September 25, 2008, 11:06 PM CT

Continuous glucose monitoring in diabetic pregnant women

Continuous glucose monitoring as part of antenatal care for women with diabetes improves maternal blood glucose control and lowers birth weight and risk of macrosomia* (excessive birth weight in babies), as per a research studypublished on bmj.com today.

During pregnancy it is important that women with diabetes keep their blood glucose under control. If not, there may be an increase in the amount of glucose reaching the baby, which makes the baby grow faster than normal, and may cause difficulties at birth as well as an increased longer term risk of insulin resistance, obesity and type 2 diabetes.

Evidence suggests that measuring glucose more often improves outcomes, but the optimum frequency of blood glucose testing is not known.

Dr Helen Murphy and his colleagues examined whether continuous glucose monitoring during pregnancy can improve maternal glucose control and reduce birth weight and risk of macrosomia in babies of mothers with diabetes.

They recruited 71 pregnant women with type 1 and type 2 diabetes from antenatal clinics in the UK.

The women were randomly assigned to standard antenatal care (intermittent self monitoring of glucose levels using the finger prick technique) or intermittent monitoring plus continuous glucose monitoring (using glucose values from subcutaneous tissues measured electronically every 10 seconds, giving up to 288 measurements a day)......... Posted by: Emily      Read more         Source

August 27, 2008, 9:02 PM CT

Young Type-2 Diabetic Men Suffer Low Testosterone Levels

Young men with type 2 diabetes have significantly low levels of testosterone, endocrinologists at the University at Buffalo have found -- a condition that could have a critical effect on their quality of life and on their ability to father children.

This study follows research published earlier by these researchers reporting that one-third of middle-aged men with type 2 diabetes have low testosterone levels, requiring therapy for erectile dysfunction.

"These new findings have several clinical implications besides the impairment of sexual function in these young men," said Paresh Dandona, Ph.D., UB Distinguished Professor in the Department of Medicine and senior author on both studies.

"The lack of testosterone during these critical years may lead to diminished bone mass and the lack of development or lose of skeletal muscle. In addition, these patients may gain more weight (with an average body mass index of 38 they already were obese) and become more insulin resistant.

"Also, patients with low testosterone and type 2 diabetes have been shown to have very high concentrations of C reactive protein," he added, "which increases their risk of developing atherosclerosis and heart disease above and beyond the risk linked to diabetes".

Results of the new study appear in the online edition of Diabetes Care and will be published in an upcoming edition of the journal......... Posted by: JoAnn      Read more         Source

July 1, 2008, 8:50 PM CT

A step towards better diabetes treatment

In today's issue of the prestigious journal Cell Metabolism Uppsala researchers are presenting new findings that shed light on the processes that determine the release of the blood sugar-lowering hormone insulin. The discovery is based on the development of image analysis methods that make possible the detailed study of events immediately inside the plasma membrane of the insulin-secreting cells.

Cyclic AMP (cAMP) is a universal messenger molecule that controls many different functions inside the cell. For example, it plays a role in the release of insulin from the beta cells in the pancreas (see Facts). It is well-known that the production of cAMP explains how certain hormones can amplify insulin secretion. Conversely, it has been unclear to what extent cAMP also contributes to the major release of insulin triggered by an increase in blood sugar (glucose).

Anders Tengholms research team at Uppsala University has developed methods that make it possible for the first time to measure both the secretion of insulin and the cAMP concentration in individual beta cells. The results show that ATP, the energy-rich molecule that is produced when glucose is metabolized, causes an increase in cAMP concentration right at the cell membrane where the release of insulin takes place. This increase varies rhythmically and coincides with similarly regular variations in another stimulant messenger, the calcium ion, resulting in pulsatile secretion of insulin......... Posted by: Scott      Read more         Source

June 5, 2008, 10:28 PM CT

Vitamin D and type 1 diabetes

Sun exposure and vitamin D levels may play a strong role in risk of type 1 diabetes in children, as per new findings by scientists at the Moores Cancer Center at University of California, San Diego (UCSD) and the Department of Family and Preventive Medicine. This association comes on the heels of similar research findings by this same group regarding vitamin D levels and several major cancers.

In this new study, the scientists observed that populations living at or near the equator, where there is abundant sunshine (and ultraviolet B irradiance) have low incidence rates of type 1 diabetes. On the other hand, populations at higher latitudes, where available sunlight is scarcer, have higher incidence rates. These findings add new support to the concept of a role of vitamin D in reducing risk of this disease.

