Diabetes Watch Blog

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

July 8, 2008, 8:56 PM CT

Trans-fatty acids and insulin sensitivity

Trans-fatty acids have been the topic of a lot of negative health news, but in the July Journal of Lipid research, a dietary study in rats suggests that trans-fats do not increase the risk of insulin resistance and diabetes, which may ease at least one area of concern.

Epidemiological studies indicate that chronic consumption of trans-fats may alter muscle insulin sensitivity, as their unusual molecular shapes can reduce muscle's ability to burn energy; in turn, reduced fat oxidation may promote insulin resistance.

The data in this area has been conflicting, so Beatrice Morio and his colleagues undertook a detailed study in rats. They gave rats an eight-week diet enriched in either industrial trans-fats (processed oils), natural trans-fats (dairy fat), or regular unsaturated fats.

In none of the cases did the diet alter the rat's insulin or glucose responses, nor did it significantly affect their muscle capacity. The scientists confirmed their rat studies in cell culture studies by incubating muscle cells with either trans-fatty acids or oleic acid (olive oil); as in the rats, there were no noticeable difference in the insulin sensitivity of the cells.

So while trans-fatty acids are still relatively unhealthy, these findings do show that muscles can utilize them, whether natural or industrial, much like regular fats; thus, trans-fat metabolites won't accumulate in muscles and increase the risk of insulin resistance and diabetes......... Posted by: Josly2006      Read more         Source

July 1, 2008, 9:51 PM CT

Dietary Adherence Associated with Better Glucose Control

A study by scientists at the Joslin Diabetes Center has shown that adherence to prescribed dietary recommendations is linked to better glucose control in children with type 1 diabetes.

"In recent years, diabetes management has been focused around new medications and technologies," said Lori Laffel, M.D., senior author of the paper, which is reported in the recent issue of Diabetes Care. "In this study, we were encouraged to identify the unique importance of diet on blood sugar control in children and teens with type 1 diabetes".

Laffel is Chief of Joslin Diabetes Center's Pediatric, Adolescent and Young Adult Section and an Investigator in the Joslin Section on Genetics and Epidemiology.

The study surveyed the parents of 119 children and teens ages 9-14 years and asked how closely they followed prescribed dietary behaviors, such as estimating carbohydrate intake, matching the child's insulin dose to carbohydrate intake and the quality of the diet itself, in terms of intake of sweets and fats.

Subjects who most closely adhered to the dietary recommendations had lower A1C levels - a measurement of average blood glucose deemed the best way to estimate overall glucose control. Lower A1C levels mean better glucose control.

Children who adhered closely or fairly closely to the prescribed dietary recommendations showed an A1C level of up to almost a full point lower than those who were least adherent. Those who adhered the least had an average A1C of 9 percent, while those who adhered more closely to the recommendations had an average A1C between 8.1 and 8.4 percent, depending on their level of adherence......... Posted by: Josly2006      Read more         Source

July 1, 2008, 8:51 PM CT

A step towards better diabetes treatment

In today's issue of the prestigious journal Cell Metabolism Uppsala scientists are presenting new findings that shed light on the processes that determine the release of the blood sugar-lowering hormone insulin. The discovery is based on the development of image analysis methods that make possible the detailed study of events immediately inside the plasma membrane of the insulin-secreting cells.

Cyclic AMP (cAMP) is a universal messenger molecule that controls a number of different functions inside the cell. For example, it plays a role in the release of insulin from the beta cells in the pancreas (see Facts). It is well-known that the production of cAMP explains how certain hormones can amplify insulin secretion. On the other hand, it has been unclear to what extent cAMP also contributes to the major release of insulin triggered by an increase in blood sugar (glucose).

