Does Selenium Reduce Diabetes Risk?

Does Selenium Reduce Diabetes Risk?

French researchers say that high levels of selenium, an antioxidant found in nuts and liver, may protect men from developing diabetes.

The study, published in the journal Nutrition and Metabolism, found that men who had high levels of selenium in their bloodstream were half as likely to develop dysglycemia as men with low levels. Dysglycemia is a condition of abnormal glucose levels in which the body fights to normalize blood sugar, and can lead to diabetes.

The study, which was conducted at the University of Montpellier, followed 1,162 healthy men and women for nine years. At the beginning of the study, the volunteers were between the ages of 59 and 71.

"Our results showed that for elderly males, having (blood) selenium concentrations in the upper third of the population was significantly associated with a lower risk of developing dysglycemia over the following nine years," said study leader Tasnime Akbaraly in a statement.

However, selenium did not protect women. "The reason we observed a protective effect of selenium in men but not in women is not completely clear," Akbaraly said, "but might be attributed to women being healthier at baseline, having better antioxidant status in general, and possible differences in how men and women process selenium."

Other researchers have suggested that selenium could help regulate insulin levels in the body, although not all studies have shown selenium to lower the risk of diabetes. In fact, a previous study at the State University of New York at Buffalo found that cancer patients who took 200 micrograms of selenium daily were almost 50 percent more likely to develop diabetes.

The American Diabetes Association says that 23.6 million children and adults in the United States have diabetes, and 57 million people are prediabetic.

Diabetes may increase risk of death following cancer surgery

Diabetes may increase risk of death following cancer surgery

Diabetes patients who undergo cancer surgery may be at a greater risk of death following the procedure than those not afflicted with the condition, a new study has found.

In a meta-analysis of 15 previously conducted studies involving nearly 40,000 participants, a team of Johns Hopkins researchers found that newly diagnosed cancer patients who also had type 2 diabetes were at a 50 percent increased risk of death following surgery compared to those without diabetes.

Lead author Jessica Yeh, assistant professor of general internal medicine at the university, noted that those with diabetes and colorectal or esophageal tumors were at the greatest risk of dying after surgery.

"When people are diagnosed with cancer, the focus often is exclusively on cancer, and diabetes management may be forgotten," said Yeh. "This research suggests the need to keep a dual focus."

Although Yeh and her colleagues were unable to define the specific factor responsible for the higher mortality rate, they suggested that the close link between diabetes and infection risk may be to blame.

Diabetes Screening Should Begin Earlier

Diabetes Screening Should Start Sooner

TUESDAY, March 30 (HealthDay News) -- Current recommendations suggest that screening for type 2 diabetes start at age 45, especially for those who are overweight, but new research shows cost-effective screening can begin between the ages of 30 and 45 for everyone.

When screening began between ages 30 and 45 and was repeated between every year to five years, the average cost per quality-adjusted year of life was $10,500 versus $15,509 when screening began at age 45 and was repeated every year, the study found.

"If you start screening between 30 and 45, you are really getting cost-effective screening," said study author Richard Kahn, a clinical professor of medicine at the University of North Carolina, Chapel Hill, who was with the American Diabetes Association at the time of the study.

More than 23 million Americans have diabetes, according to the American Diabetes Association (ADA). Most have type 2 diabetes, which occurs when the body stops using insulin efficiently or doesn't produce enough insulin. Uncontrolled diabetes is associated with a significantly increased risk of heart disease, stroke, kidney disease, serious eye problems, infections and nerve damage, according to the ADA.

It's suspected that many people have had the disease for years by the time they're finally diagnosed because it has so few symptoms in its early stages. Other research has shown that diabetes treatments can help reduce the risk of complications, and the earlier they're started, the better.

To assess whether population-based screening could reduce complications and costs associated with diabetes, the researchers used a sophisticated computer modeling system.

"This model is a virtual replication of the world of health care, and takes into account cardiovascular and other complication risks, costs, tests, procedures, everything," said Kahn. "It's the SIM City of health care," referring to a popular computer game where people build their own virtual worlds.

Kahn and his colleagues evaluated eight simulated screening strategies for type 2 diabetes, such as beginning screening at age 30 and repeating the test every three years, or starting at age 45 and repeating the test every year, or waiting until age 60 and repeating the test every three years.

For all of the screening simulations that began between ages 30 and 45, the researchers found a cost and quality-of-life benefit.

"Everybody should get screened for diabetes on a regular basis between 30 and 45 years, and repeat the screen every three to five years," said Kahn. "Screening is cost-effective. It's a bargain in the world of medicine to screen and get someone into effective treatment."

"One of the big questions we've had is: does screening make a difference? This study shows us that screening in ages 30 to 45 will probably make a difference in number of people diagnosed with heart disease, kidney disease and other morbidities," said Dr. Rita Louard, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

"We've come a long way in our ability to manage people with diabetes, so screening becomes more important because once people get identified, we now have better tools to get them to their goals. And, it's not only the blood sugars we're looking at. It's really about the other complications that track with the disease, like heart disease. So, we're more aggressive with blood pressure and with their lipids [cholesterol] once diabetes is identified," she explained.

Results of the study are published in the March 30 online edition of The Lancet. Study funding was provided by Novo Nordisk, Bayer Pharmaceuticals and Pfizer. These companies all produce diabetes treatments or products. However, the sponsors had no role in the design of the final study, data collection or analysis, or in the writing of the report, according to the report.

Undiagnosed Diabetes Could be Linked to Chronic Kidney Disease

Undiagnosed Diabetes Could be Linked to Chronic Kidney Disease

It’s important when a person begins showing symptoms of diabetes to get checked out by a medical professional, as letting the disease progress without proper diabetes natural remedies could lead to other health complications.

According to a new study published in the Clinical Journal of the American Society Nephrology (CJASN), undetected kidney disease could be a result of undiagnosed diabetes.

The scientists estimate that more than 13 million Americans could have chronic kidney disease (CKD) and may not realize it. Research showed that there was a link between both undiagnosed kidney disease and diabetes.

"Our research indicates that much of the CKD burden in the United States is in persons with prediabetes and undiagnosed diabetes, who are not being screened for CKD," said researcher Laura C. Plantinga.

The researchers found that based on lab tests, 42 percent of participants who had undiagnosed diabetes also had CKD. Additionally, individuals who had been diagnosed with the disease also had a 40 percent instance of CKD, indicating that the two problems coincide with each other.

Pre-Diabetes Patients & Kidney Disease

Pre-Diabetes Patients Have Extremely High Cases of Kidney Disease

Researchers have drawn a connection between the prevalence of kidney disease among undiagnosed people with diabetes or pre-diabetes. The Clinical Journal of the American Society of Nephrology (CJASN) recently released the results on findings taken from 1999 to 2006.

Participants in the study filled out the National Health and Nutrition Examination Survey and were aged 20 and older. The questionnaire "is a representative survey of the civilian, noninstitutionalized US population."

Findings concluded that participants with pre-diabetes or undiagnosed diabetes had a 70 percent higher prevalence of chronic kidney disease (CKD). The shocking estimates also point out that if this is true, that means about 13 million American adults who are pre-diabetes or undiagnosed, have kidney disease, both being somewhat "silent" but dangerous.

"Thus, greater community awareness of diabetes and its risk factors may be needed to improve detection of both diabetes and subsequent chronic kidney disease among these individuals." About 8,200 Americans participated in the survey that is now causing reason for further study.

Early diagnosis of diabetes can help prevent chronic kidney disease. High blood glucose levels can be damaging to kidneys because it's the organ responsible for filtering waste from the blood. For the kidneys to work properly over long periods of time, blood sugar levels must remain within healthy ranges.

China Facing Diabetes Epidemic

China Faces Diabetes Epidemic

After working overtime to catch up to life in the West, China now faces a whole new problem: the world's biggest diabetes epidemic.

One in 10 Chinese adults already have the disease and another 16 percent are on the verge of developing it, according to a new study. The finding nearly equals the U.S. rate of 11 percent and surpasses other Western nations, including Germany and Canada.

The survey results, published Thursday in the New England Journal of Medicine, found much higher rates of diabetes than previous studies, largely because of more rigorous testing measures. With 92 million diabetics, China is now home to the most cases worldwide, overtaking India.

"The change is happening very rapidly both in terms of their economy and in terms of their health effects," said David Whiting, an epidemiologist at the International Diabetes Federation, who was not involved in the study.

"The rate of increase is much faster than we've seen in Europe and in the U.S."

Chronic ailments, such as high blood pressure and heart disease, have been steadily climbing in rapidly developing countries like China, where many people are moving out of farms and into cities where they have more sedentary lifestyles.

Greater wealth has led to sweeping diet changes, including eating heavily salted foods, fatty meats and sugary snacks - boosting obesity rates, a major risk factor for Type 2 diabetes, which accounts for 90 percent to 95 percent of all diabetes cases among adults.

"As people eat more high-calorie and processed foods combined with less exercise, we see an increase of diabetes patients," said Huang Jun, a cardiovascular professor at the Jiangsu People's Hospital in Nanjing, capital of northern China's Jiangsu province, who did not participate in the study.

