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May 14, 2006, 3:46 PM CT

New Findings On Insulin Signaling In The Liver

New Findings On Insulin Signaling In The Liver
Insulin uses two distinct mechanisms to control glucose and the metabolism of blood fats (lipids) in the liver, a new Joslin Diabetes Center-led study has discovered. Failures in each of these networks can lead to serious health problems: the breakdown of glucose metabolism that can lead to type 2 diabetes, and the malfunction of lipid metabolism contributing to metabolic syndrome, which is a cluster of conditions that puts people at increased risk of heart disease, vascular disease and type 2 diabetes.

The new study, led by C. Ronald Kahn, M.D., and Cullen Taniguchi, M.D., Ph.D., of Joslin Diabetes Center in Boston and their colleagues, is reported in the May edition of Cell Metabolism. The findings open the door to the development of new therapys that one day may target directly the conditions that contribute to type 2 diabetes and the metabolic syndrome.

"Patients with the metabolic syndrome have high levels of both glucose and lipids in the blood. We now understand that insulin that controls the pathways that control glucose levels are different from those that regulate lipid levels. By targeting these specific pathways, we might be able to improve problems with glucose metabolism, lipid metabolism or both," says Dr. Kahn, President of Joslin Diabetes Center and Mary K. Iacocca Professor of Medicine at Harvard Medical School.........

Posted by: JoAnn      Permalink         Source


May 8, 2006, 11:49 PM CT

Antidepressant Drug May Help Depression In Diabetics

Antidepressant Drug May Help Depression In Diabetics
team of scientists at Washington University School of Medicine in St. Louis found that an antidepressant medicine may reduce the risk of recurrent depression and increase the length of time between depressive episodes in patients with diabetes.

"That's important not only because people with diabetes will feel better if we can control their depression. It's also key to helping manage blood sugar," says Patrick J. Lustman, Ph.D., principal investigator and professor of psychiatry. "As depression improves, glucose levels also tend to improve."

Eventhough depression affects about 5 percent of the general population, the rate is about 25 percent for patients with diabetes. Lustman's team previously demonstrated that therapy with antidepressant drugs and psychotherapy is an effective way to treat depression in patients with diabetes, but often depression would quickly redevelop.

"As we better understand depression, it's clear that for a number of patients, it is a chronic and recurring disease," Lustman says. "That appears to be particularly true for patients with diabetes compared to those otherwise free of medical illness".

Eventhough they knew that short-term therapy with antidepressants was helpful with mood and with control of blood glucose, Lustman's team didn't know whether the drug could prevent the recurrence of depression in patients with diabetes. He also didn't know what would happen to glucose levels in the months following successful depression treatment.........

Posted by: JoAnn      Permalink         Source


May 7, 2006, 10:56 PM CT

Gene That Increases Type 2 Diabetes

Gene That Increases Type 2 Diabetes
In a painstaking set of experiments in overweight mice, researchers from the University of Wisconsin-Madison have discovered a gene that appears to play an important role in the onset of type 2 diabetes.

The finding is important because it provides evidence that the same gene in humans could provide clinicians with a powerful tool to determine the likelihood that some individuals will acquire the condition. Moreover, the finding that the gene works through a pathway not generally studied in the context of diabetes, suggests new avenues to explore in the search for new drugs to treat or prevent the disease, says Alan Attie, a UW-Madison professor of biochemistry and the senior author of the study published this week (May 7) in the journal Nature Genetics.

Type 2 diabetes is the most common form of the condition in the United States, with an estimated 16 million Americans afflicted with the disease. It is caused by an inability of the pancreas to produce enough insulin, or by the body's reduced ability to respond to insulin, or both. Insulin is necessary for the body to properly utilize sugar.

Often, the development of type 2 diabetes is caused by obesity. Obese individuals tend to have insulin resistance; that is, it takes more insulin for the body to respond normally. Type 2 diabetes occurs when the pancreas is unable to manufacture enough insulin to compensate for the body's increased demand for the hormone, which it does by growing more insulin-producing beta cells or by ramping up insulin secretion.........

Posted by: JoAnn      Permalink         Source


April 23, 2006, 9:23 PM CT

How Insulin-producing Beta Cells Grow And Function

How Insulin-producing Beta Cells Grow And Function
A new Joslin Diabetes Center-led study has shown conclusively that two receptors in the insulin-producing beta cell do not affect developmental growth, refuting a long-held hypothesis in diabetes research. This finding is helping researchers in their efforts to isolate the growth factors that do stimulate beta cell growth and understand the defects in insulin production and secretion that cause diabetes.

These two receptors have been a major focus of research on beta cell development as researchers seek to find ways to promote the growth of these essential insulin-producing cells in diabetes patients. This latest research will appear in an upcoming issue of Nature Genetics and will be published online April 23 on the journal's Web site, http://www.nature.com/ng.

