The FDA has approved a new artificial sweetener for diet drinks. Pepsi announced that it would use Sunett in a new 1 calorie soda. Sunett is 200 times sweeter than sugar and already is used in sugarless gum and puddings. The manufacturer, Netrinova, says that the combination of Sunett and aspertaine has less after taste because less of the artificial sweeteners are necessary. In fact, up to 40% less is used to get the same effect. No new product comes without some controversy. In 1996, a consumer advocacy group asked the FDA to ban Sunett because of suspected increased tumors in laboratory rats. Several scientific groups have rejected these findings and Pepsi One is on the way.
The current issue of the Weight Control Digest, Vol.8, No. 3, May-June, 1998, 718, has an article reprinted from Journal of Nutrition, 1998:128:541-547 by J. Gittleson, et al entitled "Dietary Intake, Food Preparation, Diabetes, and Obesity. The research done at Johns Hopkins University, the University of Toronto, and the University of Western Ontario, examined the relationships among how people eat, the fat content of their food, and whether the person was diabetic and obese. The rational for this research was the knowledge that non-insulin dependent diabetes and obesity frequently occur together and represent a major health problem. Researchers found that foods high in fat and low in dietary fiber are associated with a much higher risk for diabetes. They also found that certain methods of preparing foods, especially using lard, were associated with high rates of diabetes in these patients. In contract, foods low in fat and high in fiber seemed to have a protective affect.
In our e-mail we get regular questions about the effects of supplements on diabetes and cholesterol. The June 17th issue of the Journal of the American Medical Association (JAMA) had an article called the Effect of a Garlic Oil Preparation on Serum Lipoproteins and Cholesterol Metabolism by Heiner, K. et al. The researchers knowing that garlic-containing drugs have been used in the treatment of hypercholesterolemia even though their efficiency has not been established, tried to estimate the hypocholesterolemic effect of garlic oil and to investigate the possible mechanism of action. To this end they investigated 25 patients (mean age 58 years) with mild hypercholesterolemia. Half the patients were given 5 mg steam-distilled garlic oil twice a day vs the placebo for 12 weeks with wash-out periods for 4 weeks. Results indicated that the commercial garlic oil preparation investigated has no effect on serum lipoproteins, cholesterol absorption, or cholesterol synthesis. The researchers concluded that garlic therapy treatment of hypercholesterolemia cannot be recommended on the basis of their study.
On June 4, 1998, The National Institute of Diabetes and Kidney Diseases discontinued the study of troglitazone (Resulin) to prevent type 2 diabetes in people with impaired glucose tolerance following the recommendation of the Data Monitoring Board for the Diabetes Prevention Program (DPP). Resulin is FDA approved for the treatment of typo 2 diabetes, but was being studied in the DPP as a potential preventive measure in people with impaired glucose tolerance who are at high risk for developing type 2 diabetes. This action pertains only to the DPP clinical trials, not to people who have diabetes and are under treatment for control of elevated glucose levels. The reason for the withdrawal of this medication was the death on May 17 of one of the 585 recipients of troglitazone in the PDD following liver failure and a liver transplant. Although the course and ultimate death of the patient were complex, the panel of experts concluded that the drug induced liver toxicity which was the probable cause of liver failure. In view of the report and the fact that the DPP is a prevention study, the Board recommended that the Institute discontinue the troglitazone arm of the study. The study has four arms: troglitazone, two lifestyle interventions, and metformin, another drug approved for the treatment of type 2 diabetes, but with different mechanism of action. The National Institute of Diabetes and Kidney Diseases has informed all 26 DPP centers of their decision and the participants have been asked to return pills to these centers. Those persons taking troglitazone will be given the opportunity to be followed for diabetes by the study group. All people in the study, regardless of the intervention, will be apprised of the discontinuation of this arm of the study.
The University of Pennsylvania Health System released the following announcement on June 8, 1998. "Newly Recognized Cell-Surface Receptor Protects Heart Tissue Against Damage." The university along with the National Institutes of Health (NIH) have identified a new molecular target that could lead to novel and improved therapies for schematic cardiovascular disease. This disease occurs when heart cells don't get enough oxygen and accounts for nearly 90% of the 1.5 million heart attacks in the United States annually. The researcher found that receptors for adenosine--a nucleic-acid derivative--found on the surface of ventricle cells were a powerful, sustained protection against injury during exposure to schema. It is thought that adenosine mimics could be given as drugs to alter the effects of heart attack. The spokesmen for the National Institute of Diabetes and Digestive and Kidney Diseases stated that although researchers have known that adenosine protects the overstressed heart, now it has been shown that a specific target molecule on the cell protects the heart muscle. Heart cells release adenoise under stressful conditions such as blockage of the coronary artery. It binds receptors on the cell's surfaces making the cells more resistant to the effects of schema by essentially shutting them down. The next steps, say the researchers, will be to develop a drug that activates the receptor and to design pre-clinical trials. Keep this in mind as you read the news or watch TV. We all know the incidence of heart disease is high in people with diabetes.
Our new blood glucose monitor of the month is brought to the market by Boehringer Mannheim Corporation and is called ACCU-CHECK Complete.
The physicians' PR materials indicate that the monitor is very quick and easy. It records information on blood glucose, insulin, carbohydrates, ketones, HbA1c, stress, and exercise. The machine turns on when a strip in inserted. It has an ATM-like push button selection and a quick and simple meter set up. No cleaning is required. The meter precludes the need for a computer. It has a large memory, collecting, storing, and analyzing up to 1,000 values. It shows graphic presentation at the push of a button. There is insulin pump profile storage and personalized reminders and tips for patients to read while testing. The monitor can be linked to Accutility Software and Acculink Modem for therapy planning. The corporation's Medical Service Center is available to answer questions 24 hours a day at 1-800-858-8072.
