical studies have been conducted since the last 11 years in over 20,000 patients worldwide, and ACTOS has shown good results without any proof of increased danger of heart attack, stroke or death. Thus, adding the company’s confidence on the consistency and positive results of ACTOS data.

Takeda’s initiatives in the field of diabetes 

• The company in 2005, completed PROactive (PROspective PioglitAzone Clinical Trial In MacroVascular Events) trial, which was undertaken to access significant CV outcomes in type 2 diabetes patients. 
• In 1999, the company introduced ACTOS commercially for treatment of type 2 diabetes.

Research: Blueberries Improve Pre-diabetic Condition

Blueberries have properties that help improve factors related to pre-diabetes and decrease inflammation in obese men and women, as per a research conducted by the Pennington Biomedical Research Center (PBRC).

                                        

Study:

Conducted over a six week period, the study involved 36 obese subjects diagnosed with insulin resistance, but who had no evidence of Type 2 Diabetes. The participants were randomly kept on a blueberry-rich or nutritionally equivalent blueberry-free smoothie for 42 days. The subjects were asked to intake the smoothie twice a day.

Result:

Dr. April Stull, PBRC Researcher, said, "The participants who consumed the blueberry smoothies had improved insulin sensitivity compared to those consuming no blueberries. We now know that compounds in blueberries may help obese, non-diabetic individuals maintain healthy blood glucose levels.”

PBRC is urging additional research to study whether the same effects would be found in people with Type 2 Diabetes.

FDA may Restrict Use of Diabetes Drug Avandia to Patients with Type 2 Diabetes

FDA has declared that the organization will restrict the use of the Diabetes drug Avandia (rosiglitazone) to patients with Type 2 Diabetes who were unable to achieve glucose control on other medications since the drug elevated risk of cardiovascular events, such as heart attack and stroke. The administration further announced that current users of Avandia, who are benefiting from the drug, can continue using the medication if they choose to do so.

Avandia, manufactured by GlaxoSmithKline (GSK), is intended to be used in conjunction with diet and exercise to improve glucose (blood sugar) control in patients with Type 2 Diabetes Mellitus. The drug is in a class of drugs known as thiazolidinediones, or TZDs.

The U.S. Food and Drug Administration ordered GSK to develop a restricted access program for Avandia under a risk evaluation and mitigation strategy (REMS). Under the REMS, Avandia will be available to new patients only if they are unable to achieve glucose control on other medications and are unable to take Actos (pioglitazone), the only other drug in this class.

In addition, the FDA ordered GSK to convene an independent group of scientists to review key aspects of the company's clinical trial known as RECORD, which studied the cardiovascular safety of Avandia compared to standard diabetes drugs.

The agency has also stopped the GSK's clinical trial known as TIDE and rescinded all of the regulatory deadlines for completion of the trial. The TIDE trial compares Avandia to Actos and to standard diabetes drugs.

The FDA may take additional actions after the independent re-analysis of RECORD is completed.

Study: Analog Glulisine Improves Glycemic Control in Hospitalized Type 2 Diabetes Patients

According to the researchers, insulin therapy in hyperglycemic inpatients is difficult due to vacillating meal times in hospitals, irregular food intake, and medical conditions that can lead to hypoglycemia. Hence, they studied the benefit of rapid-acting insulin in this setting in 180 patients with Type 2 Diabetes who were admitted for non-critical medical or surgical care for at least 3 days.

The primary end points of the study were glycemic control, quantified by the mean daily blood glucose concentration and the incidence of hypoglycemia.

After being removed from any prior Diabetes medication, the patients were randomized in two groups to either rapid-acting glulisine (Apidra, Sanofi-Aventis) or regular insulin (Novolin R, Novo Nordisk) before meals, as well as insulin glargine (Lantus, Sanofi-Aventis) at bedtime.

Results: 

• For the first four days, the average blood glucose concentrations were the same, 159 mg/dL, in the both groups. 
• However, after four days, the concentration levels stood at 140 vs. 162 mg/dL (p<0.0007) in the glulisine and normal insulin groups, respectively. 
• After seven days, the levels were 133 vs. 164 mg/dL (p<0.0001) in the glulisine and normal insulin groups, respectively. 

For hypoglycemia, the study stated that "there were 123 hypoglycemic events: 56 in the glulisine group and 67 in the regular insulin group." However, Dr. Meyer and colleagues report, the number of subjects with one or more hypoglycemic episodes (30% vs. 35%, p>0.5) was not significantly different.

The researchers concluded, "The present study provides evidence suggesting that treatment with glulisine can provide superior glycemic control compared (to) regular insulin in hospitalized T2DM patients, especially in those who have a prolonged length of stay."

Study: Risk of Type 2 Diabetes Mellitus increases if breast-feeding period is below 30 days

A study reported in the American Journal of Medicine revealed that breast-feeding for less than 1 month can increase the risk of Type 2 Diabetes. The study’s lead author, Eleanor Bimla Schwarz, MD, MS, from the University of Pittsburgh, Pennsylvania, said, "Diet and exercise are widely known to impact the risk of Type 2 Diabetes, but few people realize that breastfeeding also reduces mothers' risk of developing the disease later in life by decreasing maternal belly fat."