"Whereas 20 years ago, people took naps during the work week, people are now faced with the stress of making more money to support a family and a buy a house."

Previous studies over three decades have shown a gradual climb in China's diabetes rates. The sharp rise in the latest study, conducted from 2007-2008, is largely explained by more rigorous testing methods, said lead author Dr. Wenying Yang from the China-Japan Friendship Hospital in Beijing.

Earlier nationwide studies relied only on one blood sugar tolerance test, while this survey of nearly 50,000 people caught many more cases by checking levels again two hours later, an approach recommended by the World Health Organization. More than half of the people with diabetes didn't know they had it, the study found.

The study did have some limitations, sampling more women and city residents - 152 urban districts compared to 112 rural villages. Yang said she was alarmed by the findings, and China's Ministry of Health has been alerted. She said there are plans to promote a national prevention strategy.

Diabetes occurs when the body is unable to regulate blood sugar. It is a major risk factor for heart disease, which remains the biggest killer in the world's most populous nation.

"I don't think it's unique to China, but it's certainly a concern that the rates are high," said Colin Bell, a chronic disease expert at WHO's regional office in Manila. "It emphasizes the need for strong prevention and treatment programs."

The Asia-Pacific, the world's most populous region, was highlighted in another study last year estimating that by 2025, it would be home to more than 60 percent of the 380 million diabetes cases globally.

And while the world's giants China and India already have the highest number of cases worldwide, the per capita rate is higher in several other countries - up to 30 percent of all people living on the tiny Pacific Island of Nauru have the disease, according to estimates from the International Diabetes Federation.

The Chinese study sampled people from June 2007 to May 2008 across 14 cities and provinces. It revealed men were slightly more affected and there were more diabetes cases in cities than in the countryside - one in 11 city dwellers were diabetics, compared with one in eight in rural areas.

However, the number of people on the verge of developing diabetes was higher in rural areas.

The WHO estimates that diabetes, heart disease and stroke will cost China $558 billion between 2006-2015

Diabetes symposium to be held Tuesday

Diabetes symposium to be held Tuesday

The Juvenile Diabetes Research Foundation is hosting a free research symposium on Tuesday, March 30, at Crowne Plaza Hotel on Main Street in Moncton.

Guest speakers include renowned diabetes researcher Dr. Derek van der Kooy, a professor in the department of molecular genetics at the University of Toronto and formerly a professor in the department of anatomy and cell biology at the same university.

van der Kooy's lab works on stem cell biology and developmental biology research projects. Some of van der Kooy's research relates to pancreatic stem cells and their potential for treatment.

Sara Robinson, a spokesperson for the Juvenile Diabetes Research Foundation, says van der Kooy will speak about the latest research and treatments relating to diabetes.

Other speakers at the research symposium include Dr. T. Michael Vallis, a professor in the departments of psychiatry and psychology at Dalhousie University, and Jonny White, an athlete with Type 1 diabetes who bicycled 12,000 km (7,456 miles) across Africa (top to bottom). White is now completing his Ph.D. in media psychology and produced Long Road, a three-part web documentary chronicling his journey.

Emcee for the evening is Moncton native Colin Matheson.

Robinson says the event is aimed at anyone who is touched by Type 1 diabetes or diabetes in general.

A free meal will be provided by Crowne Plaza at the symposium. A cocktail reception will be held at Crowne Plaza at 6 p.m. Dinner will be served at 6:30 p.m. and the symposium will begin around the same time. The event is expected to wrap around 9:30 p.m. Anyone can attend, but they must RSVP by calling 852-4415 or e-mailing moncton@jdrf.ca.

Diet & Exercise May Beat Drugs

To Cut Diabetes Heart Risks, Diet and Exercise May Beat Drugs

More than 1 in 10 American adults have diabetes, and many of them successfully keep their blood sugar levels under control with various medications. Unfortunately, these multibillion-dollar blockbuster drugs haven't proved to be so successful against the biggest cause of death related to diabetes: heart disease. Four new studies published in this week's New England Journal of Medicine bring nothing but disappointing news for diabetics who rely on drugs to lower their risk of heart attacks and strokes. One found that using antihypertensives to lower systolic (the top number) blood pressure below a healthful measurement of 120 mm Hg does nothing to lower a diabetic's risk of heart complications; another found no benefit to adding a drug to raise HDL "good" cholesterol levels in diabetics who were already taking a statin to lower the bad kind. And no heart benefits were associated with two drugs given to lower high blood sugar levels, according to the two other studies.

What all this new evidence suggests is that more may not always be better when it comes to finding ways to prevent heart disease in diabetics. "It's not enough to show that a drug lowers high blood sugar levels or other risky biomarkers," says Steven Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic, whose research linked the diabetes drug Avandia with an increased rate of heart attacks. "Does it actually improve clinical outcomes? Does it cause more benefits than risks?"

Evidence is accumulating that diabetics may not benefit—and may even be worse off—when they're treated with medications to drive down their blood sugar levels or blood pressure to normal or below normal levels. The new study examining blood pressure found that diabetics with moderately high blood pressure levels—about 135 mm Hg on average—didn't benefit from taking extra blood pressure medication to lower those levels down to slightly less than 120 mm Hg. In fact, they were more likely than those who kept their levels in the 130s range to experience fainting, heart arrhythmias, and abnormally high potassium levels, all associated with low blood pressure. "Most doctors still aim for a goal blood pressure of 130 or below when treating diabetics, even though no there's no good data to support that," says study leader William Cushman, who is chief of preventive medicine at the VA Medical Center in Memphis. Still, he emphasizes, previous research has shown that diabetics can significantly lower their risk of heart attacks and strokes by getting treated with high blood pressure medications if they have a systolic blood pressure above 140 or a diastolic (lower number) pressure above 90.

The real take-home message here is that those with diabetes shouldn't forget about the importance of lifestyle factors even if they're already achieving optimal blood glucose levels with medications. "We have an abundance of evidence," says Cushman, that losing excess weight, increasing activity levels, and improving nutrition habits will lead to better control of diabetes and lower risks of heart disease. Plus, lifestyle modifications pose none of the side effects or long-term health risks that are associated with blood-sugar-lowering drugs. And these changes appear to be more effective than drugs like metformin at preventing diabetes from occurring in the first place in those who have prediabetes or insulin resistance, according to David Nathan, director of the diabetes Center at Massachusetts General Hospital, who wrote an editorial that accompanied two of the NEJM studies.

Here's a smart action plan:

1. Use drugs wisely. Those with diabetes should take a cholesterol-lowering statin drug to lower their heart-disease risks. They should take a blood pressure medication if they have a level above 140/90 mm Hg to reduce heart disease risks but shouldn't aim to achieve a level below 130 mm Hg for the systolic number, says Cushman. Glucose-lowering medications like metformin should be used to achieve a hemoglobin A1c level—a marker used to determine blood sugar control—of about 7.5 percent. "Personally," he adds, "I'm concerned about driving levels below that with more medication because our previous research found a higher mortality rate in those who had levels as low as 6 percent."

DIABETES - A SUMMARY

Diabetes is a group of diseases marked by
high blood glucose levels due to defects in
insulin production, insulin action, or both.

Diabetes can cause serious complications
and premature death. However, diabetics
can take steps to prevent diabetes and
control the disease, through a special
diabetic diet thereby lowering the risk
of complications.

There are many recipes available to prepare
a suitable diabetes diet

TYPES OF DIABETES

Type 1 diabetes develops when the body's
immune system destroys pancreatic beta
cells, the only cells in the body that make the
hormone insulin that regulates blood sugar.
For diabetics to survive with type 1 diabetes
means they must have insulin delivered by
injection or a pump.

This form of diabetes usually strikes children,
known as juvenile diabetes, and young adults
although the disease onset can occur at any age.
Type 1 diabetes accounts for 5% to 10% of all
diagnosed cases of diabetes.

Symptoms of diabetes type 1 tend to develop
quite quickly, over a few days or weeks.
They include: excess thirst, passing large
amounts of urine, tiredness, weight loss,
and feeling generally unwell. After treatment
is started these symptoms soon go. But, without
treatment, the blood glucose level can go
very high causing you to become very ill,
lapse into a coma and even die.


Type 2 diabetes usually begins as insulin
resistance, a disorder in which the body cells
cannot use insulin properly. As the need for
insulin rises, the pancreas gradually loses its
ability to produce it.

Type 2 diabetes is the most common form.

Type 2 accounts for around 90% to
95% of all diagnosed cases of diabetes.

Symptoms of type ii diabetes include:
excess thirst, passing large amounts of urine,
tiredness, weight loss, and feeling generally
unwell. Type 2 diabetes symptoms tend to
develop quite slowly, over weeks or months.

Gestational diabetes is a form of glucose
intolerance that occurs in some women
during pregnancy. Women who have had
gestational diabetes have a 20% to 50%
chance of developing diabetes in the next 5
10 years.

Other types of diabetes result from specific
genetic conditions, surgery, drugs, infections,
malnutrition, and other illnesses, accounting
for 1% to 5% of all diagnosed cases

March 23, 2010- American Diabetes Association Alert Day

March 23, 2010- American Diabetes Association Alert Day

There are 23.6 million adults and children living with diabetes. That's 7.8% of the US population. Five million American are diabetic and don't know it. If it's left untreated, diabetes can lead to heart attack, stroke, blindness and kidney failure.

