Diabetes Watch Blog

April 30, 2009, 9:41 PM CT

Sitagliptin could trigger pancreatitis

A drug widely used to treat Type 2 diabetes may have unintended effects on the pancreas that could lead to a form of low-grade pancreatitis in some patients and a greater risk of pancreas cancer in long-term users, UCLA scientists have found.

As per a research findings reported in the online edition of the journal Diabetes, scientists from the Larry L. Hillblom Islet Research Center at UCLA observed that sitagliptin, sold in pill form as Januvia, caused abnormalities in the pancreas that are recognized as risk factors for pancreatitis and, with time, pancreas cancer in humans. Januvia is marketed by Merck & Co. Inc. Sitagliptin is a member of a new class of drugs that enhance the actions of the gut hormone known as glucagon-like peptide 1 (GLP-1), which has been shown to be effective in lowering blood sugar in people with Type 2 diabetes. The study is available at http://diabetes.diabetesjournals.org/cgi/content/abstract/db09-0058v1.

"Type 2 diabetes is a lifelong disease people often take the same drugs for a number of years, so any adverse effect that could over time increase the risk for pancreas cancer would be a concern," said Dr. Peter Butler, director of the Hillblom Center and the study's lead investigator. "A concern here is that the unwanted effects of this drug on the pancreas would likely not be detected in humans unless the pancreas was removed and examined." ......... Posted by: Josly2006      Read more         Source

April 7, 2009, 5:23 AM CT

Reducing sugar and increasing fiber intake

Reducing sugar intake by the equivalent of one can of soda per day and increasing fiber intake by the amount equivalent to one half cup of beans per day appears to improve risk factors linked to type 2 diabetes in Latino adolescents, as per a report in the recent issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Almost 40 percent of Mexican American adolescents age 12 to 19 were overweight or at risk for overweight from 2003 to 2006, as per background information in the article. "Latino children are more insulin resistant and thus more likely to develop obesity-related chronic diseases than their white counterparts," the authors write. "To date, only a few studies have examined the effects of a high-fiber, low-sugar diet on metabolic health in overweight youth, and to our knowledge, none have tested the effects of this type of intervention in a mixed-sex group of Latino youth".

Emily Ventura, M.P.H., of Keck School of Medicine, University of Southern California, Los Angeles and his colleagues conducted a 16-week study to examine if reductions in added sugar intake or increases in fiber intake would affect risk factors for developing type 2 diabetes in 54 overweight Latino adolescents (average age 15.5). Participants were split into three groups: control, nutrition (receiving one nutrition class per week) or nutrition plus strength training (receiving one nutrition class per week along with strength training twice a week)......... Posted by: Josly2006      Read more         Source

March 24, 2009, 6:19 AM CT

Those diabetics high-fiber diets

Scientists at UT Southwestern Medical Center report that patients with noninsulin-dependent diabetes (type 2) excreted less calcium through their urine when they consumed 50 grams of fiber a day than when they ate 24 grams a day. Excreting less calcium indicates that they absorbed less of the mineral.

"We already know that fiber helps improve your cholesterol and glucose control and improves your bowel regularity. Our new findings suggest that dietary fiber reduces the body's capacity to absorb calcium," said Dr. Abhia number ofu Garg, professor of internal medicine and an investigator in the Center for Human Nutrition at UT Southwestern. He is senior author of a study appearing online in Diabetes Care. "Because more calcium equals better bone health, we recommend that people on high-fiber diets talk to their doctor about increasing their dietary calcium as well, in order to get the most benefit from both".

Dr. Garg said it's important to speak with a doctor or a registered dietitian before increasing your calcium intake because excessive levels may cause kidney stones.

The American Diabetes Association (ADA) recommends a daily intake of 24 grams of dietary fiber, but the average American consumes about 14 to 15 grams of fiber a day.

