Wednesday, 30 June 2010

New Genes Linked to Type 2 Diabetes

New Genes Linked to Type 2 Diabetes

London: Scientists have identified a dozen new genes linked to the most common form of diabetes, bringing the known total to 38.

Researchers at Edinburgh University hope to search for better ways of preventing and treating the Type 2 diabetes, which alters levels of insulin, the body's sugar-regulating hormone.

The genes are involved in the function of insulin-producing pancreatic cells, the control of insulin's action in the body, and the regulation of cell growth.

"One important theme is that several of the genes seem to be important in controlling the number of pancreatic beta-cells that an individual has," Nature quoted Professor Mark McCarthy, of Oxford University, as saying.

According to Dr Jim Wilson, a member of the research team from the University of Edinburgh, regulation of these genes can lead to many different diseases because they contain variants that increase the risk of unrelated diseases, including skin and prostate cancer, coronary heart disease and high cholesterol.

The research was published yesterday in the journal Nature Genetics.

Monday, 28 June 2010

Liver at 50% Greater Risk in Diabetes

Liver at 50% Greater Risk in Diabetes

According to Gillian Booth, MD, MSc, of St. Michael's Hospital in Toronto, in a population-based study, newly-diagnosed diabetes was associated with a near doubling in the rate of liver cirrhosis, liver failure, or liver transplant compared with people in the general population who did not have diabetes.

After adjusting for important contributors to liver disease, the association remained significant with a 77% increased risk for newly-diagnosed diabetes patients (95% confidence interval 68% to 86%).

"The negative impact of diabetes on the retinal, renal, nervous, and cardiovascular systems is well recognized, yet little is known about its effect on the liver," they wrote.

According to Kenneth Cusi, MD, who has been studying this condition at the University of Texas Health Science Center in San Antonio, although much still remains to be discovered about the mechanisms and cause of the link between diabetes and liver disease, nonalcoholic steatohepatitis (NASH) is almost certainly involved.

"Steatosis is known to arise in relationship to insulin resistance in obesity, and most people with the condition do have some degree of glucose abnormality.... The two seem to 'feed on each other'."

Unlike with eye disease, cardiovascular disease, and kidney disease, guidelines for diabetes care don't recommend screening for liver disease.

"However, when the liver fails," Booth's group cautioned in the paper, "there is no equivalent form of management, such as hemodialysis or retinal photocoagulation."

They suggested that liver disease "may be appropriate for addition to the list of target-organ conditions related to diabetes," with annual screening by means of a blood test, such as for the liver enzyme alanine aminotransferase.

But the sensitivity of blood tests and even ultrasound aren't great for identifying fatty liver disease that is the precursor to more serious liver problems and liver biopsy is not a feasible screening method, Cusi noted.

Also, it would first have to be shown that preventive measures such as weight loss and glycemic and lipid control are effective in diabetes, as they are in isolated fatty liver without diabetes, the researchers said.

To expand evidence for the link, the researchers retrospectively examined the administrative databases of the universal healthcare system in the province of Ontario from 1994 through 2006.

They compared 438,069 adults with newly diagnosed diabetes and an age-, sex-, and regionally-matched control group of 2,059,708 individuals without known diabetes. Preexisting liver or alcohol-related disease were cause for exclusion.

During a median of 6.4 years of follow-up, serious liver disease -- liver cirrhosis, liver failure, or liver transplant -- developed in 2,463 newly-diagnosed diabetes cases and 5,902 controls.

Thus, unadjusted liver disease incidence was 92% higher with diabetes (8.19 per 10,000 person-years with diabetes and 4.17 without it).

This difference remained significant across mutually-adjusted patient subgroups by age, gender, urban versus rural residence, and income level.

Diabetes appeared to have the most pronounced link with liver and the least with liver transplantation.

Hypertension and obesity didn't appear to entirely account for the relationship with diabetes. The risk of serious liver disease in nondiabetic individuals with preexisting hypertension or obesity was elevated but less so than among those with diabetes.

But the researchers cautioned that it is difficult to separate out the effects of these related conditions.

"Although our findings and those of the U.S. study [which found elevated chronic NASH risk in veterans with diabetes] edge forward the idea that diabetes may be harmful to the liver, the question remains of whether this effect extends beyond the metabolic syndrome," they wrote.

Another question that remains to be answered is causality.

Booth's group pointed out that hepatic fat content rises in parallel with insulin resistance and glucose dysregulation and that diabetes as a complication of cirrhosis typically doesn't arise until cirrhosis reaches an advanced stage.

However, they noted, they couldn't rule out the pre-existence of subclinical liver disease before study entry.