It's a growing epidemic in this country, and Tuesday, March 23rd is a national wake up call. It's American Diabetes Association Alert Day. The message is simple: know your risk. Here is a risk assessment test . It takes less than a minute.

Your risk for developing diabetes increases with age. While Gen Xers aren't quite in that age bracket yet, we may be at risk in other ways. We can also encourage our parents and other family members who do fall into that category to arm themselves with knowledge as well.

If you know your risk, you can help lower it. You can't change your family history, race or age, but eating nutritious meals and staying active are fully within your power. You have the ability to take control over those risk factors, and help prevent diabetes.

Diabetes Control Through Healthy Eating

Diabetes Control Through A Healthy Diet

A diagnosis by your doctor of pre-diabetes or an existing diabetic condition conjures up a number of not too pleasant visions. Among the many are thoughts of having to give up many of your favorite foods. In fact this need not be so, you can find an assortment of diabetic recipes that you can wrap your taste buds around. You do not have to start eating special foods nor do you need to follow any complicated diet. For most people, eating at regular intervals and sticking to a varied diet in moderate quantities will go a long way towards avoiding many of the serious complications associated with diabetes. Eating approximately the same amount and at the same time each day is a major step towards keeping blood sugar levels stable.

Your first critical step towards formulating a diabetic diet plan must be with the assistance of a dietitian. The dietitian will consider your lifestyle, your medication, your weight and any other existing medical conditions in order to tailor a plan which is just right for you. It is not inconceivable that this plan could also include your favorite foods, thus you will still be able to derive pleasure from your meals. The focus of your plan will be on consuming foods which are high in nutrients, low in fat, and moderate in calories. There are numerous diabetes cookbooks available with nutritious yet tasty meals to assist you in this endeavor.

Getting Started

Not always do we pay close attention to what we eat, our focus is more on pleasing our palate rather than nutrition. For the diabetic this will be a major but critical adjustment.Here’s the ABC of making those adjustments as suggested by the American Dietetic Association:

(A) ”Moderate sugar, fat and carbohydrates” – Typically carbohydrates take from five minutes to three hours to be digested, fats can take eight or more hours as opposed to proteins which take three to six hours. Therefore the reason why foods high in fat (ice cream) raises blood sugar level more slowly than vegetables (carrots). It is recommended that fat intake should be less than 30% of your daily calories. Desserts and sweets do not have to be completely eliminated from your diet but can be eaten once or twice per week, in moderate amounts.

(B) “Eat five fruits and vegetables every day” – Replace your sugar producing foods with fruits or vegetables, these are good sources of vitamins, minerals and fibers. Soluble fibers found mostly in fruits, vegetables and some seeds, trap carbohydrates and slow the absorption of glucose. Vegetables which are highly recommended are: cooked kidney beans (rated among the highest soluble fiber foods) and carrots which are also highly rated for having a positive effect on blood glucose levels.

(C) “Eat more starches” – Starchy foods are an important part of a healthy meal plan. Whole grain breads, cereals, pasta, rice and starchy vegetables like peas, corn, potatoes and yams can be included in your meals. Your portion though must be moderate, 3 to 4 daily servings of carbohydrate-containing foods are considered adequate.

Learning what, how and when to eat is a giant step towards taking control of your illness. There is no perfect food or diet for the diabetic, the goal of each plan is to supply a variety of foods which will provide enough sustenance while still keeping your blood sugar level under control. Your diet plan does not have to be bland, there are a number of diabetic recipe books available, also you can be daring and experiment with some of your favorite recipes, always being aware of your dietary limitations. For additional information on following a diabetes meal plan you can research or ask your dietitian about “The Food Guide Pyramid”, “Creating your Plate”, and “Carbohydrate Counting”. These are all different plans and you can choose which is most suited to you. As previously mentioned there are various diabetic recipes and diabetes cookbooks to help you make this transition more pleasurable. With careful management of your diet, exercise and taking your medication (if necessary) as prescribed by your doctor, will minimize any risk of your disease escalating to a more critical level or even eliminate your dependence on insulin or other medications.

Intensive blood pressure control in diabetes 'has no benefit'

Intensive blood pressure control in diabetes 'has no benefit'

Intensive controlling the blood pressure of patients with type 2 diabetes is not beneficial – even in patients at high risk of cardiovascular disease according to data from the latest analysis of the pivotal ACCORD study.

A subset of the trial included 5,000 patients with type 2 diabetes treated to a systolic target of either below 120 or 140 mm Hg. After one year, the mean systolic blood pressure was 119.3 mm Hg in the intensive group and 133.5 mm Hg in the standard therapy group.

But researchers found no significant difference between intensive and standard control of blood pressure in the overall annual rate of non-fatal heart attacks and strokes or deaths from cardiovascular disease. Although intensive blood pressure control did significantly reduce the annual rate of stroke it was associated with a more than doubling in adverse events.

After a mean follow-up period of 4.7 years the annual rate of the primary outcome – the composite incidence of non-fatal heart attacks, non-fatal strokes and death from cardiovascular causes – was 1.9% in the intensive therapy group and 2.1% in the standard therapy group. The hazard ratios showed intensive therapy increased the risk of the primary outcome by 12%, though this was not statistically significant.

The annual rates of death from any cause were 1.3% and 1.2% in the intensive and standard groups respectively, while the annual rates of strokes, a pre-specified secondary outcome, were 0.3% and 0.5% respectively.

Intensive antihypertensive treatment resulted in significantly more serious adverse events, reported by 3.3% of the intensive group compared to 1.3% of the standard treatment group, mostly hypotension, hypokalaemkia and increases in serum creatinine.

Lead researcher Dr William Cushman, professor of preventive medicine at the University of Tenneesee, concluded: ‘It is possible that lowering systolic blood pressure from the mid-130s to approximately 120 mm Hg does not further reduce most cardiovascular events or the rate of death, and most of the benefit from lowering blood pressure is achieved by targeting a goal of less than 140 mm Hg.’

In an accompanying editorial, Dr Peter Nilsson, a cardiologist at the University Hospital Malmö in Sweden said: ‘The main conclusion to draw from this study must be that a systolic blood-pressure target below 120 mm Hg in patients with type 2 diabetes is not justified by the evidence.

‘Flexible goals should probably be applied to the control of hyperglycaemia, blood pressure, and dyslipidaemia in patients with type 2 diabetes, taking into account individual clinical factors of importance.

Dr Richard Lehman, a GP in Banbury, Oxfordshire with an interest in cardiology, said: ‘This confirms that we have to go by hard endpoints. You can’t assume that by treating everybody to a lower and lower target you will get benefit, because you don’t. You actually mess up people’s lives but for very little reward.’

Mrs. Obama on Childhood Obesity

Mrs. Obama on childhood obesity

By Dr. Ananya Mandal, MD

Consider this –

• More than one third of American children are obese and barely reach adulthood before they are plagued by Type II Diabetes, hypertension, high cholesterol and heart disease.
• The number of obese children has tripled over the last three decades.

Who is to blame?

While lack of exercise is a cause of such alarming trends, unhealthy and non-nutritious diet is one of the major villains in this scene.

So what do we do now?

Let’s Move

Last month First Lady Michelle Obama launched a programme called “Let’s Move” aiming at reducing and eradicating the childhood obesity epidemic in the existing generation so that the nation as a whole attains a healthy adulthood in the coming decades.

She said that the major role players in this effort are not only parents, teachers and government officials but also the food industry as a whole.

Need for More

Grocery Manufacturers Association (GMA) Chairman Richard Wolford, said "In recent years, our companies have reduced calories, sugar, fat and sodium in more than 10,000 products". "They have also enhanced the nutritional profile of many products with the addition of whole grains, fiber or other nutrients and created the informative and convenient 100-calorie pack.”

She commended the initial efforts made by the food industry but said that there is sill a long way to go to provide healthy food alternatives to children. She said "we need you not just to tweak around the edges but to entirely rethink the products that you're offering, the information that you provide about these products and how you market those products to our children." Replacement of unhealthy alternatives like trans fats with more unhealthy options like salt or high calorie fibers, she said is not the solution. She said unhealthy foods are not only responsible for obesity but also have a negative impact on the child’s productivity at school.

Take the pledge

She called on the big food industry giants to pledge their marketing strategies to manufacture and sell only healthy foods to children. She went on to say that food labels should have exact information about the quality and quantity of foods and how much of it was safe for the child. The First Lady pointed out that food manufacturers are aware of the impact their advertisements have especially on children and urged them to promote healthy eating among children by constructive marketing.

Her words were greeted warmly and have drawn a healthy response from the food industry which has unanimously agreed to rethink and reformulate their products and also make labeling more parent-friendly.

"We have not ever had this kind of leadership from the White House. Changing the way we make and market food isn't enough to end childhood obesity in a generation," said Sean McBride, GMA's vice president of communications. "Now we have a leader to help make the cultural change that is required."

Improve Glycemic Control with Salsalate ?