Sometimes called "roughage," dietary fiber is the indigestible portion of plant foods that pushes food through the digestive system, absorbing water and easing defecation. Calcium is a nutrient found in food that is absorbed by the body and then excreted in urine, feces or sweat. It is the most abundant mineral in the human body......... Posted by: Josly2006      Read more         Source

January 28, 2009, 6:59 PM CT

An Old Dawg Can Learn New Tricks!

In an interview with Diabetes Forecast - the consumer magazine of the American Diabetes Association - Randy Jackson reveals his type 2 diabetes story, the hurdles and the path to therapy.

This year, Randy Jackson celebrates 10 years of type 2 diabetes:

Jackson, who was diagnosed with type 2 diabetes in 1999, was shocked when he learned that he had a chronic disease. "They were sneaky symptoms," he says. "Of course, I didn't take into consideration that a history of type 2 diabetes ran in my family, because you always believe that happens to somebody else, not you."

But soon after his diagnosis, Jackson took charge. He turned his diet around from the "Southern-fried" foods he was accustomed to, began to exercise regularly, and after much careful consideration, had gastric bypass surgery. As a result of these changes, Jackson has set out to talk to people about changes in lifestyle that can prevent diabetes and its complications.

Also in the recent issue of Diabetes Forecast:

Update on glucose control and heart health: Last year many major studies were published to look at the connections between cardiovascular health and controlling cholesterol, blood pressure and blood glucose in people with type 2 diabetes. Some of the initial results have been confusing, but Diabetes Forecast offers a few key points to help you and your heart......... Posted by: Josly2006      Read more         Source

January 20, 2009, 7:43 PM CT

Five Eye Care Tips for Diabetics

If you have diabetes you should know that you are more susceptible to eye disorders like glaucoma, cataracts, retinopathy and blindness. But there is a lot that you can do to take charge of and prevent such problems. Here are some tips for diabetics that can help fight these eye disorders.

1. Keep your blood sugar levels in control. In order to achieve this you must stay away from sugary snacks and foods that are highly processed and made from white flour. The diet must include a lot of high fiber food, unsalted nuts, fruits and vegetables. Drink lots of water so that toxins and wastes are removed from the system. The right diet keeps blood sugar levels steady without many spikes.
2. Control High Blood Pressure. Obesity and a sedentary lifestyle are risk factors for high blood pressure. The best way to control high blood pressure is to exercise regularly. Even though you don’t have the time to sweat it out at the gym, it would be very beneficial to walk the dog or take the stairs instead of the elevator or do some active gardening etc. A heart-friendly diet with less salt goes a long way in controlling blood pressure.
3. Say Bye to Smoking. It has been observed that smoking triples the retinopathy progression in diabetics. When you realize that your eyes are in danger because of smoking, isn’t it time you took an effort to quit that killer habit?
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December 23, 2008, 10:22 PM CT

Treating gum disease in diabetics

A new report shows that treating gum disease in patients who have diabetes with procedures such as cleanings and periodontal scaling is associated with 10 to 12 percent lower medical costs per month.

The findings are encouraging but the study was not designed to firmly establish cause and effect, said George Taylor, University of Michigan associate professor of dentistry, who also has an appointment in epidemiology in the U-M School of Public Health. Taylor led the research project to investigate whether routine, non-surgical therapy for gum disease is associated with lower medical care costs for people with diabetes.

In periodontal disease, the body reacts to the bacteria causing the gum infection by producing proteins or chemicals called inflammatory mediators. Ulcers and open sores in the gums become passageways for these proteins and for the bacteria themselves to enter the body's blood circulation. These inflammatory mediators, as well as some parts of the bacteria, prevent the body from effectively removing glucose, or sugar, from the blood.

The higher level of blood sugar is known as poor diabetes control. Poor diabetes control leads to serious diabetes complications such as vision disorders, cardiovascular and kidney disease and amputations, among others......... Posted by: Josly2006      Read more         Source

December 11, 2008, 5:19 AM CT

Type 1 diabetes and celiac disease linked

Type 1 (juvenile) diabetes and celiac disease appear to share a common genetic origin, scientists at the University of Cambridge and Barts and The London School of Medicine and Dentistry, have confirmed.