Ultraviolet B (UVB) exposure triggers photosynthesis of vitamin D3 in the skin. This form of vitamin D also is available through diet and supplements.

"This is the first study, to our knowledge, to show that higher serum levels of vitamin D are linked to reduced incidence rates of type 1 diabetes worldwide," said Cedric F. Garland, Dr. P.H., professor of Family and Preventive Medicine in the UCSD School of Medicine, and member of the Moores UCSD Cancer Center......... Posted by: JoAnn      Read more         Source

May 8, 2008, 9:14 PM CT

How slow growth as a fetus can cause diabetes as an adult

Intrauterine growth retardation (IUGR), which results in a baby having a low weight at birth, has been associated with the development of type 2 diabetes in adulthood. It has been suggested that this is because the expression of key genes is altered during fetal development and that this affects disease susceptibility during the later part of life. Evidence to support this hypothesis and indicating that the changes in gene expression might be permanent has now been provided by Rebecca Simmons and his colleagues, at the University of Pennsylvania, Philadelphia, using a rat model of IUGR.

Pervious studies using the rat model of IUGR have shown decreased fetal expression of the gene Pdx1, which is critical for the development and function of the cells that become defective in type 2 diabetes (pancreatic beta-cells), and adult onset of diabetes. In this study, expression of Pdx1 was found to be reduced in pancreatic beta-cells throughout life following IUGR. The molecular mechanisms (known as epigenetic mechanisms because they affect gene expression without altering the information in the gene) that reduced Pdx1 expression in pancreatic beta-cells were found to change during development. One mechanism was observed in the fetus, one following birth, and one after the onset of diabetes in adulthood. Of interest, the mechanisms reducing Pdx1 gene expression in the fetus and following birth could be reversed, whereas those reducing Pdx1 gene expression in the adult were irreversible. These data provide new insight into the mechanisms by which diabetes develops in adulthood following IUGR......... Posted by: Emily      Read more         Source

April 30, 2008, 5:55 PM CT

Salk study links diabetes and Alzheimer's disease

Diabetic individuals have a significantly higher risk of developing Alzheimers disease but the molecular correlation between the two remains unexplained. Now, scientists at the Salk Institute for Biological Studies identified the probable molecular basis for the diabetes Alzheimers interaction.

As per a research findings reported in the current online issue of Neurobiology of Aging, researchers led by David R. Schubert, Ph.D., professor in the Cellular Neurobiology Laboratory, report that the blood vessels in the brain of young diabetic mice are damaged by the interaction of elevated blood glucose levels characteristic of diabetes and low levels of beta amyloid, a peptide that clumps to form the senile plaques that riddle the brains of Alzheimers patients.

Eventhough the damage took place long before the first plaques appeared, the mice suffered from significant memory loss and an increase in inflammation in the brain. Eventhough the toxic beta amyloid peptide was first isolated from the brain blood vessels of Alzheimers patients, the contribution of pathological changes in brain vascular tissue to the disease has not been well studied, says Dave R. Schubert, Ph.D., professor and head of the Cellular Neurobiology Laboratory. Our data clearly describe a biochemical mechanism to explain the epidemiology, and identify targets for drug development......... Posted by: JoAnn      Read more         Source

April 8, 2008, 9:58 PM CT

Cholesterol, blood pressure control in diabetics

Aggressively lowering cholesterol and blood pressure levels below current targets in adults with type 2 diabetes may help to prevent and possibly reverse hardening of the arteries, as per new research supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. Hardening of the arteries, also known as atherosclerosis, is the number one cause of heart disease and can lead to heart attack, stroke, and death.

The three-year study of 499 participants is the first to compare two therapy targets for LDL (bad) cholesterol and systolic blood pressure levels, key risk factors for heart disease, in people with diabetes. Results are reported in the April 9 issue of the Journal of the American Medical Association.

This study provides good news for adults with type 2 diabetes, said Elizabeth G. Nabel, M.D., NHLBI director. These patients are two to four times more likely than people without diabetes to die from heart disease. For the first time, we have evidence that aggressively lowering LDL cholesterol and blood pressure can actually reverse damage to the arteries in middle-aged adults with diabetes.