Anders Tengholms research team at Uppsala University has developed methods that make it possible for the first time to measure both the secretion of insulin and the cAMP concentration in individual beta cells. The results show that ATP, the energy-rich molecule that is produced when glucose is metabolized, causes an increase in cAMP concentration right at the cell membrane where the release of insulin takes place. This increase varies rhythmically and coincides with similarly regular variations in another stimulant messenger, the calcium ion, resulting in pulsatile secretion of insulin......... Posted by: Josly2006      Read more         Source

June 16, 2008, 10:17 PM CT

Hearing loss is common in people with diabetes

Hearing loss is about twice as common in adults with diabetes in comparison to those who do not have the disease, as per a new study funded by the National Institutes of Health (NIH).

"Hearing loss may be an under-recognized complication of diabetes. As diabetes becomes more common, the disease may become a more significant contributor to hearing loss," said senior author Catherine Cowie, Ph.D., of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), who suggested that people with diabetes should consider having their hearing tested. "Our study found a strong and consistent link between hearing impairment and diabetes using many different outcomes."

The scientists discovered the higher rate of hearing loss in those with diabetes after analyzing the results of hearing tests given to a nationally representative sample of adults in the United States. The test measured participants' ability to hear low, middle, and high frequency sounds in both ears. The link between diabetes and hearing loss was evident across all frequencies, with a stronger association in the high frequency range. Mild or greater hearing impairment of low- or mid-frequency sounds in the worse ear was about 21 percent in 399 adults with diabetes in comparison to about 9 percent in 4,741 adults without diabetes. For high frequency sounds, mild or greater hearing impairment in the worse ear was 54 percent in those with diabetes in comparison to 32 percent in those who did not have the disease......... Posted by: Josly2006      Read more         Source

May 26, 2008, 8:37 PM CT

Cocoa could be a healthy treat for diabetic patients

For people with diabetes, sipping a mug of steaming, flavorful cocoa may seem a guilty pleasure. But new research suggests that indulging a craving for cocoa can actually help blood vessels to function better and might soon be considered part of a healthy diet for the prevention of cardiovascular disease.

Flavanols, natural plant compounds also found in tea, red wine, and certain fruits and vegetables, are responsible for cocoas healthful benefits. In fact, as per new research reported in the June 3 issue of the Journal of the American College of Cardiology (JACC), after diabetic patients drank specially formulated high-flavanol cocoa for one month, blood vessel function went from severely impaired to normal.

The improvement was as large as has been observed with exercise and a number of common diabetic medications, the scientists noted. These findings suggest that it may be time to think not just outside the box, but inside the cup, for innovative ways to ward off cardiovascular diseasethe number one cause of death in diabetic patients.

Medical therapys alone often do not prevent complications of diabetes that are linked to atherosclerosis and cardiovascular disease, said Malte Kelm, M.D., a professor and chairman of cardiology, pulmonology and vascular medicine at the University Hospital Aachen and the Technical University Aachen, in Aachen, Gera number of. Physicians should be increasingly looking to changes in lifestyle and new approaches to help in addressing the cardiovascular risks linked to diabetes......... Posted by: Josly2006      Read more         Source

May 11, 2008, 10:15 AM CT

Caught "red-handed" for the first time

Researchers at Washington University School of Medicine in St. Louis working with diabetic mice have examined in unprecedented detail the immune cells long believed to be responsible for type 1 diabetes.

Scientists were able to examine the immune cells from isolated insulin-making structures in the pancreas known as the islets of Langerhans. They caught the immune cells, known as dendritic cells, "red-handed" carrying insulin and fragments of insulin-producing cells known as beta cells. This can be the first step toward starting a misdirected immune system attack that destroys the beta cells, preventing the body from making insulin and causing type 1 diabetes.

The results, reported online in The Proceedings of the National Academy of Sciences, push researchers a step closer to finding ways to treat this condition.

"Now that we've isolated dendritic cells from the pancreas, we can look at why they get into the pancreas and determine which of the materials that they pick up are most critical to causing this form of diabetes," says senior author Emil R. Unanue, M.D., the Paul and Ellen Lacy Professor of Pathology. "That may allow us to find ways to inhibit dendritic cell function in order to block the disorder."

