After the headlines, we bring you abstracts about activity, BMI and weight and risk of type 2 diabetes, coping styles of adolescents with type 1 diabetes and acute alcohol consumption and insulin action in type 2 diabetes. Have a grand 4th and a glorious July.
Our first headline comes from Reuters, June 7 and is cited from the Journal of Experimental Medicine. Kritin Tarbell et al from Rockefeller University report that using one type of immune system cell to turn off another stopped type-one diabetes in mice and may offer a new approach to retrain a faulty immune system which causes this disease. They report that they used immune system cells called dendritic cells to stimulate production of suppressor T-cells. These T-cells turn off the body's faulty immune response. In the case of the mice, they stopped the destruction of their pancreatic islet cells that cause type-one diabetes.
Reuters Health, June 4 reported that Professor Kay-Tee Khaw's study of the University of Cambridge in England found that a marker for raised sugar level in the blood could be an indicator of people more likely to develop bowel cancer. In a study of 10,000 people those with the highest blood sugar levels, even if they were below amounts diagnosed for diabetes, were more likely to have bowel cancer six years later. The researchers did not suggest that diabetes causes colorectal cancer, but that to may be a marker for something else that increases the risk. They found that people who had the most raised blood sugar levels had rates of colorectal cancer about three times the risk factor of people with the lowest glucose levels.
Headline number three also from Reuters is dated June 6. In it Pfizer Inc.'s cholesterol fighter Lipitor halved the risk of stroke in patients with diabetes in a study and cut cardiovascular events, including heart attacks, by more than a third. "We need to shift thinking toward a presumption that most people with type ll diabetes are likely to receive very substantial benefit," Helen Colhoun, professor of genetic epidemiology at University College Dublin, told Reuters. The findings from the Lipitor study, which were presented at the annual meeting of the American Diabetes Association in Orlando, add to the growing body of evidence favoring statins in the treatment of diabetes.
Two new drug studies have been reported as positive. Amylin Pharmaceuticals and Eli Lilly report late-stage clinical trials that their new drug derived from lizard saliva which we have reported on before here that it reduced blood glucose levels and weight in type 2 diabetics. Novartis also has a mid-term trial with their new medication. This is a new class of medication which raises the level os a compound in the body callaed glucagon-like- peptide or GLP-1 which helps boost the level of insulin in the body.
Yahoo News, May 28, had a news article quoting Professor Claude Bouchard, president of the International Society on Obesity (IASO).Obesity, a major risk factor for diabetes, already affects 300 million people worldwide while an estimated194 million suffer from diabetes. "I suspect that within a short period of time we will begin to see a reduction in life expectancy because of the twin epidemics". A new report on diabetes by the IDF and the IASO, released at the conference, estimated that at least half of all diabetes cases could be eliminated if weight gain could be prevented.
I can't you how many e-mails we get from people who want to know if there are painless ways to check blood glucose levels. There were two that were presented at the latest ADA meetings in Orlando. One group of researchers is working on a device that measures levels of volatile organic compounds in human breath. Dr. Stuart Weiss form New York University says that initial findings will have to be substantiated. Also there may be a lag between what's going on in the bloodstream and what's going on at the periphery of the body. The device would have to be small to be appealing. Another group of researchers describe the HypoMon, a chest belt transmitter that continuously takes measurements on the surface of the skin. One advantage of this system is that it would be able to monitor glucose levels even during sleep. The down side Weiss said is that movement and sweat could affect the readings. Short term readings should not replace longer term monitoring like the A1c test which measures blood glucose levels for three months. Keep reading and we'll keep monitoring what's being investigated.
Dr. Robert A. Gerber from Pfizer Global Research and Development et al in June 2004 Diabetes Care reports that they followed 121 participants in the original study who participated in a 1-year extension study that inhaled insulin provides good long-term control of blood sugar. During the year extension, participants taking the inhaled insulin reported significantly greater improvements in overall satisfaction, ease of use, and social comfort than patients on injected insulin. "Results from the current investigation are the first to suggest that the rapid improvement in patient satisfaction with inhaled insulin is sustained and that long-term improvements in glycemic control and patients satisfaction are maintained up to 1-year follow-up."
Reuters, June 4 reported that a jury in Los Angeles found that a diabetes drug sold by Warner-Lambert which has since been acquired by Pfizer Inc was not responsible for the deaths or illness of three plaintiffs. The jury determined that the facts presented did not support the claims that Rezulin caused or contributed to the deaths of two people of or the liver disease of a third plaintiff.