In the Stop Atherosclerosis in Native Diabetics Study (SANDS), approximately one-half of the participants (247) were asked to lower to standard levels their LDL cholesterol (to 100 milligrams per deciliter) and blood pressure (systolic blood pressure of 130 mmHg or lower), while the other half (252) aimed for more aggressive lowering of LDL cholesterol to 70 mg/dL or lower and of systolic blood pressure to 115 mmHg or lower. All participants were American Indians 40 years or older (average age of 56) who had diabetes, high blood cholesterol, and hypertension but no history of heart attack or other evidence of heart disease. The study was conducted at four clinical centers in southwestern Oklahoma; Phoenix, Ariz.; northeastern Arizona; and South Dakota. All participants continued to receive their medical care, including diabetes management, dietary and exercise counseling, and smoking cessation, from their health care providers with the Indian Health Service. Like the NIH, the Indian Health Service is part of the U.S. Department of Health and Human Services......... Posted by: JoAnn      Read more         Source

April 1, 2008, 8:34 PM CT

Bacteria in the digestive system and obesity

Obesity is more than a cosmetic concern because it increases a persons risk for developing high blood pressure, diabetes and a number of other serious health problems. Its well understood that consuming more calories than you expend through exercise and daily activities causes weight gain. But with about one in every three American adults now considered obese, scientists are attempting to identify additional factors that affect a persons tendency to gain and retain excess weight. In the recent issue of Mayo Clinic Proceedings, scientists from Mayo Clinic Arizona and Arizona State University examine the role that bacteria in the human gastrointestinal tract play in regulating weight and the development of obesity.

Known as gut microbiota, the trillions of bacteria that populate the human gastrointestinal tract perform a variety of chores. These friendly microbes help extract calories from what we eat, help store these calories for later use, and provide energy and nutrients for the production of new bacteria to continue this work.

As per John DiBaise, M.D., a Mayo Clinic Arizona gastroenterologist and lead author of the Mayo Clinic Proceedings article, several animal studies suggest that gut microbiota are involved in regulating weight and that modifying these bacteria could one day be a therapy option for obesity......... Posted by: JoAnn      Read more         Source

March 31, 2008, 9:30 PM CT

Actos preventes progression of atherosclerotic plaque

New data from a clinical trial using intravascular ultrasound (IVUS) technology observed that in patients living with type 2 diabetes, ACTOS® (pioglitazone HCl) reduced the atherosclerotic burden in the coronary arteries in comparison to glimepiride, and prevented progression in comparison to baseline. These data stem from the PERISCOPE (Pioglitazone Effect on Regression of Intravascular Sonographic Coronary Obstruction Prospective Evaluation) trial.

The PERISCOPE trial was presented today as a late breaker at the 57th Annual Scientific Session of the American College of Cardiology in Chicago. This trial adds to the body of cardiovascular data for ACTOS. ACTOS studies, conducted over the past 10 years in more than 16,000 patients, including short- and long-term trials, as well as prospective and findings based on observation, have shown no evidence that ACTOS is linked to an increased risk of heart attack, stroke, or death.

We are pleased with the results of the PERISCOPE, which further expands our cardiovascular data with ACTOS, said David P. Recker, M.D., senior vice president, Clinical Sciences and interim president at Takeda Global Research & Development. While not definitive, data from PERISCOPE combined with results from a prior study, looking at surrogate endpoints, have shown a consistent trend toward decreasing cardiovascular risk by reducing the atherosclerotic burden in people with type 2 diabetes......... Posted by: Daniel      Read more         Source

March 25, 2008, 10:26 PM CT

Antidepressants and type 2 diabetes

While analyzing data from Saskatchewan health databases, Lauren Brown, researcher with the U of As School of Public Health, found people with a history of depression had a 30 per cent increased risk of type 2 Diabetes.

Brown then studied the medical history of 2,400 people who were diagnosed with depression and were taking antidepressants to determine whether there was a clear connection between that disease and type 2 Diabetes.

Brown divided the group into four categories: those who took antidepressants that were considered older therapies, patients who were using newer therapys, those using a combination of both an old and new therapys and people who were switching medications.

What she found was the risk of diabetes almost doubled for the patients who were using two types of therapies at the same time, tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). Brown says people are commonly prescribed multiple medications if they have severe depression or if they are having a problem finding the right treatment.

