April 10, 2007, 6:32 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 usually linked to 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 correlation 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 as per 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: Josly2006      Read more         Source

March 23, 2007, 10:29 PM CT

Lifestyle Changes Against Type II Diabetes

Changing to a healthier lifestyle appears to be at least as effective as taking prescription drugs in reducing the risk of developing Type 2 diabetes, says a new British Medical Journal study.

Type 2 diabetes is a growing problem -- in England around 1.3 million people have diabetes and around 5% of total NHS resources are used for the care of people with diabetes.

Scientists from Leicester evaluated studies which measured the effects of different interventions -- lifestyle, diabetes drug and anti-obesity drug -- on people with impaired glucose tolerance. (People with impaired glucose tolerance have a high risk of developing type II diabetes.).

They observed that changes in lifestyle, e.g. switching to a healthier diet and increasing exercise to be at least as effective as taking prescription drugs. On average, changes in lifestyle helped to reduce the risk of developing type 2 diabetes by around half. Changes in lifestyle were also less likely to have adverse side-effects.

However, the scientists say that both changes in lifestyle and prescription drug taking must be sustained in order to prevent the development of Type 2 diabetes.

The authors say that as global rates of Type 2 diabetes are likely to double by 2030, interventions to prevent the condition will have an important role to play in future health policies. The study findings have large implications for public health policy, however, the authors note that if changes in lifestyle are to be truly effective more needs to be done to support people to adopt healthier lifestyles......... Posted by: Josly2006      Read more         Source

March 23, 2007, 9:54 PM CT

Diabetes and Risks Of Colorectal Cancer

A new study confirms that patients with diabetes are significantly more likely to have colon cancer than individuals without diabetes. Scientists at the Medical University of South Carolina reported results from a large cross-sectional analysis assessing the risk of colon cancer among patients with diabetes at the 70th Annual Scientific Meeting of the American College of Gastroenterology.

Scientists analyzed data from a comprehensive nationally representative sample of patients using the 1997-2003 National Health Interview Survey. Of the 226,953 patients in the study, 5.9 percent had a history of diabetes. Scientists controlled for age, race, gender, obesity, alcohol use, tobacco use, and physical activity. Adjusting for potentially confounding factors, scientists observed that people with diabetes were 1.4 times more likely to have colon cancer as individuals without diabetes.

"This work is important because it suggests that people with diabetes may be at higher risk of colon cancer. Until we know for sure, diabetics should pay particular attention to their doctor's recommendations for colorectal screening," said Donald Garrow, M.D. one of the investigators......... Posted by: Josly2006      Read more         Source

March 13, 2007, 10:12 PM CT

Diabetics Have Increased Cancer Risk

Japanese adults with diabetes may have a higher risk of cancer overall and in several specific organs, including the liver, pancreas and kidney, according to results of a large study published in a recent issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Researchers have long suspected that there might be an association between diabetes and cancer, but no conclusive evidence has been obtained, according to background information in the article. Diabetes is rapidly becoming more common in Japan, as it is in many other countries. More than 7.4 million Japanese individuals were estimated to have diabetes in 2002, and by 2025, 8.7 percent of the population is expected to develop the disease. "Clarification of the association between diabetes mellitus and cancer in populations with an increasing prevalence, such as Japanese persons, is a crucial task, not only from the causative point of view but also with regard to the formulation of clinical strategies and public health policies for the target population," the authors write.

Manami Inoue, M.D., Ph.D., National Cancer Center, Tokyo, and colleagues studied the association in 97,771 Japanese individuals (46,548 men and 51,223 women) age 40 to 69 who were enrolled in the study between 1990 and 1994. The participants, who had an average age of 51 at the beginning of the study, completed a lifestyle questionnaire at that time that included information about smoking, alcohol drinking, medical history, physical activity and food and beverage intake. They were also asked if they had ever been diagnosed with diabetes or taken diabetes medications. Researchers consulted the national registry of Japanese residents, major hospitals, cancer registries and death certificates to track deaths and cancer cases......... Posted by: Josly2006      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, especially 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 prior to conception. The Joslin researchers 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: Josly2006      Read more         Source

February 23, 2007, 5:04 AM CT

Amputations Worse Than Cancer

The Spanish National Symposium on the Diabetic Foot last week was the scene for a keynote address that delivered a strong message proposing "a marriage of technology with common sense for the next decade." The address was delivered by David G. Armstrong, DPM, PhD, Professor of Surgery and Associate Dean at Scholl College at Rosalind Franklin University. More than 500 specialist physicians, surgeons, and healthcare providers packed a standing-room-only lecture hall in historic Toledo, Spain, to hear Dr. Armstrong's keynote address. "I think that the outpouring of interest in this area is emblematic of the importance of the problem," noted Dr. Armstrong.

In the lecture, Dr. Armstrong editorialized about the scope of the problem: ".my friend and colleague, Dr. Jeff Robbins, often equates a diabetes-related amputation with a high-grade cancer, like breast or colon or lung. But 5-year survival is generally worse with amputation. We would never withhold high-quality treatment from a cancer patient but we do so all the time with people at high risk for amputation or re-amputation. This must stop".

Workshops with Armstrong also included other members of Scholl's Center for Lower Extremity Ambulatory Research (CLEAR), including Dr. Lee C. Rogers and Dr. Nicholas Bevilacqua, who joined via video conference to help highlight a number of technologies being used at Scholl's North Chicago-based foot and ankle center......... Posted by: Josly2006      Read more         Source

February 19, 2007, 8:41 PM CT

Diabetes Risk Factors Develop Earlier in Women

The "diabetes clock" may start ticking in women years in advance of a medical diagnosis of the disease, new research has shown.