In two prior Joslin studies, insulin receptor, a protein that mediates the action of insulin, and the receptor for insulin-like growth factor I (IGF-I), a hormone, which were suggested as critical for mediating islet/beta cell development and growth, were individually "knocked out" in beta cells in genetically altered mice. Scientists were surprised to discover that the beta cells developed and grew normally without these receptors, as per Rohit N. Kulkarni, M.D., Ph.D., Investigator at Joslin Diabetes Center and Assistant Professor of Medicine at Harvard Medical School, who led the latest study and was lead author in the two prior Joslin studies.........

Posted by: JoAnn      Permalink         Source


April 20, 2006, 8:57 PM CT

Diabetes and Cancer: Alpha Connection

Diabetes and Cancer: Alpha Connection
A study published by Nature today has defined the function of p110 alpha, the flag-ship molecule of the eight member PI3K family, which is one of the most frequently activated pathways in cancer. The function of p110 alpha in the body has eluded scientists for over a decade but a new approach to generating mouse models, has allowed researchers from the Ludwig Institute for Cancer Research's (LICR) UCL Branch and the UCL Centre for Diabetes & Endocrinology to solve the mystery and yield important information for planned clinical trials with PI3K inhibitors.

The study showed that p110 alpha controls the action of insulin and other key hormonal signals that play roles in growth, diabetes and obesity. p110 alpha is frequently mutated or overexpressed in cancer, and the results of the present work imply that cancer cells hijack a key signalling pathway to fuel their energy needs and drive their proliferation and survival. The current work has far-reaching implications, given that several million of people are affected by metabolic disorders, and every year, several hundreds of thousand new cancer cases with mutations in p110 alpha are diagnosed.

Importantly, says LICR's Dr. Bart Vanhaesebroeck, the senior author of the study, the findings have immediate implications for the testing of p110 alpha-specific inhibitors for human therapies. "Accurate information on the specific role of p110 alpha is needed urgently by the pharmaceutical industry, which is preparing to initiate clinical trials based on PI3K inhibition, not only in cancer but also in inflammation, allergy and auto-immunity. These mice mimic the effect of systemic administration with a p110 alpha-specific drug,".........

Posted by: JoAnn      Permalink         Source


April 20, 2006, 8:39 PM CT

Acidity Increases Risk For Kidney Stones In Diabetics

Acidity Increases Risk For Kidney Stones In Diabetics
People with type 2 diabetes have highly acidic urine, a metabolic feature that explains their greater risk for developing uric-acid kidney stones, scientists at UT Southwestern Medical Center have found.

The study - the first to compare the urinary biochemical characteristics of type 2 diabetics with those of normal volunteers - is available online and would be reported in the recent issue of the Journal of the American Society of Nephrology.

Individuals with type 2 diabetes (non-insulin dependent diabetes mellitus) are at increased risk for developing kidney stones in general, and have a particular risk for uric-acid stones. The mechanisms for this greater risk were previously not entirely understood. This new study demonstrates that the propensity for type 2 diabetics to develop uric-acid stones is elevated because their urine is highly acidic.

"Our next step is to find out what causes type 2 diabetics to have an abnormally acidic urine, and what other urinary factors protect some diabetics who do not form uric-acid stones," said Dr. Mary Ann Cameron, the paper's lead author and a postdoctoral trainee in internal medicine.

Obesity and a diet rich in animal protein are associated with abnormally acidic urine. In earlier studies, UT Southwestern scientists also concluded that uric-acid stones are associated with insulin resistance and type 2 diabetes.........

Posted by: JoAnn      Permalink         Source


April 17, 2006, 10:54 PM CT

Contro Blood Sugar Prior To Surgery

Contro Blood Sugar Prior To Surgery
Patients with diabetes who have good control of blood glucose levels before having surgery may be less likely to have infections after their procedures, as per a research studyin the recent issue of Archives of Surgery, one of the JAMA/Archives journals.

Postoperative infections, including pneumonia, wound infection, urinary tract infection and sepsis (systemic blood infection), can lead to poor outcomes and high health care costs, as per background information in the article. The risk of infection is higher in patients with diabetes. Controlling blood sugar has been shown to reduce a number of of the complications associated with diabetes, including kidney, nerve and eye diseases. However, prior studies have not examined whether controlling blood sugar before surgery can affect outcomes afterward.

Annika S. Dronge, M.D., Yale University School of Medicine, West Haven, Conn., and his colleagues examined the relationship between glycemic (blood sugar) control and postoperative infections in 490 diabetic patients. All of the participants underwent major noncardiac surgery in the Veterans Affairs Connecticut Healthcare System between Jan. 1, 2000, and Sept. 30, 2003, and had their hemoglobin (Hb A1c) levels measured within 180 days previous to surgery. Hb A1c reflects the patient's control of blood glucose levels over the prior two to three months. Good glycemic control was defined as meeting the American Diabetes Association target, an Hb A1c level of less than 7 percent.........