Their findings, which are reported in this week's edition of the New England Journal (NEJM), identified seven chromosome regions which are shared between the two diseases. The research suggests that type 1 diabetes and celiac disease may be caused by common underlying mechanisms such as autoimmunity-related tissue damage and intolerance to dietary antigens (foreign substances which prompt an immune response).

Type 1 diabetes is an autoimmune disorder which causes the body to attack the beta cells of the pancreas, limiting its ability to produce the insulin necessary to regulate blood sugar levels. Celiac disease, also an autoimmune disorder, attacks the small intestine and is triggered by the consumption of gluten (a protein found in wheat, barley and rye) and cereals. The development and anatomy of the small intestine and pancreas are closely related, and the gut immune system shares connections with pancreatic lymph nodes, which have been linked to an inflammation of the pancreas and the destruction of beta cells.

In order to assess the genetic similarities and differences between the two inflammatory disorders, the researchers obtained 9339 control samples, 8064 samples from people with type 1 diabetes and 2560 samples from individuals with celiac disease. They found a total of seven loci (regions of a chromosome) were shared between the two......... Posted by: Josly2006      Read more         Source

November 24, 2008, 9:49 PM CT

New source of insulin-producing cells

Scientists at the Joslin Diabetes Center have shown that insulin-producing pancreatic beta cells can form after birth or after injury from progenitor cells within the pancreas that were not beta cells, a finding that contradicts a widely-cited earlier study that had concluded this is not possible.

The study, published online this week in the Proceedings of the National Academy of Sciences Early Edition, identifies the source of the progenitor cells as being pancreatic duct cells.

"This means that there is a population of pancreatic cells that can be stimulated, either within the body or outside the body, to become new beta cells, the cells that are lacking in diabetes," said Susan Bonner-Weir, Ph.D., the study's lead researcher and a Senior Investigator in the Section on Islet Transplantation and Cell Biology at Joslin and Associate Professor of Medicine at Harvard Medical School.

The experiments, conducted in animal models, suggest a new source of beta cells for replacement treatment to treat or cure diabetes.

In type 1 diabetes, the pancreas produces little or no insulin since the insulin producing beta cells are destroyed by the body's own immune system. While transplantation of human islets from donor pancreases has been successful in getting people with type 1 diabetes off insulin therapy, this insulin independence is only successful for a few years......... Posted by: Josly2006      Read more         Source

October 27, 2008, 10:37 PM CT

Diabetes treatment becomes more complex

A progressively more complex and expensive array of therapys for type 2 diabetes is being prescribed to an increasing number of adults, as per a report in the October 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

In 2000, more than 11 million Americans had been diagnosed with diabetes, as per background information in the article. "By 2050, the number of Americans with diabetes is expected to soar to 29 million, a prevalence of 7 percent," the authors write. "The annual economic burden of diabetes is estimated at $132 billion and increasing. In 2002, more than one-tenth of U.S. health care expenditures were attributable to diabetes." As costs and prevalence increase, managing diabetes also has become increasingly complex, as physicians prescribe more medications to each patient and combine drugs from different therapeutic classes.

To evaluate these trends, G. Caleb Alexander, M.D., M.S., of the University of Chicago Hospitals, and his colleagues gathered diabetes prescription information and costs from national databases. The scientists analyzed prescription data from U.S. patients age 35 and older with type 2 diabetes who visited a physician's office between 1994 and 2007. Information about medicine costs was available from 2001 to 2007......... Posted by: Josly2006      Read more         Source

September 2, 2008, 8:34 PM CT

Battling Diabetes with Beta Cells

Affecting eight percent of America's population, diabetes can lead to blindness, kidney failure, strokes and heart disease. Thanks to Tel Aviv University researchers, a new cure -- based on advances in cell treatment -- may be within reach.