Salsalate May Improve Glycemic Control in Type 2 Diabetes

THURSDAY, March 18 (HealthDay News) -- Salsalate improves markers of glycemic control in patients with type 2 diabetes and may provide a new avenue for the treatment of the disease, subject to further research on the drug's renal and cardiac impact, according to a study in the March 16 issue of the Annals of Internal Medicine.

Allison B. Goldfine, M.D., of Harvard Medical School in Boston, and colleagues conducted a study of 108 patients aged 18 to 75 years with type 2 diabetes, 27 of whom were each assigned to received 3.0, 3.5 or 4.0 g/day salsalate or placebo for 14 weeks, as well as their existing therapy.

Compared to the placebo group, the researchers found that more of the patients in the three salsalate treatment arms had reductions in hemoglobin A1c of 0.5 percent or more from baseline. The three salsalate groups also had improvements in other markers of glycemic control, as well as circulating triglyceride and adiponectin. However, patients also taking sulfonylureas had a higher incidence of mild hypoglycemia, and participants in all three treatment arms had higher urine concentrations of albumin, the investigators discovered.

"The drug's long-term safety in this population, and particularly its effects on renal function, require further investigation," the authors write. "Because of salsalate's anti-inflammatory effects, our results suggest that inflammation plays a role in the pathogenesis of type 2 diabetes and that anti-inflammatory therapy may therefore be useful for treating diabetes."

One author reported financial relationships with various pharmaceutical companies.

Diabetes Management to Reduce Heart Disease & Strokes

Manage diabetes to prevent heart disease and strokes

Heart disease is common in people with diabetes, but the good news is that taking good care of diabetes and the body today can help delay or possibly prevent this and other serious health problems.

The American Heart Association says that heart disease and stroke are responsible for two-thirds to three-fourths of deaths among people with diabetes.

Not only are people with diabetes at higher risk for heart disease, but the condition also puts them at greater risk of developing eye problems, foot problems, and skin issues.

Two Types of Diabetes

There are two major types of diabetes. In type 1 diabetes, the body completely stops producing insulin, a hormone that enables the body to use glucose found in foods for energy.

Individuals with this type of diabetes must take daily insulin injections to survive. This form of diabetes usually develops in children or young adults, but can occur at any age.

Most people with diabetes have type 2. With this type of diabetes, the body produces insulin, but not enough to properly convert food into energy.

This form typically occurs in people over the age of 45 who are overweight, don't exercise, have cholesterol problems and have a family history of diabetes.

Women who develop diabetes while pregnant (a condition known as gestational diabetes) are more likely to develop type 2 diabetes later in life.

Type 2 diabetes often develops so gradually that symptoms may not be recognized. People can live for months, even years, without knowing they have the disease.

Managing Diabetes

The goal of diabetes management and prevention of heart disease is to keep blood glucose, blood pressure and cholesterol levels as close to the normal range as safely possible.

In some people, diet and exercise can keep diabetes under control. When diet and exercise aren't effective, a physician may prescribe diabetes pills or insulin. The treatment prescribed depends on the type and severity of the disease, the person's age, family history and lifestyle.

Diet Supplement can reduce diabetes in men

Dietary supplement can reduce diabetes risk – but only in men

Researchers found that men who had high levels of selenium, an antioxidant found naturally in nuts and liver, in their body were at significantly less risk of developing the condition.

But the supplement, also sold in capsules from health food stores, did not appear to protect women, the research shows.

Men who had high levels of selenium in the bloodstream were half as likely those with low levels to develop dysglycemia, a condition in which the body struggles to regulate blood sugar and which can lead to full-blown diabetes.

The study, by researchers at the University of Montpellier in France, followed 1,162 healthy men and women for nine years.

All of the volunteers were aged between 59 and 71 at the start of the study.

Tasnime Akbaraly, from the University of Montpellier, who led the study, said: "Our results showed that for elderly males, having (blood) selenium concentrations in the top third of the population was significantly associated with a lower risk of developing dysglycemia over the following nine years.”

She added: “The reason we observed a protective effect of selenium in men but not in women is not completely clear, but might be attributed to women being healthier at baseline, having better antioxidant status in general and possible differences in how men and women process selenium".

The findings were published in the journal Nutrition and Metabolism.

Selenium is found in many multivitamins and researchers have previously suggested that it could have an effect on regulating insulin levels in the body.

However, three years ago researchers from the State University of New York reported that taking selenium could actually increase the risk of developing diabetes.

Cancer patients who took 200 micrograms of selenium a day were almost 50 per cent more likely to develop the disease than sufferers given a placebo, the study of 1,200 people showed.

More than 2.5 million people in Britain have diabetes, although that number is expected to mushroom in coming decades, in part because of lifestyle issues such as obesity.

Share a bite in April and help diabetes

Share a bite in April and help make a difference to diabetes

Diabetes Australia-NSW is calling on everyone in the state to host a Great Australian Bite this April and share a bite to eat with family and friends to help the 3,000,000 Australians who are living with or at risk of diabetes.

Hosting a ‘bite’ is as easy as 1,2,3…

1. Register at www.greataustralianbite.com.au or 1300 342 238 to host a bite in April.

2. Invite your friends, family, neighbours and workmates to join in the fun.

3. Ask your guests for a donation for the wonderful food and company they are enjoying in support of those living with and at risk of diabetes.

Your ‘bite’ could be a movie night, community barbeque, workplace morning tea or even a raffle and could involve a couple of friends or a whole suburb. It’s so simple to get involved.

No matter what type of ‘bite’ you choose, you will be raising funds for Diabetes Australia-NSW and helping to improve the health and enhance the lives of people living with diabetes.

Last year the event raised $80,000 and this year we hope to raise more than $100,000.

Even if you can’t hold a ‘bite’ this April, you can still help out by making an online donation at http://gab.gofundraise.com.au/

So share a ‘bite’ and help the fight against diabetes.

Taylor a role model battling diabetes

Taylor a role model while battling through disease

PHOENIX — Michael Taylor receives the occasional letter from parents who thank him for being an inspiration to their child.

They're not talking about Taylor being one of the major leagues' top prospects.

The A's outfielder is paving his way to the big leagues while battling Type 1 diabetes, a condition Taylor was diagnosed with at age 9.

Before he hits the field every morning, Taylor pricks his finger to draw blood and measure his blood-sugar level. Then he injects himself with a shot of insulin, an exercise he repeats five or six times daily.

That's the laborious part of dealing with a disease that affects up to three million Americans.

The payoff comes when he talks to children with diabetes and sees their faces light up as his message sinks in: Being diabetic doesn't mean you can't live a normal life, or even be a professional athlete.

"That's the coolest part about this experience," Taylor, 24, said.

One glance at Taylor shows why the A's were enamored with the former Stanford star. He's listed at 6-foot-6, 260 pounds, and he combines that size with good speed and surprising agility.

The A's traded highly regarded third baseman Brett Wallace to Toronto in exchange for Taylor on Dec. 16, immediately after Taylor had been dealt from Philadelphia to Toronto as part of the Roy Halladay trade.

Baseball America ranks Taylor as the majors' No. 29 overall prospect, one spot behind teammate Chris

Isle of Wight Diabetes Support Group

Making a Difference: Tammy Glover, Barbara Hinman lead diabetes support group

SMITHFIELD — Tammy Glover didn't want to believe the diagnosis when she was told her 2-year-old daughter, Morgan, had Type 1 diabetes.

"It was a lot easier for my husband to accept. I didn't want to accept it."

With some help, Glover has turned her shock into outreach and support for other families dealing with the condition.

"I've dreamed about this for about five to six years," Glover said, "to have a place where kids and parents can forget about diabetes."

Glover's daughter, now 11 and a sixth-grader at Westside Elementary School in Smithfield, is successfully handling the disease.

"From what I have seen here in our own school clinic, there is a real need for these families to be able to reach out to each other, if nothing else just to share the daily trials of dealing with this illness," said Barbara Hinman, Westside school nurse.

She and Glover created a diabetes support group for parents and students in Isle of Wight to share management ideas, dieting tips and their concerns. The group meets the first Monday of every month at Westside.

"This community didn't have a support group," Hinman said. "There is definitely a need."

Disease's impact

Hinman said there are five students at Westside with Type 1 diabetes, which was previously known as juvenile diabetes.

Within the county school system, there are 11 juvenile diabetics, she said. "This is certainly the largest number of this type of chronic illness we have seen in our school system," she said.

The support meetings also encourage students to be independent in managing their diabetes.

"It's not a quick fix — it's a way of life," she said. "We can't be there 24/7."

"Any time you feel a bit abnormal, you check," Glover said. "You just have to stay on top of it."

About the ailment

Type 1 diabetes is a disease in which the body's immune system attacks and destroys the insulin-producing cells of the pancreas.

According to the American Diabetes Association, Type 1 diabetes is usually diagnosed in children and young adults.

In Type 1 diabetes, the body does not produce insulin, a hormone that is needed to convert sugar (glucose), starches and other food into energy needed for daily life. Only 5 percent to 10 percent of people with diabetes have this form of the disease.

Various factors can contribute to Type 1 diabetes, including genetics and exposure to certain viruses, although the exact cause in unknown, according to the Mayo Clinic.