Posted by: JoAnn      Permalink         Source


April 16, 2006, 8:29 PM CT

Infused Spleen Cells Have No Effect On Type-Diabetes Recovery In Mice

Infused Spleen Cells Have No Effect On Type-Diabetes Recovery In Mice
Scientists from Joslin Diabetes Center have reported in the March 24, 2006, issue of the journal Science a significant study about islet cell recovery and reversal of type 1 diabetes in mice.

It is generally believed that an effective cure for type 1 diabetes will require two substantial scientific advances. First, in order to restore the pancreas' ability to produce insulin, new islet beta cells must be provided, either by transplanting cells from a healthy donor or by encouraging the growth and/or function of the diabetic patient's own cells. Second, to protect the new beta cells, no matter what their origin, it is necessary to repair the breakdown in immunological tolerance that precipitated the anti-islet attack in the first place.

In a widely discussed paper that appeared in Science in 2003, Dr. Denise Faustman and her colleagues reported successful achievement of both of these advances, resulting in the "cure" of a substantial fraction of severely diabetic NOD mice, the most popular animal model of human type 1 diabetes. Their method entailed giving diabetic mice a temporary islet transplant from a genetically identical mouse, administering a single injection of an immuno-stimulatory compound called Complete Freund's Adjuvant (CFA), and repeatedly injecting a large number of spleen cells taken from genetically different mice. It was thought that the islets served to keep the animals with diabetes healthy long enough for the other therapys to have their effects, that the CFA eliminated the autoimmune attack on the islets, and that the spleen cells somehow gave rise to insulin-producing cells, presumably beta-cells, ultimately leading to islet regeneration.........

Posted by: JoAnn      Permalink         Source


April 14, 2006, 11:25 AM CT

Two Tests Better Than One

Two Tests Better Than One
In a strongly worded review reported in the recent edition of The Journal of the American Medical Association (JAMA), the head of the Johns Hopkins Diabetes Center urges physicians and patients to better use the blood-testing tools at hand to manage the disease and prevent most of its dire impact on the heart, kidneys, nerves and vision.

"The message is, we have tools that are very accurate, but they don't work at all if they are not used properly," says Christopher Saudek, M.D., a former president of the American Diabetes Association and lead author of the article. "If the goal of therapy is to prevent morbidity and mortality, we need to do a better job of monitoring our patients, as well as advising them."

Saudek and his colleagues reviewed data from studies conducted between 1976 and 2005 and concluded that both self-monitoring of blood glucose (SMBG) and more precise doctor testing of hemoglobin A1c (HbA1c) can help diabetics take proper control of their blood sugar levels and successfully manage their disease.

"Used together, self monitoring and A1c do work," says Saudek, along with "consistent communication between the patient and health care professional."

As per the ADA, an estimated 14.6 million people in the United States have been given a diagnosis of diabetes, most of them with so-called type 2 or adult onset. Their disease is marked by the body's inability to respond to insulin to break down glucose, or sugar.........

Posted by: JoAnn      Permalink         Source


April 13, 2006, 0:25 AM CT

Turmeric Could Help Diabetics

Turmeric Could Help Diabetics
Brisbane immunologist Dr Brendan O'Sullivan hopes to put a dent in skyrocketing rates of diabetes in Australia by creating a new treatment for Type 2 diabetes.

The Senior Research Officer and his team at UQ's Centre for Immunology and Cancer Research (CICR) are developing a drug that targets liver cells to prevent their inflammation in obesity -- a common precursor to diabetes.

Dr O'Sullivan has received a three-year $150,000 Smart State Fellowship from the State Government to explore potential diabetes treatments.

Arthritis Queensland and the CICR will also contribute a further $150,000 each during the project.

People with Type 2 diabetes cannot produce enough insulin or do not use the insulin they produce properly.

Insulin is a hormone produced by the pancreas which moves sugar from the food we eat into the body's cells.

Dr O'Sullivan said his technique involved coating treatment drugs in absorbable fat which formed an injectable dose that could last up to one week.

"One of the drugs we're using is curcumin, which is basically the yellow compound that you see in curries, which is an anti-inflammatory compound," Dr O'Sullivan said.

"The idea is to encapsulate that compound and then deliver it to the liver cells to prevent them from producing all these inflammatory compounds".........

Posted by: JoAnn      Permalink         Source



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Type-2 Diabetes
Type-2 diabetes is the most common form of diabetes, accounting for 90% of cases diabetes. This disease affects nearly 17 million Americans and is the seventh leading cause of death in the United States. Even though 17 million Americans have type-2 diabetes only half of these people are aware that they have diabetes. The death rate in patients with diabetes may be up to 11 times higher than in persons without the disease. The occurrence of diabetes in persons 45 to 64 years of age is 7 percent, but the proportion increases significantly in persons 65 years of age or older. Type-2 diabetes accounts for more than 90% of all diabetes worldwide.

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