Prof. Shimon Efrat from TAU's Sackler Faculty of Medicine, whose research group is among world leaders in beta cell expansion, has developed a way to cultivate cells derived from insulin-producing beta cells from human tissue in the laboratory. It may be possible to implant these new healthy cells into patients with type 1 diabetes.

If proved to be successful, this method, which artificially replicates the insulin cells people need, could ensure that fewer people will die while waiting for a life-saving pancreas and kidney. Prof. Efrat's research paves the way for new and alternative forms of therapy in cases in which organ transplantation is not an option. And one day, the procedure may be as simple as a blood transfusion.

The Multiplication Effect.

Type 1 diabetes, the most severe form of the condition, emerges as a chronic condition in childhood or early adulthood, when the body's immune system stops working properly and destroys the beta cells in the pancreas. Beta cells are needed to produce insulin, and a shortage of insulin inhibits the breakdown of food into energy. By the time a diagnosis is made, most beta cells are destroyed beyond repair. Injections of insulin can ease the symptoms, but some sufferers from the disease eventually require extreme measures, such as organ transplants, to stay alive......... Posted by: Josly2006      Read more         Source

August 25, 2008, 9:30 PM CT

Leptin Can Also Aid Type 1 Diabetics

Terminally ill rodents with type 1 diabetes have been restored to full health with a single injection of a substance other than insulin by researchers at.

UT Southwestern Medical Center.

Since the discovery of insulin in 1922, type 1 diabetes (insulin-dependent diabetes) in humans has been treated by injecting insulin to lower high blood sugar levels and prevent diabetic coma. New findings by UT Southwestern researchers, which appear online and in a future issue of the Proceedings of the National Academy of Sciences, suggest that insulin isn't the only agent that is effective. Leptin, a hormone produced by the body's fat cells, also lowers blood glucose levels and maintains them in a normal range for extended periods, they found.

"The fact that these animals don't die and are restored to normal health despite a total lack of insulin is hard for a number of scientists and clinicians to believe," said Dr. Roger Unger, professor of internal medicine and senior author of the study. "A number of scientists, including us, thought it would be a waste of time to give leptin in the absence of insulin. We've been brainwashed into thinking that insulin is the only substance that can correct the consequences of insulin deficiency".

The mechanism of leptin's glucose-lowering action appears to involve the suppression of glucagon, a hormone produced by the pancreas that raises glucose levels. Normally, glucagon is released when the glucose, or sugar, level in the blood is low. In insulin deficiency, however, glucagon levels are inappropriately high and cause the liver to release excessive amounts of glucose into the bloodstream. This action is opposed by insulin, which tells the body's cells to remove sugar from the bloodstream......... Posted by: Josly2006      Read more         Source

August 20, 2008, 6:24 PM CT

Diabetes transmitted from parents to children

A new study in the recent issue of the Journal of Lipid Research suggests an unusual form of inheritance may have a role in the rising rate of diabetes, particularly in children and young adults, in the United States.

DNA is the primary mechanism of inheritance; kids get half their genes from mom and half from dad. However, researchers are just starting to understand additional kinds of inheritance like metabolic programming, which occurs when an insult during a critical period of development, either in the womb or soon after birth, triggers permanent changes in metabolism.

In this study, the scientists looked at the effects of a diet high in saturated fat on mice and their offspring. As expected, they observed that a high-fat diet induced type 2 diabetes in the adult mice and that this effect was reversed by stopping the diet.

However, if female mice continued a high-fat diet during pregnancy and/or suckling, their offspring also had a greater frequency of diabetes development, even though the offspring were given a moderate-fat diet. These mice were then mated with healthy mice, and the next generation offspring (grandchildren of the original high-fat fed generation) could develop diabetes as well.