The American Diabetes Association estimates that 1 million to 2 million Americans suffer from type 1 diabetes, which is also called juvenile diabetes because it frequently develops in children......... Posted by: Josly2006      Read more         Source

May 5, 2008, 8:18 PM CT

Gene linked to severe diabetic eye

Scientists at the John A. Moran Eye Center at the University of Utah and collaborative institutions have identified a gene called erythropoietin (EPO) that contributes to increased risk of severe diabetic eye and kidney diseases, called retinopathy and nephropathy.

The sight-threatening form of diabetic retinopathy, termed proliferative diabetic retinopathy (PDR), is the most common cause of legal blindness in working-aged adults in the United States, accounting for 10% of new onset blindness overall. Diabetes is also the leading cause of kidney disease, called end-stage renal disease (ESRD), in the U.S. and the Western world.

Led by Kang Zhang M.D., Ph.D., Director of the Division of Ophthalmic Genetics at the Moran Eye Center and Associate Professor of Ophthalmology and Visual Sciences at the University of Utah, the study will be published online on May 5, 2008 in the journal Proceedings of National Academy of Sciences. Dr. Zhang explains the significance of the discovery: We know that the development of PDR and ESRD in diabetic patients can be inherited. Eventhough genetic factors are known to be important in the susceptibility (or resistance) to these complications, until now the genes involved have been mostly unknown.

How did the scientists discover that this gene is involved in PDR and ESRD" In this study the scientists compared 1,618 people with PDR and ESDR, and 954 diabetes patients without any eye or kidney disease in three separate populations. Their studies demonstrate that if a person has a copy of mutant EPO gene, they have an increased risk of developing PDR and ESRD during their lifetime......... Posted by: Josly2006      Read more         Source

March 16, 2008, 9:27 PM CT

Protein reverses diabetic retinopathy in mice

Two major eye diseases and leading causes of blindnessage-related macular degeneration and diabetic retinopathycan be reversed or even prevented by drugs that activate a protein found in blood vessel cells, scientists at the University of Utah School of Medicine and several other institutions have announced in a new study.

Damage from both diseases was prevented and even reversed when the protein, Robo4, was activated in mice models that simulate age-related macular degeneration (AMD) and diabetic retinopathy, as per Dean Y. Li, M.D., Ph.D., senior author of the study published March 16 in Nature Medicine online.

Robo4 treated and prevented the diseases by inhibiting abnormal blood vessel growth and by stabilizing blood vessels to prevent leakage. Abnormal blood vessel growth and leakage are two primary factors in both age-related macular degeneration (AMD) and diabetic retinopathy. But the studys ramifications go beyond eye diseases.

Serious infections such as SARS (Severe Acute Respiratory Syndrome), for example, kill people when an infection destabilizes blood vessels, allowing fluids to leak into the lungs. Tumors hijack blood vessel growth to feed on nutrients and grow. Eventhough this study did not prove Robo4 would treat those diseases, Li believes it merits investigation......... Posted by: Josly2006      Read more         Source

February 28, 2008, 10:14 PM CT

ADVANCE diabetes trial

Data from the ADVANCE Study, involving 11,140 high-risk patients with type 2 diabetes, provides no evidence of an increased risk of death among those patients receiving aggressive therapy to lower blood glucose.

This contrasts findings from the 10,251 patient ACCORD trial which halted the intensive glucose control arm of the study 18 months early because a data review revealed that patients who received intensive therapy to lower blood glucose are at higher risk for death. While the trial will continue, patients will be transitioned from the intensive therapy arm (targeting A1c levels of <6.0 %) to the less intensive, standard therapy arm (targeting A1c levels of 7.0 to 7.9%).