The Juvenile Diabetes Research Foundation says that as many as 3 million Americans might have Type 1 diabetes. Each year, more than 15,000 children — 40 per day — are diagnosed with Type 1 diabetes in the U.S.

The group's big plans

Hinman also uses the meeting to facilitate how students can tell nurses at other schools in order to effectively treat a young person with diabetes.

"Although I am involved with their daily care at school," Hinman said, "I have pretty much just tried to facilitate getting this group off the ground and the families can make it their own."

Bowersox on track to win American Idol

Crystal Bowersox likely to win American Idol

Even this early in season nine of American Idol, Crystal Bowersox has all but convinced most of America and the judges that she is the best of the bunch and deserves to win. Simon has already declared Bowersox the one to beat this year. But will the 24-year-old mom be sidetracked by a health problem, or will she be a fighter and not let it hold her back?

A couple of weeks ago, Bowersox had to be hospitalized for an undisclosed health problem [why all the secrecy, AI?]. The chatter on TV and online was that Bowersox was suffering from some complication related to diabetes. For the first time in the show's history, the producers shuffled that week's schedule so the men performed first, giving Bowersox an extra day to rest.

The accommodation helped - Bowersox showed up onstage the next night and performed Creedance Clearwater Revival's "Long As I Can See The Light" to raves from the audience and judges, particularly Simon, who said, "This was like the moment we realized with Kelly Clarkson that we've got a really serious artist here."

Bowersox received similar acclaim for her performance of Tracy Chapman's "Give Me One Reason" this week, cementing her position in the top 12.

If Bowersox does have diabetes, it is not necessarily an illness that can't be well-managed. Millions of people have the disease and are able to live perfectly normal lives. Take Nick Jonas for example - the young star was diagnosed with Type 1 diabetes in 2005, but he hasn't let it interfere with his musical career. Soon after his diagnosis, Jonas was giving himself insulin injections up to 12 times a day, but now he wears an insulin pump called an OmniPod on his arm. The small device makes it easier for him to test and control his blood sugar level.

For the time being, Bowersox seems to be doing fine, so there is really no reason to believe her diabetes, or whatever health problem she has (or had), will interfere with her ability to compete and win as many predict. As long as Bowersox keeps delivering stellar performances week after week, she is all but guaranteed the number one spot in May.

Juvenile Diabetes Research Foundation Benefit

At Juvenile Diabetes Research Foundation benefit, it's reds whites and green

At a corner table inside the Staaten in West Brighton, Robert Rispoli offered visitors his homemade wines, made from imported Chilean grapes.

The 46-year-old Bay Terrace resident, who teaches the fine art of winemaking at his Vino Divino school in Charleston, noted the qualities of his vino: "No sulfates, no chemicals, all natural," he said. But no hard sell was required for attorney Tom DeVito, among others.

Staten Island Advance /Anthony DePrimoWinemaker Heidi Redell and wine distributor Nick Ziccardi talk about their Barefoot wine at the Juvenile Diabetes Research Foundation's annual wine tasting event at the Staaten. (Staten Island Advance / Anthony DePrimo)

The Lighthouse Hill resident sniffed the wine, took a sip, swirled it in his mouth and quickly declared: "It's very good. No aftertaste. It's smooth going down. In a word, velvety."

DeVito was one of 175 supporters who brought their wallets and palates last night to the third annual wine-tasting to benefit The Staten Island Branch of the Juvenile Diabetes Research Foundation.

Organizers acknowledged that the wine was a definite enticement.

"It's a very big reason the people come out," said co-chair Kathy Zazula, who noted that seven previous galas never got the crowds buzzed, so to speak, like this.

"People enjoy it and it just brings them out. They love the mingling and communicating, rather than all the ballroom stuff," added co-chair Linda Stiglitz.

Also offered were wines from the 45-year-old Barefoot Wine & Bubbly vineyard. Representative Heidi Redell offered a bevy of the California-made varietals, which she called "Fruit-Forward," bottled with stylish labels.

"We take the grapes from the vine and translate that in the bottle," she said. "There's not a lot of manipulation; they all taste like they come right off the vine and went straight into the bottle," she said.

Master of ceremonies Ed Kalegi reminded the crowd how JDRF deserves their support.

"This organization does such worthwhile and valuable work in the community... it's such a wonderful cause and it is worthwhile to the entire community to get behind something like this."

Among several young speakers describing their lives with Type 1 diabetes was Jessica Burns, 20, of Great Kills, who was diagnosed at age 13.

Now a college student, she recalled feeling as though it were the end of the world when she learned she had diabetes. But getting involved in outreach has helped enormously, she said.

"There is life beyond diagnosis. I try to tell that to people because it [diabetes] really has had an impact on me. It's no longer just a diagnosis, I am living with it and helping others," she said.

Ipsen signs obesity deal with Rhythm

Ipsen signs obesity deal with Rhythm

Ipsen has granted a licence to the USA’s Rhythm Pharmaceuticals to take over two of its metabolic disorders.

The deal covers Ipsen’s peptide therapeutics targeting obesity, metabolic diseases and gastrointestinal disorders. Specifically, Rhythm is getting access to the French firm’s ghrelin agonists - potential treatments for disorders such as postoperative ileus and diabetic gastroparesis – and melanocyte-stimulating hormone agonists, which target the melanocortin-4 (MC4) receptor.

Cashwise, Ipsen will receive up to $80 million in milestone payments and royalties on future sales of the products. It is also acquiring a 17% stake in the Boston, Massachusetts-based biotech, giving the firm one seat on Rhythm’s board of directors.

Explaining the rationale behind the deal, Stephane Thiroloix, head of corporate development at Ipsen, said the area of metabolic diseases is “outside of our core strategic focus” so Rhythm is better placed to “rapidly transform these important discoveries into valuable medical treatments”

New Tools for Diabetes

New Tools for Monitoring, Diagnosing Diabetes

A San Diego startup company has hopes of making a major impact on the health care market, with products that offer noninvasive ways to screen for diabetes and perform daily glucose monitoring.

Freedom Meditech Inc. has its headquarters in San Diego and a research facility in Cleveland. The privately financed firm is seeking federal regulatory approval for the development and sale of its ophthalmic diabetes medical devices.

Formed in December 2006, the company is developing products that scan the eye with light to monitor and screen for diabetes. One Freedom Meditech product, a hand-held glucose monitoring device, is aimed at a $10 billion market worldwide.

Painless Glucose Monitoring

“An individual with diabetes does not have to prick their finger to test their blood sugar several times a day,” said President and CEO Craig Misrach.

Freedom Meditech’s device extracts glucose information from the eye.

“It is completely noninvasive,” he said. “We just have light that shines across the eye.’’

The self-administered glucose monitoring tools that are on the market today aren’t always accurate. International standards allow them to have error rates as high as 20 percent. In reality, rate of error can be much higher, said Misrach.

“In our preclinical studies to date, we have demonstrated a less than 8 percent error rate” with the Freedom Meditech device, he said.

“The promise is there for a much better level of accuracy and reliability,” said Dr. Daniel Einhorn, medical director of Scripps Whittier Diabetes Institute. “There are many variables that make current self-glucose monitoring fraught with error.”

Another of the company’s products screens for diabetes and is expected to reach the market ahead of the glucose monitoring device. Designed for use by eye-care professionals, the device has, in clinical studies, demonstrated its ability to detect diabetes without requiring blood to be drawn. The market is estimated at $2 billion worldwide.

“Freedom Meditech aims to revolutionize the way we screen for, diagnose and manage diabetes, through the development of technologies that identify and diagnose patients earlier, improve daily glycemic control, and reduce the economic and personal costs of long-term complications of the disease,” the company said in a prepared statement.

Americans Urged to take Diabetes Risk Test

Americans Urged to take Diabetes Risk Test

Washington, DC (PRWEB) March 11, 2010 -- The Better Hearing Institute (BHI) announced today that it is joining the Stop Diabetes movement by promoting the 22nd Annual American Diabetes Association Alert Day, which will take place on March 23, 2010. BHI also is urging anyone with diabetes to get their hearing checked. To help in the effort, BHI has made available a free, quick, and confidential online hearing test at www.hearingcheck.org to help people with diabetes determine if they need a comprehensive hearing check by a hearing professional.

Hearing loss is about twice as common in adults with diabetes compared to those who do not have the disease, according to a study funded by the National Institutes of Health (NIH) and published in the Annals of Internal Medicine. Yet hearing screenings typically are not part of the regular regimen of care that people with diabetes are routinely recommended to receive. Nor do the vast majority of doctors in today’s health care system include hearing health as a routine part of annual exams, leaving people with diabetes all the more vulnerable to the negative impact that unaddressed hearing loss has on an individual’s life.

"Hearing loss affects virtually every aspect of a person's life, making it all the harder for people with diabetes to cope with their disease,” said Sergei Kochkin, PhD, BHI's executive director. “A hearing check is invaluable in determining whether or not someone with diabetes does have a hearing loss and will help to ensure that they get the treatment they need."

