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.”