Brown believes these results, and results of prior studies demonstrating an increased risk of type 2 diabetes in people with depression, emphasize the need for regular screening for type 2 diabetes in people with depression, especially those taking more than one antidepressant. She also encourages diabetes and depression organizations to educate their members about this link......... Posted by: JoAnn      Read more         Source

March 18, 2008, 9:05 PM CT

Grape skin compound fights the complications of diabetes

Research carried out by researchers at the Peninsula Medical School in the South West of England has observed that resveratrol, a compound present naturally in grape skin, can protect against the cellular damage to blood vessels caused by high production of glucose in diabetes, as per a paper reported in the science journal Diabetes, Obesity and Metabolism this week.

The elevated levels of glucose that circulate in the blood of patients with diabetes causes micro- and macrovascular complications by damaging mitochondria, the tiny power plants within cells responsible for generating energy. When they are damaged they can leak electrons and make highly damaging free radicals.

Complications that can result when this happen include nephropathy (kidney disease), heart disease and retinopathy (which if left untreated can lead to blindness).

Resveratrol stops the damage by helping cells make protective enzymes to prevent the leakage of electrons and the production of toxic free radicals.

As well as being naturally present in grape skins, resveratrol is also present in seeds, peanuts and red wine.

Dr. Matt Whiteman, Principal Investigator and Senior Lecturer at the Institute of Biomedical and Clinical Science, Peninsula Medical School, commented: Resveratrols antioxidant effects in the test tube are well documented but our research shows the link between high levels of glucose, its damaging effect on cell structure, and the ability of resveratrol of protect against and mend that damage......... Posted by: JoAnn      Read more         Source

January 28, 2008, 5:16 AM CT

Cutting caffeine may help control diabetes

Daily consumption of caffeine in coffee, tea or soft drinks increases blood sugar levels for people with type 2 diabetes and may undermine efforts to control their disease, say researchers at Duke University Medical Center.

Scientists used new technology that measured participants glucose (sugar) levels on a constant basis throughout the day. Dr. James Lane, a psychology expert at Duke and the lead author of the study, says it represents the first time scientists have been able to track the impact of caffeine consumption as patients go about their normal, everyday lives.

The findings, appearing in the recent issue of Diabetes Care, add more weight to a growing body of research suggesting that eliminating caffeine from the diet might be a good way to manage blood sugar levels.

Lane studied 10 patients with established type 2 diabetes and who drank at least two cups of coffee every day and who were trying to manage their disease through diet, exercise and oral medications, but no extra insulin. Each had a tiny glucose monitor embedded under their abdominal skin that continuously monitored their glucose levels over a 72-hour period.

Participants took capsules containing caffeine equal to about four cups of coffee on one day and then identical capsules that contained a placebo on another day. Everyone had the same nutrition drink for breakfast, but were free to eat whatever they liked for lunch and dinner......... Posted by: JoAnn      Read more         Source

November 13, 2007, 9:55 PM CT

Diabetics risk serious foot problems

More than six out of ten people with diabetes are walking around in the wrong-sized shoes, exposing themselves to serious foot problems that could lead to amputation, as per research in the recent issue of IJCP, the International Journal of Clinical Practice.

Published to coincide with World Diabetes Day (14 November) the study, by the University of Dundee, has been welcomed by an expert in podiatry. She says that ulceration can have serious implications for patients and health services, including impaired quality of life, increased amputation risk and even elevated death rates.

The United Nations, which passed a landmark resolution in December 2006 recognising diabetes as a chronic, debilitating and costly disease, has designated World Diabetes Day as an official United Nations Day for the first time in 2007.

And the World Health Organization has said that the number of people suffering from diabetes could double to 366 million by 2030 and that 80 per cent of diabetic foot amputations could be prevented.

A hundred patients aged 24 to 89 volunteered to take part in the shoe-size study carried out at a general diabetic clinic at Ninewells Hospital Medical School in Dundee, Scotland.

Patients who were also attending specialist foot clinics were excluded, as were patients who had problems standing or were wearing specially provided footwear......... Posted by: JoAnn      Read more         Source

May 14, 2007, 10:36 PM CT

Obesity And Its Complications

Due to the gastrointestinal tracts role in body weight regulation, gastroenterologists should work closely with other medical disciplines to oversee and coordinate the care of obese individuals, as per an American Gastroenterological Association (AGA) Institute Obesity Task Force Report. The Report was published in a special 13th issue of Gastroenterology, the official journal of the AGA Institute, that focuses on the growing problems correlation to obesity and nutrition. The special issue of Gastroenterology presents a series of articles on the epidemiology of obesity, pathophysiology, associated disease and management.