Unlike what we saw in ACCORD, a rigorous review of ADVANCE data by the Data and Safety Monitoring Committee shows that the therapy strategy of intensively lowering blood sugar does not pose greater risk to our patients with type 2 diabetes, says Canadian lead investigator and member of ADVANCE Management Committee Dr. Pavel Hamet, professor of Medicine, Canada Research Chair of Predictive Genomics at Universit de Montral and Chief, Gene Medicine Services at Centre Hospitalier de lUniversit de Montral. ADVANCE is a landmark study and will continue as planned to completion. The results will provide crucial information to help us better reduce the significant health risks linked to type 2 diabetes......... Posted by: Josly2006      Read more         Source

February 7, 2008, 9:25 PM CT

Diabetes Drug To Treat Depression

Researchers at Washington University School of Medicine in St. Louis are seeking individuals who have depression and are overweight to volunteer for a study evaluating whether a diabetes drug might help improve mood.

The five-year, NIH-funded study seeks 200 people with depression who are overweight and at risk for developing diabetes. Participants will be screened for depression and insulin resistance, one of the first signs of developing diabetes. Those who qualify will be treated and followed for 16 weeks.

"We've studied patients who have both diabetes and depression, but now we're focusing on patients who have insulin resistance rather than type 2 diabetes," says co-investigator Gregory S. Sayuk, M.D., assistant professor of medicine. "Often these individuals will be overweight or have abnormal blood glucose levels. Those physical traits can affect mood, and we want to better understand how."

All qualified participants will receive the antidepressant drug sertraline (Zoloft) and diet and exercise counseling. Half will receive additional therapy with a diabetes drug, metformin (Glucophage), while the others will receive an inactive substance called a placebo. After the initial 16 weeks of therapy, the scientists will follow participants whose mood improves for an additional six months to monitor for depression......... Posted by: Josly2006      Read more         Source

February 6, 2008, 9:30 PM CT

Intensive blood sugar treatment on trial

The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health has stopped one therapy within a large, ongoing North American clinical trial of diabetes and cardiovascular disease 18 months early due to safety concerns after review of available data, eventhough the study will continue.

In this trial of adults with type 2 diabetes at particularly high risk for heart attack and stroke, the medical strategy to intensively lower blood glucose (sugar) below current recommendations increased the risk of death compared with a less-intensive standard therapy strategy. Study participants receiving intensive blood glucose lowering therapy will now receive the less-intensive standard therapy.

The ACCORD (Action to Control Cardiovascular Risk in Diabetes) study enrolled 10,251 participants. Of these, 257 in the intensive therapy group have died, compared with 203 within the standard therapy group. This is a difference of 54 deaths, or 3 per 1,000 participants each year, over an average of almost four years of therapy. The death rates in both groups were lower than seen in similar populations in other studies.

A thorough review of the data shows that the medical therapy strategy of intensively reducing blood sugar below current clinical guidelines causes harm in these particularly high-risk patients with type 2 diabetes, said Elizabeth G. Nabel, M.D., director, NHLBI. Though we have stopped this part of the trial, we will continue to care for these participants, who now will receive the less-intensive standard therapy. In addition, we will continue to monitor the health of all participants, seek the underlying causes for this finding, and carry on with other important research within ACCORD......... Posted by: Josly2006      Read more         Source

January 31, 2008, 8:53 PM CT

Diabetes makes it hard for blood vessels to relax

One way diabetes is bad for your blood vessels is by creating too much competition for an amino acid that helps blood vessels relax, scientists say.

That amino acid, L-arginine, is broken down by the enzyme arginase to urea, which helps the body eliminate toxins resulting from the proteins we eat. Diabetics have a lot of arginase activity, which means they use a lot more L-arginine, says Dr. Maritza Romero, postdoctoral fellow at the Medical College of Georgia and lead author of the paper reported in the current issue of Circulation Research.

It also means too little L-arginine is available to help nitric oxide synthase make nitric oxide, the powerful vasodilator that helps blood vessels relax, says Dr. Romero, who works in the lab of Dr. R. William Caldwell, chair of the MCG Department of Pharmacology and Toxicology and the studys corresponding author.