Epidemiologists at the University at Buffalo have observed that newly identified risk factors for diabetes found in the blood, such as markers of endothelial dysfunction, chronic sub-acute inflammation and blood clotting factors, are present early on in women who eventually progress from normal glucose status to the pre-diabetic condition.

Pre-diabetes is diagnosed when blood sugar levels are higher than normal (between 100-125 mg/deciliter of blood), but not high enough to indicate full-blown diabetes (over 125 mg/deciliter of blood). The markers weren't linked to progression from normal to pre-diabetic status in men.

Results of the study appear in the February 2007 issue of Diabetes Care.

"This is one of the first reports to show that otherwise healthy women are more likely than men to show elevated levels of endothelial factors and other markers of progression to pre-diabetes," said lead author Richard Donahue, Ph.D., professor of social and preventive medicine and associate dean for research in UB's School of Public Health and Health Professions.

"Because these pre-diabetic markers are not routinely assessed, and because diabetes is strongly linked with coronary heart disease, the study may help explain why the decline in death rates for heart disease in diabetic women lags behind that of diabetic men," he said......... Posted by: Josly2006      Read more         Source

February 13, 2007, 9:49 PM CT

Elucidation of the genome for diabetics

The genome of patients with type 2 diabetes (DT2) has been elucidated, for the first time, thanks to the use of new DNA chip technologies allowing 400,000 DNA mutations to be studied simultaneously. New genes conferring a predisposition to DT2 have been identified. They include the zinc transporter of pancreatic insulin-secreting cells (ZnT8), which is a potential target for therapy. This study of the French population was carried out as a French-British-Canadian collaboration between the teams directed by Philippe Froguel (CNRS, University of Lille 2, Pasteur Institute, Imperial College London) and Rob Sladek (McGill University, Montreal, Canada). About 70% of the genetic risk of DT2 is accounted for by these new discoveries, published online in Nature on February 11 2007. This work opens up entirely new avenues of prevention and therapy for this disease.

There are more than 200 million diabetics worldwide, and it has been predicted that this number will double by 2030. This increase in the number of diabetics is associated with the obesity epidemic, which currently affects 1.1 thousand million people, including 150 million children. However, heredity also makes a major contribution to the development of DT2. Abnormalities in insulin secretion appear very early in the children of diabetic parents. These individuals become hyperglycaemic when they put on weight and are resistant to the insulin they produce. The team of Philippe Froguel was the first to identify a gene linked to DT2 that encoding glucokinase in 1992. Several other such genes have since been discovered, but together these genes account for only a small proportion of DT2 cases. Insufficient knowledge of the human genome and the absence of cheap, simple-to-use, rapid analytical techniques hampered progress in medical research for a number of years. The recent sequencing of the human genome and the establishment of a complete map of DNA variations in the human species have finally made it possible to explore genetic predisposition to DT2 in its entirety. In 2006, a revolutionary genetic analysis technique was developed in the United States. This method is based on the use of DNA chips, with a surface of only a few square centimetres, carrying almost half a million DNA mutations. Each of these chips can be used to dissect the entire genome of an individual......... Posted by: Josly2006      Read more         Source

February 7, 2007, 8:54 PM CT

Exercise Pivotal in Preventing or Fighting Diabetes

One in three American children born in 2000 will develop type II diabetes, as per the U.S. Centers for Disease Control and Prevention (CDC). A new study at the University of Missouri-Columbia says that acute exercise - as little as 15 minutes a day - can have a profound influence on preventing and fighting the disease.

This research adds to the body of evidence that indicates exercise can fight type II diabetes, one of the most widespread self-inflicted healthcare struggles in the United States, and could save Americans millions of dollars in pills, injections and medical therapy. Acute exercise is a bout of activity in which people actively participate, as opposed to activity resulting from everyday activities.

"A number of people can fight type II diabetes through diet and exercise alone," said John Thyfault, professor in the MU College of Human Environmental Sciences' Department of Nutritional Sciences. "It is important to ward off diabetes early. Exercise has proven to be effective at all levels. At any stage of type II diabetes, from an obese child to a person dependent for 20 years on insulin injections, exercise could have a dramatic effect on improving insulin sensitivity."

Type II diabetes results from a lack of insulin production and insulin resistance in skeletal muscle cells. Insulin is necessary to help drive glucose out of the blood and into the tissues of the body. As a result of insulin resistance, cells do not respond appropriately to insulin, causing more insulin to be released to have a measurable effect and ultimately causing insulin and glucose to build up dangerously in the blood.........

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January 31, 2007, 7:58 PM CT

Oral Insulin to Prevent Type 1 Diabetes

Scientists have begun a clinical study of oral insulin to prevent or delay type 1 diabetes in at-risk people, the National Institutes of Health (NIH) announced recently. Type 1 Diabetes TrialNet, an NIH-funded network of scientists dedicated to the understanding, prevention, and early therapy of type 1 diabetes, is conducting the study in more than 100 medical centers across the United States, Canada, Europe, and Australia.

"Our goal is to prevent type 1 diabetes or to delay it as long as possible. If diabetes can be delayed, even for several years, those at risk will be spared the difficult challenges of controlling glucose and the development of complications for that much longer," said TrialNet study chair Jay Skyler, M.D., of the University of Miami.

In the study, scientists are testing whether an insulin capsule taken by mouth once a day can prevent or delay diabetes in a specific group of people who are at risk for type 1 diabetes. An earlier trial suggested that oral insulin might delay type 1 diabetes for about four years in some people with autoantibodies to insulin in their blood. Animal studies have also suggested that insulin taken orally may prevent type 1 diabetes. Some researchers believe that introducing insulin via the digestive tract induces tolerance, or a quieting of the immune system. Insulin taken orally has no side effects because the digestive system breaks it down quickly. To lower blood glucose, insulin must be injected or administered by an insulin pump.........

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