An estimated 1.6 billion adults worldwide are overweight (body mass index [BMI]>25) and 400 million are obese (BMI>30), and potentially as a number of 20 million children are overweight. As obesity becomes an increasingly global problem, it is harder for government, institutions and individuals to continue to consider obesity as a problem of personal choice that can be controlled and even reversed by deciding to eat less and exercise more. The incidences of diabetes and other debilitating diseases attributable to obesity continue to rise along with the negative impact on healthcare budgets and various sectors of the economy leading to changing attitudes about the obesity epidemic......... Posted by: JoAnn      Read more         Source

April 23, 2007, 11:06 PM CT

Depression may trigger diabetes in older adults

Chronic depression or depression that worsens over time may cause diabetes in older adults, according to new Northwestern University research.

This is the first national study to suggest that depression alone -- and not lifestyle factors like being overweight can trigger Type 2 diabetes in adults 65 and older, a population with a high prevalence of diabetes and depression. The report will be published April 23 in Archives of Internal Medicine.

The study examined 4,681 men and women 65 and older from Forsyth County, N.C.; Sacramento County, Calif.; Washington County, Md.; and Pittsburgh, Pa., annually for 10 years.

"This means doctors need to take depressive symptoms in older adults very seriously because of the effect it has on the likelihood of developing diabetes," said Mercedes Carnethon, lead author of the study and assistant professor of preventive medicine at Northwesterns Feinberg School of Medicine.

An estimated 2 million older adults suffer from clinical depression, the second highest incidence of any age group. People 65 and older also have the highest prevalence of Type 2 diabetes.

"Diabetes is a scourge," said Carnethon. "It causes heart disease, blindness, kidney disease, leg amputations and lowered cognitive function because it essentially degrades the small and large blood vessels"......... Posted by: JoAnn      Read more         Source

April 10, 2007, 6:33 PM CT

Heavy Cost of Type 2 Diabetes Complications

A first-of-its-kind report looking at the prevalence and cost of type 2 diabetes complications shows that an estimated three out of five people (57.9 percent) with type 2 diabetes have at least one of the other serious health problems commonly associated with the disease, and that these health problems are taking a heavy financial toll on the United States. In 2006, the nation spent an estimated $22.9 billion on direct medical costs related to diabetes complications.*.

The new report, titled State of Diabetes Complications in America, also shows that estimated annual healthcare costs for a person with type 2 diabetes complications are about three times higher than that of the average American without diagnosed diabetes. These complications, which can include heart disease, stroke, eye damage, chronic kidney disease and foot problems that can lead to amputations, cost a person with type 2 diabetes almost $10,000 each year.* People with diabetes complications pay nearly $1,600 out of their own pockets for costs that are not reimbursed by insurance, such as co-payments and deductibles.* This amount is significant, considering that according to the National Health Interview Survey, an estimated 40 percent of adults with diabetes reported a family income of less than $35,000 per year in 2005......... Posted by: JoAnn      Read more         Source

March 5, 2007, 10:08 PM CT

Surprising Culprit in Diabetic Birth Defects

Over the past several years, Joslin Investigator Mary R. Loeken, Ph.D., and her colleagues at Joslin Diabetes Center have unlocked several mysteries behind what puts women with diabetes more at risk of having a child with birth defects. Even though those risks have decreased significantly over the years, thanks in part to advancements at Joslin, women with diabetes still are two to five times more likely than the general population to have a baby with birth defects, particularly of the heart and spinal cord, organs that form within the first few weeks of pregnancy.

In past work, Dr. Loeken and her research team were able to establish through their studies in mice that the mother's high blood glucose levels are the cause of these defects. This is one of the reasons why women with diabetes who are planning a pregnancy are encouraged to have their blood glucose levels under good control previous to conception. The Joslin scientists also have shown that the damage occurs because the extra glucose in the mother's blood inhibits the expression of embryonic genes that control essential developmental processes.

Now, in this latest study done in mice, Dr. Loeken and her colleagues have discovered that the protein called glucose transporter 2 (Glut2) makes it possible for the high concentrations of glucose to get into the embryonic cells efficiently when the mother's blood glucose concentrations are high. Also involved in the study was Rulin Li, Ph.D., a former postdoctoral fellow at Joslin. The study, supported by the National Institutes of Health, will appear in the March print edition of Diabetologia and was published online by the journal on Jan. 18......... Posted by: JoAnn      Read more         Source