Study:

The study aimed to examine the relationship amongst duration, exclusivity, and consistency of lactation with the risk of Type 2 Diabetes in 2233 female member of a healthcare delivery organization in California, aged between 40 and 78 years. The researchers controlled for age, parity, race, education, hysterectomy, physical activity, tobacco, and alcohol use, family history of diabetes, and body mass index using multivariable logistic regression.

Result: 

• Mothers who never exclusively breast-fed were more likely to have gone on to have Type 2 Diabetes as compared to those who exclusively breast-fed for 1 to 3 months 
• Compared with nulliparous women, those who consistently breast-fed their children for at least 1 month had a similar adjusted risk for Type 2 Diabetes
• Mothers who had never breast-fed an infant had greater risk 

To conclude, the authors added, "Risk of Type 2 Diabetes increases when term pregnancy is followed by <1 month of lactation, independent of physical activity and body mass index in later life. Mothers should be encouraged to exclusively breast-feed all of their infants for at least 1 month."

Study: Diabetes Does Not End Sexual Activity of People in the Middle-age

Diabetes does not end sexual activity of the middle-aged and older adults, though it affects their sexual function, revealed a new study published in the September 2010 issue of Diabetes Care. 

Study

Researchers: Lead author Stacy Tessler Lindau, MD, MAPP, FACOG, associate professor of obstetrics and gynecology and of medicine at the University of Chicago, Illinois, and colleagues

A part of the National Health, Social Life and Aging Project, the survey evaluated 1993 adults aged 57 to 85 years both with and without Diabetes.

Study Design - In-home interviews, medication inventories, and measurements of HbA1c levels

Results

The researchers reiterated the association of Diabetes with sexual dysfunction. Even though Diabetes affects libido, erectile function, and orgasm, older partnered adults with the disease still engage in sexual activity about as often as people without the disease. Almost 70% of partnered men with Diabetes and 62% of partnered women with Diabetes engage in sexual activity an average of 2 or 3 times each month.

Of the participants, 47% of men had Diabetes; about half were aware of the disease. Nearly 40% of the women surveyed were found to have Diabetes. Again, only half of them were aware they had the disease.

Men with diagnosed Diabetes were more likely to report diminished interest in sex (adjusted odds ratio [AOR], 1.72; 95% confidence interval [CI], 1.12 - 2.63) than other men and to report having more problems with Erectile Dysfunction (AOR, 2.52; 95% CI, 1.53 - 4.14). Difficulties in achieving orgasm were more common in participants with Diabetes, and such difficulties were reported in both women and men, regardless of whether they were aware they had Diabetes.

Women with Diabetes were less likely than men with Diabetes (AOR, 0.28; 95% CI, 0.16 - 0.48) and women without Diabetes (AOR, 0.63; 95% CI, 0.45 - 0.87) to be sexually active, and those with Diabetes who had no partners were only about half as likely to be sexually active as women with partners (33% vs 62%, respectively).

Symptoms of Mellitus Diabetes

Signs and symptoms of all types of Diabetes Mellitus are more likely to be similar since the blood sugar is high, either due to less or no production of insulin, or insulin resistance.

Overview of the most significant symptoms:

For Type 1:

During initial stage:

o   Nausea and vomiting

In later stage:

o   Weight loss – Since body starts breaking down the muscle tissue and fat for producing energy.

o   Dehydration – Due to electrolyte disturbance

In advanced stages:

o   Coma

o   Can also result into death

For Type 2:

• Increased fatigue - Due to inefficiency of the cell to metabolize glucose, reserve fat of body is metabolized to gain energy.
• Polydipsia – Excessive thirst
• Polyuria – Increase in urine production; body starts removing the extra sugar in the blood by excreting it through urine.
• Polyphegia – Increased hunger
• Weight fluctuation – Weight can rise due to increased appetite or weight can decrease due to factors like loss of water (Polyuria), Glucosuria, metabolism of body fat and protein.
• Blurry vision – Poor eyesight
• Irritability – a sign of high blood sugar
• Poor wound healing – High blood sugar blocks the growth of White Blood Cell (WBC), which is responsible for body immune system.
• Infections – Whenever there is fluctuation in blood sugar, skin infections like fungal or bacterial or UTI (urinary tract infection) become prominent.  

Symptoms when Diabetes turns into Autoimmune Disorder:

• Due to autoimmune infections, various skin, genito-urinary tract and respiratory problems can arise.
• Defective formation of various blood components like WBC's and platelets result in poor blood composition. This may result in complications like poor wound healing and easy susceptibility to injuries.
• If the disorders are not medicated at the early stage, problems such as blindness, cataract, gangrene, diabetic nephropathy, diabetic neuropathy, diabetic foot, etc. can occur.