Finally, one reason that you are told to exercise may become clearer. Each month we write an article about exercise because of the positive effects exercise has on your ability to control weight, cardiovascular disease and blood glucose levels as well as the fact that you just plain feel better when you are fit. At the annual meeting of the ADA in Orlando it was announced that weight training improves diabetic nerve function, so now you have even more reason to meet with your doctor to set up an exercise program. No one wants to suffer from peripheral neuropathy which most often affects the feet and hands and can cause a number of problems including numbness, tingling, pain and weakness. This research done at the University of Louisville by Dr. Regina T. Kurian et al on diabetic elderly patients was begun because the researchers noted that elderly diabetic patients were not tolerating traditional medications used for neuropathy pain or that the medications were not working. "Our research shows that resistance training is safe for elderly patients with neuropathy and it can improve their symptoms and increase muscle strength and maybe help prevent some falls." Dr. Kurian reports.
The Archives of Internal Medicine , April 26, 2004 has an article titled Physical Activity, body mass index, and risk of type 2 diabetes in patients with normal or impaired glucose regulation by Gang Hu, PhD et al. The researchers examined the records of 2017 Finnish men and 2352 Finnish women between the ages of 45 and 64 with a history of known or newly diagnosed diabetes as baseline. Single and joint associations of physical activity, body mass index blood glucose levels with risk of type 2 diabetes were examined using Cox proportional hazards model. During a mean follow-up of 9.4 years, there were 120 incident cases of type 2 diabetes after adjustment for confounding factors (age, study year, sex, systolic blood pressure, smoking and education). Physical activity was found to be inversely associated with the risk of type 2 diabetes and this was persistent in subjects with both obesity and impaired glucose regulation. There was a multivariate-adjusted positive association between BMI and the risk of type 2 diabetes and this was consistent. Obesity in subjects who reported being inactive and had normal glucose levels was indicator of increased risk of diabetes compared with a normal BMI who reported having impaired glucose regulation. The researchers concluded that increasing a physical activity can reduce the risk of type 2 diabetes. The protective qualities of physical activity were observed in subjects with excessive BMI and elevated glucose levels. Physical activity and weight control are critical factors in diabetes prevention in subjects with both normal and impaired blood glucose regulation.
Diabetes Care, 27:131301317, 2004, has an article titled The coping styles of adolescents with type 1 diabetes are associated with degree of metabolic control, by Mart Graue, et al. The objective of this study was to systematically study various coping styles in a population-based sample of adolescents with type 1 diabetes, exploring the association of different coping styles with metabolic control and reported quality of life. A total of 116 adolescents ages 13-18 participated. There was a significant correlation between a higher HbA1c values and higher degree of mental and behavioral disengagement and aggressive coping. Partial correlation analysis showed that lower scores on diabetes-specific quality of life were significantly related to greater use of emotional-focused coping. The researchers concluded that poor metabolic control and lower degree of diabetes-related quality of life are associated with greater use of emotion-focused coping in adolescents with type 1 diabetes.
Diabetes Care 27:1369-1374, 2004 has an article titled Acute Alcohol consumption improves insulin action without affecting secretion in type 2 diabetic subjects by Angelo Avogaro, MD, PHD et al. The long term exposure to alcohol is associated with an improvement in insulin sensitivity. At this time, however, there is no definite proof that alcohol per se has an effect on the insulin sensitivity index in type 2 diabetes patients. The aim of this study was to assess the role of acute moderate intake on insulin sensitivity and insulin secretion in comparable subjects with and without type 2 diabetes. Frequently sampled intravenous glucose tolerance tests (FSIGTs) were performed twice on healthy and 8 type 2 diabetic volunteers. Forty grams of alcohol (vodka 40% wt/vol) or tap water were sipped from time-60 min to end of the FSIGT. Lactate area under the curve (AUC) was higher in both groups during the alcohol study than in the control study. Free fatty acid (FFA) AUC was higher in type 2 diabetic subjects than in control subjects; alcohol slightly reduced FFA by 17% in control subjects but significantly decreased FFA by 23% in type 2 diabetic subjects. B-Cell response was markedly reduced in type 2 subjects regardless of the type of study. Alcohol significantly increases sensitivity index in both groups. The researchers concluded that acute alcohol consumption improves insulin action without affecting B-cell secretion. This effect may be due to the inhibitory effect of alcohol on lipolysis. Alcohol intake increases sensitivity and may partially explain the J-shaped relationship between prevalence of diabetes and the amount of alcohol consumption and the decreased mortality from myocardial infarction.
BSP