The American Diabetes Association Alert Day is a one-day "wake-up" call to inform the American public about the seriousness of diabetes. The American Diabetes Association (ADA) encourages people to join the movement to Stop Diabetes by taking the Diabetes Risk Test and find out if they, or their loved ones, are at risk for developing type 2 diabetes.

Diabetes is a devastating disease that, according to ADA, affects nearly 24 million Americans. Nearly 6 million Americans are unaware they have diabetes. An additional 57 million, or one in five Americans have pre-diabetes, which puts them at greater risk for developing type 2 diabetes. If current trends continue, one in three children born today will face a future with diabetes.

For many, diagnosis of type 2 diabetes may come seven to ten years after the onset of the disease. Therefore, early diagnosis is critical to successful treatment and delaying or preventing some of its complications such as heart disease, blindness, kidney disease, stroke, amputation and death.

Among the primary risk factors for type 2 diabetes are being overweight, sedentary, over the age of 45, and having a family history of diabetes. African Americans, Hispanics/Latinos, Native Americans, Asian Americans, and Pacific Islanders are at an increased risk, as are women who have had babies weighing more than nine pounds at birth. Studies have shown that type 2 diabetes can be prevented or delayed by losing just five to seven percent of body weight through regular physical activity (30 minutes a day, five days a week) and healthy eating.

"For years, physicians who treat people with diabetes have regularly ensured that their patients receive regular vision check-ups," said Kochkin. "Now we need to ensure that they get their hearing checked as well by encouraging everyone with diabetes to ask their doctors to check their hearing regularly.”

Numerous studies have linked untreated hearing loss to a wide range of physical and emotional conditions, including irritability, negativism, anger, fatigue, tension, stress, depression, avoidance or withdrawal from social situations, social rejection and loneliness, reduced alertness and increased risk to personal safety, impaired memory and ability to learn new tasks, reduced job performance and earning power, and diminished psychological and overall health.

"American Diabetes Association Alert Day is a tremendously valuable initiative because it prompts people to take a simple Diabetes Risk Test and to make changes in the way they live so they can preserve their health," said Kochkin. "It's also important that people with diabetes understand that they may be at an increased risk of hearing loss as a result of their disease. We urge anyone with diabetes to take a quick and confidential online hearing test today, at www.hearingcheck.org, to determine if they need a comprehensive hearing check by a hearing professional."

For more information about American Diabetes Association Alert Day, visit stopdiabetes.com, where anyone can join the movement to Stop Diabetes, take the Diabetes Risk Test, learn secrets to stop diabetes, and easily share tools and resources with loved ones.

Founded in 1973, the BHI conducts research and engages in hearing health education with the goal of helping people with hearing loss to benefit from proper treatment.

Daily Soda Consumption Leads to Diabetes and Heart Disease � eFitnessNow

Daily Soda Consumption Leads to Diabetes and Heart Disease

The soda craze in the US is leading to an alarming rate of diabetes and diabetes related health concerns. Researchers blame the sugary drinks for 130,000 new cases of diabetes in a ten year span. They also attribute all types of sugar sweetened beverages to at least 14,000 new cases of heart disease.

The new research was presented at the American Heart Association’s 50th annual conference. Researchers at the University of California evaluated data gathered on adults over the age of 35 between 1990 and 2000. The findings attribute more than 300 million dollars in healthcare costs can be directly related to the consumption of these sugary beverages.

Litsa Lambrakos who led the study, states there is a direct correlation between the daily consumption of these high sugar drinks and diabetes. The study provides the evidence Americans need to realize the health risks associated with their favorite drinks.

Obesity has also been linked to high-sugar drinks including fruit drinks and sport drinks that are more sugar than actual fruit juice. Each sugar filled drink is packed with approximately 200 calories. In an effort to curb the high consumption rate, lawmakers are proposing a tax on these particular sugar flavored drinks.

Higher Fast Food Prices Lead to Lower Weight, Diabetes Risk

Higher Fast Food Prices Lead to Lower Weight, Diabetes Risk

A new study that followed participants for 20 years shows both weight and risk for diabetes decreased for people in communities where fast food prices increased.

The University of North Carolina at Chapel Hill study, published in the March 8, 2010, issue of Archives of Internal Medicine, also showed the reverse – when fast food prices fell, then consumption, weight and diabetes risks rose.

“These results indicate that increasing the price of fast foods and sodas can affect adult behavior, and steer them toward healthier diets, lower weight and less risk of diabetes,” said senior author Barry Popkin, Ph.D., the Carla Smith Chamblee Distinguished Professor of Nutrition at UNC’s Gillings School of Global Public Health.

Popkin said taxes have been proposed on fast foods and soft drinks in some states, such as New York. In a number of countries, including Denmark and others in Europe, they are used to discourage consumption and encourage healthy diets.

“This study gives us strong scientific evidence that price policies, including taxes, could actually be effective at helping control obesity and the resulting chronic diseases, like diabetes,” Popkin said. “Our results provide robust evidence to support the potential health benefits of taxing selected foods and beverages as a way of improving public health.”

Popkin and his colleagues used data from more than 5,000 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study. When it started in 1985, CARDIA participants lived in four U.S. cities. In the intervening years, participants have moved to 48 states. Researchers collected information on the average prices of products, including restaurant pizza, burgers, soft drinks and whole milk in the counties in which each participant lived. Prices were adjusted to 2006 levels.

When researchers analyzed the diet, weight and insulin levels of study participants, they found that when prices of fast foods and sodas went up just 10 percent, participants consumed on average 7.1 percent fewer calories from soda and 11.5 percent fewer calories from pizza. That translates to about 56 calories a day less, which corresponds to a reduction of about 3 to 4 pounds a year per person, Popkin said. The participants who found their fast food prices rose also gained less weight and had a lower risk for diabetes based on a test for fasting insulin (HOMA-IR).

Taxation, particularly in the form of an excise tax, could be helpful as such measures were successful in the case of smoking cessation efforts, Popkin said.

“For these fast foods, taxes would represent the most effective way to reduce adult obesity that we have today, based on this research,” Popkin said. He also noted that cigarette taxes have been found to have a much larger effect on teenage versus adult smoking and he would expect that fast food taxes on children and teens would similarly have a larger effect than on adults.

Other study authors are Kiyah Duffey, Ph.D., postdoctoral fellow at the UNC Interdisciplinary Obesity Center; Penny Gordon-Larsen, Ph.D., UNC associate professor of nutrition; David Guilkey, Ph.D., Boshamer Distinguished Professor of Economics in the College of Arts and Sciences; James Shikany, Dr.P.H., associate professor of preventive medicine, University of Alabama at Birmingham; and David R. Jacobs, Jr., Ph.D., epidemiology professor, University of Minnesota, Minn. Popkin, Gordon-Larsen and Guilkey also are fellows at the UNC Carolina Population Center and Duffey is a graduate research assistant there.

Health times: Diabetes is more than the sugar blues

Health times: Diabetes is more than the sugar blues

I was getting that deer-in-the-headlights, open-mouthed look as I reviewed Mrs. Brown's lab results. It's not as dreadful as telling someone that they have cancer, but a diabetes diagnosis almost always triggers that look of disbelief and distress.

Happily, Mrs. Brown moved past that to a look of determination, asking, “So what can I do about this? I don't want to be on medicines unless I have to. I normally eat well and walk regularly. But I've had a knee injury that's been dragging on for months. So I've been doing almost no exercise and I've packed on about 20 extra pounds.”

It seems like these conversations are more and more frequent in my practice. Tennessee ranks sixth among the 50 states for prevalence of diabetes. It is no coincidence that we also rank fourth in obesity with over 30 percent of our adults being obese. Even though genetics plays a role, type 2 diabetes (often called “adult onset” or “non-insulin-dependent” diabetes) is closely tied to obesity and a sedentary lifestyle — two factors that increasingly describe a large portion of our population. Ninety percent of all diabetes in the U.S. is type 2; almost 25 million people have it. It's estimated that a third of the cases are undiagnosed.

Wouldn't you know if you had it? Not necessarily. Mrs. Brown's reaction was not uncommon: “But I feel fine.” In the early stages of type 2 diabetes, there may be few symptoms: perhaps a little more frequent urination, increased thirst, occasional blurred vision, increased yeast infections. Often there may be no symptoms at all.

Yet the damage is beginning — damage that can result in permanent harm to the nerves, kidneys, vision and circulation, and eventually result in heart attacks, strokes, and occasionally, amputations.

So how do I find out if I have it? A simple blood test can do the job. A glucose tolerance test can be done. But more often the diagnosis is based on a fasting blood sugar greater than 125, a random blood sugar of 200 or higher, or a hemoglobin A1C (HbA1C) of 6.5 or higher.

HbA1C is a poorly named blood test. But it is exceedingly helpful; it reflects the previous three months of average blood sugars. So it can track whether your blood sugar is headed up or down. If you're headed toward a HbA1C of 6.5, that's a red flag.

But, if you have a HbA1C of 6.1, and for the next three months you exercise, eat well and shave off 10 pounds to lower it to 5.7, you've made excellent progress!

In diabetics, we generally get this test every three months to track how well their overall glucose (blood sugar) control is doing. In “pre-diabetics” (the official term is “impaired glucose tolerance”), I also check it every few months to monitor how a patient's diabetes prevention efforts are doing and, worst case, to at least make an early diagnosis and begin treatment if they moved into diabetes. And speaking of prevention and treatment, let's dig into that next time — there's lots of hopeful possibilities there.