Scientists also found the amino acid, L-citrulline, as well as statins, compounds known to lower cholesterol, prevent elevation of arginase activity, restoring normal dilation abilities in animal models of type 1 diabetes. In fact, L-citrulline can be recycled into L-arginine.

Now they want to know specific factors and pathways involved in arginase activation and develop pharmaceutical agents to combat excessive arginase activity in diabetes. They also suggest clinical trials of L-citrulline as a supplemental treatment for diabetics with vascular problems......... Posted by: Josly2006      Read more         Source

January 28, 2008, 5:19 AM CT

Notch-ing glucose into place

A novel gene called rumi regulates Notch signaling by adding a glucose molecule to the part of the Notch protein that extends outside a cell, said researchers from Baylor College of Medicine in Houston and Stony Brook University in New York in a report that appears today in the journal Cell.

Cellular signaling governed by the Notch protein determines cell fate determination and differentiation.

The complete loss of rumi causes a temperature-dependent defect in Notch signaling, an unusual phenomenon said Dr. Hugo Bellen, professor of molecular and human genetics at BCM and director of the program in developmental biology. He is also a Howard Hughes Medical Institute investigator.

Bellen and his colleagues discovered the genes effect on bristles in the fruit fly. These bristles are external sensory organs that can be easily screened for changes involved in Notch signaling. Indeed, loss of Notch signaling causes loss of these external sensory organs. Fruit flies that lack the rumi protein have a higher than normal density of bristles on the thorax, indicating a subtle loss of Notch activity. However, at 25 degrees C, the bristles are lost, which suggests a severe loss of Notch signaling.

The activity of the Notch receptor needs to be inactivated in one cell to allow it to become different from the other daughter cell, and this process is used reiteratively in many consecutive cell divisions. For example, if Notch is activated inappropriately in cells of the blood lineage, it will cause leukemia in humans, said Bellen......... Posted by: Josly2006      Read more         Source

January 8, 2008, 9:40 PM CT

Carrot cake study on sugar in type 2 diabetes

Patients with type 2 diabetes are often advised to cut out sucrose (table sugar) all together. However, in recent years this traditional advice has been questioned by some scientists who suggest that moderate amounts of sugar can be safely consumed as part of the diet of patients with diabetes. Now a new study has been published that is consistent with this revised approach. It showed that patients who increased their daily sugar intake (in the form of carrot cake) but maintained a stable body weight, showed no adverse changes in their blood glucose.

The study was conducted by the Department of Nutrition and Dietetics at Londons Hammersmith Hospital. Three slices of carrot cake were added to the daily diets of nine, overweight type 2 diabetes patients over 24 days (bringing their daily total to 88g or 18 teaspoons of sugar). Consumption of the carrot cake slices was evenly distributed across the day. Several measurements were recorded at the beginning and end of the study, including the patients weight, blood sugar (glucose) levels, cholesterol levels, and insulin sensitivity (which is a measure of how well the body responds to the hormone insulin).

Professor Gary Frost, who led the study, explained In this study, the energy intake of these patients was balanced to their body weight, and their sucrose intake was spread evenly over a day. Correspondingly, they did not gain weight or show an increase in blood glucose levels at the end of the study; in addition, their cholesterol levels and insulin sensitivity did not change. He added the results of this small, short-term study support other scientific studies, which suggest that there could be more flexibility with sucrose in the diets of patients with type 2 diabetes. There is evidence from other studies (evaluated by Kirk et al 2000) that inclusion of sucrose may help people to lower their fat intake, which in turn may be beneficial to overall health......... Posted by: Josly2006      Read more         Source

January 8, 2008, 8:42 PM CT

Researchers trigger insulin production in diabetic mice

If the human body were a stage, then proteins would rank among the lead actors in the play we call Life.

These large biological molecules hold a number of starring roles, and their lines are dictated by information encoded in our genes. They are production powerhouses, regulating the basic processes of living and controlling countless functions. A number of are enzymes that produce or use energy. Others regulate genes.