In effect, exposing a fetal mouse to high levels of saturated fats can cause it and its offspring to acquire diabetes, even if the mouse goes off the high-fat diet and its young are never directly exposed......... Posted by: Josly2006      Read more         Source

July 14, 2008, 9:46 PM CT

Diabetes increases risk of tuberculosis

Taken together, studies show that diabetes increases risk of tuberculosis

People with diabetes mellitus are at increased risk of developing active tuberculosis (TB), as per an analysis published in PLoS Medicine

Searching for research over the past four decades containing data on the relationship between diabetes and TB, Christie Jeon and Megan Murray of the Harvard School of Public Health identified 13 studies involving more than 1.7 million participants, including 17,698 cases of TB. Combining the data from cohort studies in particular, the scientists calculated that diabetes increases the risk of active TB by about a factor of three.

A three-fold increased risk suggests that diabetes may already be responsible for more than 10% of TB cases in India and China. If these findings are replicated in other countries, global TB control might benefit from special attention to people with diabetes when identifying and treating latent TB. Increased efforts to diagnose and treat diabetes might also decrease the global burden of TB, which kills about 1.6 million people each year.

Citation: Jeon CY, Murray MB (2008) Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 findings based on observation. PLoS Med 5(7): e152. doi:10.1371/journal.pmed.0050152......... Posted by: Josly2006      Read more         Source

July 14, 2008, 9:36 PM CT

'Snapshots' of eyes could serve as early warning of diabetes

A new vision screening device, already shown to give an early warning of eye disease, could give doctors and patients a head start on treating diabetes and its vision complications, a new study shows.

The instrument, invented by two researchers at the University of Michigan Kellogg Eye Center, captures images of the eye to detect metabolic stress and tissue damage that occur before the first symptoms of disease are evident.

For people with diabetes diagnosed or not the new device could offer potentially significant advantages over blood glucose testing, the "gold standard" for diabetes detection.

The device takes a specialized photograph of the eye and is non-invasive, taking about five minutes to test both eyes.

In the recent issue of Archives of Ophthalmology, Victor M. Elner, M.D., Ph.D., and Howard R. Petty, Ph.D., report on the potential of the new instrument to screen for diabetes and determine its severity. If further testing confirms the results to date, the new instrument may be useful for screening people at risk of diabetes but haven't been diagnosed.

"Our objective in performing this study was to determine whether we could detect abnormal metabolism in the retina of patients who might otherwise remain undiagnosed based on clinical examination alone," says Elner, professor, Department of Ophthalmology and Visual Sciences at U-M Medical School......... Posted by: Josly2006      Read more         Source

July 9, 2008, 7:35 PM CT

Diabetes linked to male infertility

This release is available in Spanish. .

Barcelona, Spain: Diabetes in men has a direct effect on fertility, a scientist told the 24th annual conference of the European Society of Human Reproduction and Embryology today (Wednesday 9 July). Dr. Con Mallidis from Queen's University, Belfast, UK, said that, despite the prevailing view that it had little effect on male reproductive function, the Belfast group had shown that diabetes caused DNA damage in sperm.

The increase in the numbers of diabetics diagnosed at a young age has coincided with worldwide concerns over male fertility, he told the conference. "But this is not simply a coincidence," he said. "We have demonstrated for the first time that diabetes adversely influences male fertility at a molecular level".

The researchers studied semen samples from men with diabetes who were receiving insulin treatment. On initial routine microscopic examination the semen samples appeared normal, apart from a slight decrease in volume.

"But when we looked for DNA damage, we saw a very different picture," said Dr. Mallidis, adding that this is not part of a routine semen analysis. "Sperm RNA was significantly altered, and a number of of the changes we observed are in RNA transcripts involved in DNA repair. And comparison with a database of men of proven fertility confirmed our findings. Diabetics have a significant decrease in their ability to repair sperm DNA, and once this is damaged it cannot be restored"......... Posted by: Josly2006      Read more         Source