Dr. Andrew Smith is board-certified in family medicine and practices at 1503 E. Lamar Alexander Parkway, Maryville.

Pregnancy Pounds Add up to Diabetes | Ivanhoe's Medical Breakthroughs

Pregnancy Pounds Add up to Diabetes

Women who gain excessive weight during pregnancy, especially in the first trimester, may increase their risk of developing diabetes later in pregnancy.

A three-year study by the Kaiser Permanente Division of Research of 1,145 pregnant women from an ethnically diverse population found that women who gained more weight than is recommended by the Institute of Medicine had a 50 percent increased risk of developing gestational diabetes mellitus (GDM). The association between pregnancy weight gain and gestational diabetes was more pronounced among overweight and non-white women. The study included 345 pregnant women with gestational diabetes and 800 pregnant women without gestational diabetes.

Gestational diabetes is defined as glucose intolerance that typically occurs during the second or third trimester of pregnancy. It causes complications in as many as seven percent of pregnancies in the United States. It can lead to early delivery, C-sections and type 2 diabetes, and can increase the child's risk of developing diabetes and obesity later in life.

The study followed women members of Kaiser Permanente Northern California region and examined their overall rate of pregnancy weight gain up to the time of screening for gestational diabetes (typically between 24-28 weeks), as well as the trimester-specific rates of weight gain compared to the Institute of Medicine's 2009 guidelines for recommended pregnancy weight gain.

After adjusting for age at delivery, race/ethnicity, previous births, and pre-pregnancy body mass index, the risk of gestational diabetes increased with increasing rates of pregnancy weight gain. Women who exceeded the IOM guidelines for weight gain had a 50 percent increase in the risk of gestational diabetes compared to women who gained within or below the IOM recommendations.

The researchers hypothesized that rapid weight gain early in pregnancy may result in an early increase in insulin resistance that leads to the "exhaustion" of the beta-cells in the pancreas that make and release insulin, which controls the level of glucose in the blood. This could reduce beta-cells' capacity to secrete adequate levels of insulin to compensate for the insulin resistance induced by the progression of pregnancy and therefore lead to the development of gestational diabetes.

Lead author Monique Hedderson, Ph.D., at the Kaiser Permanente Division of Research, was quoted as saying, "Health care providers should talk to their patients early in their pregnancy about the appropriate gestational weight gain, especially during the first trimester, and help women monitor their weight gain. Our research shows that weight gain in early pregnancy is a modifiable risk factor for gestational diabetes. Randomized studies are needed to determine the feasibility of this early intervention and the best methods to help women meet the IOM recommendations."

SOURCE: Obstetrics and Gynecology, February 22, 2010

Remove Diabetes Drug Avandia From Market: FDA Reports - US News and World Report

Remove Diabetes Drug Avandia From Market: FDA Reports - US News and World Report

The blockbuster type 2 diabetes drug Avandia raises users' odds for heart attack and heart failure and should be removed from the market, according to confidential government reports.

The New York Times on Saturday reported on documents from the U.S. Food and Drug Administration that find that if people now taking (rosiglitazone) Avandia switched to a similar medication, Actos, about 500 heart attacks and 300 cases of heart failure would be eliminated each month. And in a report from the Institute for Safe Medication Practice, Avandia was linked to 304 deaths in the third quarter of 2009 alone, the highest for any prescribed drug in that time period, the Times reported.

In one of the FDA documents, dated October 2008, Drs. David Graham and Kate Gelperin -- drug safety officials at the agency -- agreed that "rosiglitazone should be removed from the market."

The reports, obtained early by the Times, are yet another chapter in Avandia's checkered history. The drug was once taken by millions worldwide, but that changed after a study released in early May of 2007 by the Cleveland Clinic suggested that Avandia carried cardiovascular risks. That study, which included more than 28,000 people, found that Avandia increased a user's odds of heart attack by 43 percent compared to those not taking the medicine.

At the time, Dr. Bruce M. Psaty of the University of Washington -- who also co-wrote an accompanying editorial in the New England Journal of Medicine -- urged the FDA to restrict access to Avandia and cited both the agency and the drug's maker, GlaxoSmithKline, for poor oversight.

"The primary problem here is that studies that were needed early on about the health benefits of this drug were never done," Psaty told HealthDay. "As a result of the failure of the sponsor to do long-term clinical trials to show health benefits, as a result of the failure of the FDA to insist on it, we have data that are weak."

Following on the Cleveland Clinic study, the FDA demanded "black box" warnings on labeling for both Avandia and Actos, warning of a potentially heightened risks for heart failure. However, other studies found no raised level of heart risk, and at the time the agency said it had not reached a definitive conclusion on the data.

In November of the same year, the FDA updated Avandia's labeling to include a caution regarding heart attack risk. At the time, Dr. Janet Woodcock, acting director of the FDA's Center for Drug Evaluation and Research, said that, "we are keeping Avandia on the market because we have concluded there isn't enough evidence to indicate that the risk of heart attack is higher for Avandia than other type 2 diabetes treatments."

The story got more complicated in 2008, as a number of studies emerged tying the use of Avandia to increased bone fracture risk.

Throughout 2009, more studies reiterating the drug's heart risks also came to light, including one published in the BMJ suggesting that Avandia's risk for heart failure seemed to outstrip those of its related rival, Actos.

By that point, "most clinicians [had] stopped using Avandia -- some will use Actos instead or go to another class completely," Dr. Carl J. Lavie, medical director of cardiac rehabilitation at the Ochsner Heart and Vascular Institute in New Orleans, told HealthDay at the time.

The emergence of the leaked documents on Saturday comes at a time when officials within the FDA seem to be at loggerheads over whether to ban Avandia or not, the Times reported. The newspaper said that some officials believe that safer alternatives exist, while others say the evidence on Avandia's safety is conflicted and the drug should remain available as a treatment option.

Trying to sort things out, in December of 2009 Woodcock asked officials at the FDA to convene another advisory committee to determine whether Avandia should remain on the market, with a decision expected this summer.

In the meantime, a bipartisan Senate investigation -- overseen by Sen. Max Baucus (D-Mont.) and Sen. Charles E. Grassley(R-Iowa) -- has pored over 250,00 internal documents from GlaxoSmithKline. The investigation has placed much of the blame for the Avandia debacle on the company, contending that it neglected to warn patients for years of the drug's dangers.

Newer Blood Test Predicts Diabetes, Heart Disease: MedlinePlus

Newer Blood Test Predicts Diabetes, Heart Disease

WEDNESDAY, March 3 (Health Day News) -- The newer hemoglobin A1C test predicts diabetes as well as the traditional fasting blood sugar test, but it beats that old standard in predicting a patient's future risk of heart disease and stroke, new research shows.

After adjusting for common cardiovascular disease risk factors, the study found that while A1C levels high enough to diagnose diabetes were associated with nearly twice the risk of coronary heart disease, no such association was found with fasting glucose readings high enough to trigger a diabetes diagnosis.

The A1C test is also known as a glycated hemoglobin test, and using a small blood sample, it measures your average blood sugar levels for the past two to three months.

"Our data show that glycated hemoglobin is a really potent risk factor for diabetes and cardiovascular disease. If you have abnormal glycated hemoglobin results, you should be targeted for diabetes and cardiovascular disease interventions," said the study's lead author, Elizabeth Selvin, an assistant professor of epidemiology and medicine in the department of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

In January, the American Diabetes Association (ADA) recommended that doctors could begin using the A1C test for diagnosis of diabetes. Previously, the test wasn't recommended because it hadn't been standardized from lab to lab. The ADA set the level for diagnosis of diabetes at 6.5 percent or higher, and the diagnosis of pre-diabetes for levels of 5.7 to 6.4 percent.

The A1C percentage is the amount of a person's hemoglobin that is glycated or glycosylated.

For the current study, Selvin and her colleagues measured A1C from more than 11,000 stored blood samples from the Atherosclerosis Risk in Communities Study, which began in 1990. None of the study volunteers had diabetes or cardiovascular disease at the time the blood samples were taken.

The researchers then compared the A1C levels to fasting blood sugar levels and to the 15 years of overall health follow-up information gathered for the previous study.

During that time, 2,251 people were diagnosed with diabetes, nearly 1,200 were diagnosed with heart disease and 358 people had an ischemic (non-bleeding) stroke, according to the study.

As expected, the researchers found that elevated A1C levels were associated with an increased risk of being diagnosed with diabetes. Those with an A1C of less than 5 percent had a 48 percent reduced risk of diabetes, while people whose A1Cs were between 5 and 5.5 percent had a normal risk of diabetes. From there, however, the risk quickly went up. Those with an A1C of 5.5 to 6 percent had an 86 percent increased risk of diabetes. For those between 6 and 6.5 percent, the risk more than quadrupled. For people with levels above 6.5 percent, the odds of being diagnosed were more than 16 times higher than for someone with levels under 5.5 percent. These results were similar to those for fasting glucose levels, the study authors noted.