Scientists are increasingly studying proteins as potential therapies for a variety of dread diseases because they can influence cell behavior by fueling or dampening certain molecular signals.

Now University of Florida scientists have coaxed liver and pancreatic cells within diabetic mice into churning out insulin by injecting the animals with a naturally occurring protein called Pdx1, opening up a new research avenue that someday could lead to safer therapys for type 1 diabetes. Pdx1 activates the genes controlling the development of the pancreas cells that make and release insulin to maintain safe levels of glucose in the body. The UF research teams novel approach is described online in the journal Diabetes.

Pdx1 is so special because it possesses a unique amino acid sequence that acts as a sort of molecular passport, allowing it to pass freely into cells, enter the nucleus and activate insulin production and release, said lead scientist Dr. Li-Jun Yang, an associate professor of pathology, immunology and laboratory medicine at UFs College of Medicine......... Posted by: Josly2006      Read more         Source

December 11, 2007, 10:44 PM CT

Smoking associated with increased risk of diabetes

A review of prior studies indicates that people who currently smoke have an increased risk of developing type 2 diabetes, compared with non-smokers, as per an article in the December 12 issue of JAMA.

Many studies have examined the association between smoking and occurence rate of glucose abnormalities, and have suggested that smoking could be independently linked to glucose intolerance, impaired fasting glucose and type 2 diabetes, which could make smoking a modifiable risk factor for type 2 diabetes. However, it appears the quality and clinical features of these studies have not been fully assessed regarding this possible association.

Carole Willi, M.D., of the University of Lausanne, Switzerland, and his colleagues conducted a systematic review and meta-analysis of studies describing the association between active smoking and the occurence rate of diabetes or other glucose metabolism irregularities. A search of databases yielded 25 studies, which were published between 1992 and 2006. The number of participants per study ranged from 630 to 709,827, for a total of 1.2 million participants. A total of 45,844 new cases of diabetes were reported during a study follow-up period ranging from 5 to 30 years.

Analysis of the data indicated that active smokers have a 44 percent increased risk of developing type 2 diabetes compared with non-smokers. Further analyses suggested a dose-response relationship between smoking and diabetes, with the association stronger for heavy smokers (20 or more cigarettes/day; 61 percent increased risk) compared with lighter smokers (29 percent increased risk). The association also was weaker for former smokers (23 percent increased risk) than it was for active smokers......... Posted by: Josly2006      Read more         Source

December 2, 2007, 9:01 PM CT

Sleep duration raises the risk for diabetes

The most common factors believed to contribute to diabetes are a decreased amount of physical activity and access to highly palatable processed foods. However, there is growing evidence that another aspect of our modern lifestyle, short sleep duration, is also contributing toward the diabetes epidemic, as per a research studyreported in the December 1 issue of the journal SLEEP.

The study, authored by James E. Gangwisch, PhD, of Columbia University in New York, explored the relationship between sleep duration and the diagnosis of diabetes over an eight-to-10-year follow-up period between 1982 and 1992 among 8,992 subjects who participated in the Epidemiologic Follow-Up Studies of the first National Health and Nutrition Examination Survey. The subjects ages ranged from 32 to 86 years.

As per the results, subjects who reported sleeping five or fewer hours and subjects who reported sleeping nine or more hours were significantly more likely to have incident diabetes over the follow-up period than were subjects who reported sleeping seven hours, even after adjusting for variables such as physical activity, depression, alcohol consumption, ethnicity, education, marital status, age, obesity and history of hypertension.

The effect of short sleep duration on diabetes incidence is likely to be related in part to the influence of short sleep duration upon body weight and hypertension, said Dr. Gangwisch. Experimental studies have shown sleep deprivation to decrease glucose tolerance and compromise insulin sensitivity by increasing sympathietic nervous system activity, raising evening cortisol levels and decreasing cerebral glucose utilization. The increased burden on the pancreas from insulin resistance can, over time, compromise -cell function and lead to type two diabetes, warned Dr. Gangwisch......... Posted by: Josly2006      Read more         Source

November 27, 2007, 8:59 PM CT

Pathway to increased inflammation in diabetes patients

Scientists at UC Davis Health System have discovered a novel pathway that results in increased inflammation of blood vessels in patients with type 1 diabetes. Their findings suggest that, with good diabetes control, this inflammation may be reduced, possibly resulting in a reduction of cardiovascular disease as well.