Where fasting glucose and A1C differed greatly, however, was in the prediction of future heart disease and stroke risk. While fasting glucose failed to predict future risk, the study found that A1C levels accurately did so.

People with A1Cs under 5.5 percent had an average risk of heart disease and stroke, but for people with an A1C between 5.5 and 6 percent, the risk went up 23 percent. For those with an A1C between 6 and 6.5 percent, the risk of cardiovascular disease jumped to 78 percent. When A1C went over 6.5 percent, the risk of cardiovascular disease went up nearly twofold.

Results of the study are published in the March 4 issue of the New England Journal of Medicine.

"This is a test that's been around for a long time, and the old dictum was that it couldn't be used to predict cardiovascular disease," said Dr. Rafael Gonzalez, director of cardiology at Scott & White Healthcare in Round Rock, Texas. "But this study shows it may be a great marker -- the higher the A1C, the greater the risk. This tells us we may need to be more aggressive with prevention in people with higher levels, maybe push for lower LDL (bad) cholesterol, emphasize lifestyle factors," he explained.

"Diabetes is like high blood pressure -- the consequences don't come right away. And, sometimes that makes people think, 'Why do I need to be on this medicine?' So, this is further evidence, and may be a good way to get people's attention," Gonzalez added.

Walk honors Kelso boy's struggle with diabetes

Walk honors Kelso boy's struggle with diabetes

The LaFave family of Kelso has been in numerous walkathons for juvenile diabetes research, but Friday's event at Coweeman Middle School was truly a family affair. It was organized by the older LaFave siblings to honor their younger brother's struggle with the condition.

The entire Coweeman student body and staff took turns walking around the gym Friday in three shifts to raise money for diabetes research in classmate Ryan LaFave's honor. Friends and family also took park, as well as the Family House Academy and the shift crew from Cowlitz 2 Fire & Rescue, where Ryan's dad, Dave LaFave, is fire chief.

Figures are still being tallied, but regional diabetes association officials working with the LaFaves think they'll break $5,000 by the time everything is said and done.

"That much money would be great," said 18-year-old Jake LaFave, who organized the walk with his twin sister Lacey. "It's cool to see everyone come together for one common cause."

Ryan, 14, was born with both Down syndrome and juvenile diabetes and recently struggled with non-diabetes related kidney problems.

The family has participated in a number of regional diabetes research fundraisers and organized two locally that raised $65,000 combined. So when Lacey and Jake started thinking about their required senior project at Kelso High School, it only seemed natural to center it on Ryan.

"It all just comes back to my brother," Jake said Thursday. "He's the whole reason (for this). He plays a big role in our lives."

Ryan, an eighth-grader at Coweeman, was born with diabetes, but the condition also can develop from a sedentary lifestyle or poor diet. The LaFaves said they wanted Ryan's classmates to know all the risk factors.

"We knew we wanted to do it at Coweeman because it was about Ryan and we wanted his friends to be aware and teach them how personal habits can bring this on," Lacey said. "Not everyone realizes that because he also has Down syndrome. But the difference is Down is just something you're born with, but diabetes can be brought on (by lifestyle)."

Ryan's mother, Amy LaFave, has organized the previous fundraisers. Friday, she said the hardest but proudest part was stepping back and letting Jake and Lacey handle things this time.

"It's a different role for me," she said, beaming as Jake, Lacey and Ryan all took laps around the gym Friday morning.

"This has really been the Lacey and Jake show," said Elizabeth Squires, special events manager with the Juvenile Diabetes Research Foundation in Portland. "They've really rocked and rolled pulling this together."

Seventh-grader Savannah Casey took part in the march because her grandmother and several other family members have diabetes.

"It can make you really sick," she said in between laps Friday.

People with diabetes either don't produce or properly absorb insulin, a hormone that regulates blood sugar. Insulin instead has to be replaced with regular injections - three a day for Ryan until he got an external insulin pump that regulates insulin as needed.

The LaFave's hope diabetes research will someday lead to a cure instead of just maintenance treatment. Friday, though, they were just happy to see the walk become a reality.

"I just think it's cool that the kids are all doing it for Ryan," Lacey said.

Jake added: "Even if we didn't raise much money it would just be good letting everyone know what diabetes is all about.".

Boosting Vitamin D levels with age could curb heart disease and diabetes

Boosting Vitamin D levels with age could curb heart disease and diabetes

A review of studies performed by researchers from Warwick University shows that high levels of vitamin D in older people could help prevent heart disease and diabetes in older individuals. Vitamin D levels that were higher significantly decreased the risk of diabetes, metabolic syndrome and cardiovascular disease.

The study review revealed a 33 percent lower risk of heart disease in men and women from various ethnic groups, compared to low levels of vitamin D in 28 studies that included 99,745 participants. The risk of type II diabetes from high levels of vitamin D was reduced 55 percent, and metabolic syndrome risk declined by 51 percent.

The study, led by Johanna Parker and Dr Oscar Franco, Assistant Professor in Public Health at Warwick Medical School included publications from 1990 and 2009 from the US, Europe, Australasia, Iran and India.

Dr. Franco says, "We found that high levels of vitamin D among middle age and elderly populations are associated with a substantial decrease in cardiovascular disease, type 2 diabetes and metabolic syndrome", findings that are significant for curbing increasing rates of cardiovascular disease as well as the alarming incidence of type II diabetes.

Vitamin D from food sources, that include tuna, mackerel, salmon, fortified cereals and dairy products, sunlight, or supplements could reduce heart disease or diabetes by 43 percent among middle age and older individuals according to the findings.

Low levels of vitamin D has also been linked to increased chances of cancer, inability to lose weight, asthma, chronic pain, and greater risk of colds and flu. The new study shows that higher levels of vitamin D could provide substantial protection from cardiometabolic disorders that include heart disease and type II diabetes among older adults.

Walker takes sand, sun and diabetes in his stride

Walker takes sand, sun and diabetes in his stride

WITHOUT constant awareness and regular medical intervention, within hours Alex Williams would be delirious as his blood sugar burnt away - and by the next day he would be dead.

The 52-year-old is a type 1 diabetic, so every meal is a challenge to his system. Even moderate exercise threatens his health.

He doesn't strike you as the ideal competitor for a six-day marathon across the Sahara Desert. But today the chatty banking IT expert is pounding a trail on Wilsons Promontory in preparation for one of the most gruelling challenges on the planet.

Partly to help educate people about the disease, partly to raise money for research into a cure, and more than slightly out of sheer bloody-mindedness, Mr Williams will compete in the Marathon des Sables in April.

The Marathon of the Sands is a six-day, 250-kilometre ultra-marathon through the dunes, mountains and rocky desert-scapes of Morocco.

On the longest single stage of 90 kilometres - taking Mr Williams almost 24 hours - temperatures can nudge 50 degrees and a fifth of the course is along slippery dunes. Past races were hit by a week-long sandstorm and a plague of crickets. It has killed healthy runners (or walkers), who carry their belongings and food for the entire event in backpacks.

After reading about it two years ago, Mr Williams decided he would give it a go.

''My family used to live in Saudi Arabia and I fell in love with the desert,'' he said. ''I gave myself two years to train and prepare. I knew this was literally life and death, and I needed a lot of training.

''There have been a number of moments that I have wondered, 'What have I let myself in for?' ''

Having walked the 100-kilometre Oxfam trail in 2003, he knew the accumulation of fatigue in a long event. ''Boy, did I suffer,'' he said. ''And this is going to be something else again.''

First he had to get fit. By November 2008 he could cover a marathon distance. He used Google Earth to plot a 100-kilometre track through Wilsons Promontory for monthly ultramarathon tests, but twice he lost the trail in the dead of night and had to find shelter.

''I had to stop and wait until morning in the freezing cold and rain,'' he said. ''I slept on a rock under my poncho, and I had to remember to keep up my injections and food. Diabetes never goes away.''

The second part of his preparation was to deal with his diabetes. Exercise burns carbohydrates, and the disease leaves his body unable to naturally balance that loss.

The first sign of low blood sugar is mental confusion, so he has learnt some mental gymnastics, such as counting backwards from 10 in Arabic, to test himself regularly for hypoglycaemia.

He has found fruit strips from a company in NSW that deliver an energy hit, and has calculated the exact time and distance before he needs another. A bag of almonds provides variety to this monotonous, sticky diet.

He must inject insulin, and he has hooked up a satellite GPS tracking system so friends and relatives can follow his every move over the internet.

Finally, he has to deal with the heat. ''I have experienced the heat of the desert. It's diabolical,'' he said.

A special hat covers almost his entire head. A long-sleeved shirt and sand-coloured pants keep cool air moving about his body, and his bag is packed with sunscreen.

Is he ready? In a way, this race is like his disease: an enemy he knows he cannot dismiss, but he is ready to face.

''Physically I have reached a pinnacle. I'm as ready as I will ever be,'' he said. ''Medically … it's something I cannot guarantee. All you can do is be prepared. It's like all type 1 diabetes. All you can do is prepare, learn as much as you can about yourself, and work out what the risks will be.''

Mr Williams hopes to raise $100,000 for the Juvenile Diabetes Research Foundation to support diabetes research in Australia.