In a study now available both in the online edition of the Journal of Clinical Endocrinology & Metabolism as well on the National Institutes of Health's PubMed, the scientists provide the first-ever demonstration of increased expression and signaling in type 1 diabetics of two key receptors within the body's innate immune system. Called TLR2 and TLR4, they are part of a family of pattern recognition receptors known as Toll-like receptors (TLRs), so-called because of their similarities to the well-defined Toll gene found in much-studied fruit flies.

Type 1 diabetes is a pro-inflammatory state linked to increased cardiovascular mortality. Inflammation plays a pivotal role in all stages of atherosclerosis, the progressive narrowing and hardening of the arteries over time. The UC Davis study observed that TLR2 and TLR4 expression and signaling are increased in type 1 diabetes patients and contribute to the pro-inflammatory state.

"It is not unreasonable to speculate that TLR2 and TLR4 promote atherogenesis by contributing to the pro-inflammatory state in type 1 diabetes," said lead author Ishwarlal Jialal, director of the Laboratory for Atherosclerosis and Metabolic Research and professor of internal medicine at UC Davis. "Inflammation is central to heart disease, playing a pivotal role in plaque formation and stroke. We may well find that a serendipitous byproduct of controlling diabetes is the simultaneous control of this new pathway, leading to less inflammation and lower risk of heart problems"......... Posted by: Josly2006      Read more         Source

November 19, 2007, 8:22 PM CT

Pedometers motivate people with diabetes to walk more

The use of a pedometer and a Web site that tracked physical activity levels proved to be powerful motivators for people with diabetes who participated in a recent walking study conducted by scientists from the University of Michigan Health System and VA Ann Arbor Healthcare System. The study also suggests that certain types of goal-setting may be more effective than others.

All participants in the study wore pedometers and received automated weekly goals that were based on their prior weeks walking activity. For half of the participants these goals were lifestyle goals, meaning that any step taken during the day counted. The other half received structured goals, in which only steps taken during long walks that lasted at least 10 minutes counted. These participants had a smaller target number of steps to take in a day than the lifestyle group.

Study participants in both groups increased their walking significantly during the program and there was no difference between the groups in terms of increased walking. However, the type of goals that participants were given in the six-week study strongly influenced their satisfaction with the program. Those who received lifestyle goals were more satisfied with the walking program, and wore the pedometer more days during the study period and for more hours during each day than those who received structured goals......... Posted by: Josly2006      Read more         Source

November 13, 2007, 8:47 PM CT

Older people with diabetes face a heavy burden

As if diabetes werent enough to handle, a new study shows that 92 percent of older people with the disease have at least one other major chronic medical condition and that nearly half have three or more major diseases besides their diabetes.

The sheer number, and the severity, of these other conditions appears to decrease patients ability to manage their diabetes. The type of co-existing condition also matters, as diabetes self-care lags most among patients with conditions that they think arent correlation to their diabetes.

The new findings make it more important than ever, the scientists say, for doctors to treat the whole person by helping diabetes patients learn how to deal with their other conditions in ways that will also allow them to control their diabetes.

The study, published online ahead of print in the recent issue of the Journal of General Internal Medicine, uses data from a nationally representative sample of 1,901 adults with diabetes who were age 55 or older in 2002.

The researchers, from the University of Michigan Health System and the VA Ann Arbor Healthcare System, looked at the influence that a range of medical conditions had on the participants ability to manage their diabetes, whether or not those conditions were physically associated with diabetes. For one condition, heart failure, they also assessed how the severity of another condition affected diabetes management......... Posted by: Josly2006      Read more         Source