Saturday, 26 June 2010

Diabetes Doubles Heart Disease Risk

Diabetes Doubles Heart Disease Risk

Diabetes doubles the risk of heart disease and strokes, a study has shown - but scientists are still uncertain why.

The new findings confirm diabetes is strongly associated with disorders linked to the health of blood vessels.

One in 10 deaths from heart and artery diseases - around 325,000 a year in all the industrialised countries combined - are now thought to be due to diabetes.

But only a small fraction of the harmful effects can be explained by known risk factors including high levels of blood fats, high blood pressure, and obesity, the research showed.

Scientists also found higher-than-average blood sugar levels in people without diabetes were only weakly related to cardiovascular disease. High blood sugar is the key hazard of diabetes.

The findings suggest diabetes damages blood vessels through other undisclosed pathways.

An international group of researchers led by Cambridge University scientists analysed data from 102 studies in 25 countries involving 700,000 participants.

They found having diabetes roughly doubled the risk of developing heart disease or suffering different kinds of stroke.

Dr Nadeem Sarwar, one of the Cambridge scientists, said: "Our findings highlight the need for better prevention of diabetes coupled with greater investigation of the mechanisms by which diabetes increases the risk of cardiovascular disease."

The research appears in The Lancet medical journal and was also presented at a meeting of the American Diabetes Association in Orlando, Florida.

Friday, 25 June 2010

New Type 1 Diabetes Treatment Shows Promise

New Type 1 Diabetes Treatment Shows Promise

City of Hope researchers have found that bone marrow transplantation with islet cell transplantation shows promise as a treatment for late-stage Type 1 diabetes.

Islet cells come from the pancreas. The cells from this combination of treatments could enable diabetics to once again make their own insulin.

Results from laboratory research, led by Dr. Defu Zeng, an associate professor in the departments of Diabetes Research and Hematology & Hematopoietic Cell Transplantation at City of Hope in Duarte, were published online this month in the journal "Diabetes."

In Type 1 diabetes, patients' immune cells mistakenly attack insulin-producing cells in the pancreas, decimating the cells and leaving patients without enough insulin to function.

More than 23.6 million people in the United States have been diagnosed with diabetes, and an estimated 5 to 10 percent of these individuals have Type 1 diabetes, according to the American Diabetes Association.

One investigational therapy for severe Type 1 diabetes is islet cell transplantation, a procedure in which physicians transplant donated islet cells into the patient's liver, where they can engraft, take root and produce insulin.

Yet, there are several challenges to long-term islet transplantation success. Patients' immune cells may again attack the transplanted cells, and immunosuppressive medications sometimes keep the new cells from properly functioning. The liver also can be an inhospitable site for these transplanted cells.

"Islet cell transplants usually only provide two to three years of insulin independence for most recipients," said co-lead author Dr. Miao Wang, a postdoctoral fellow in Zeng's lab. "We wanted to find a way to extend that insulin independence."

Wednesday, 23 June 2010

Middle Age Spread Raises Risk of Diabetes

Middle Age Spread Raises Risk of Diabetes

Putting on a stone and a half in weight between the age of 50 and 65 triples the risk of developing type two diabetes, researchers have found.

So-called middle-age spread poses a real danger to health as people age, American research has found.

The study, conducted by a team at University of Washington in Seattle, found the regardless of a person's weight at age 50, if they gained 20 pounds or more they were three times more likely to develop diabetes than those who did not gain weight.

Those who were already classed as obese at age 50 and then gained a further 20 pounds were five times more likely to develop type two diabetes compared with those who were not obese and did not gain weight.

The findings are published in the Journal of the American Medical Association.

The study also found that people who gained weight around their middle also increased their risk of diabetes.

There area thought to be around two million people in Britain with diabetes, and type two is the most common form.

Lead author Dr Mary Biggs said: "The results of this study affirm the importance of maintaining optimal weight during middle age for prevention of diabetes and, while requiring confirmation, suggest that weight control remains important in reducing diabetes risk among adults 65 years of age and older."

Food Items that Aggravate and Control Diabetes

Food Items that Aggravate and Control Diabetes

A recently conducted study has revealed the food items to consume and to avoid in order to prevent the development of diabetes as well as preventing the disease completely. The research study has been conducted by a group of researchers from the American Diabetes Association of Harvard Medical School.

Making certain lifestyle and dietary changes can help keep a tab on the development of diabetes. The report also suggested that regular workout also helps to control the blood sugar.

Foods which may help cut down its development are citrus fruits, onions and cinnamon which may help regulate insulin activity, oatmeal cereal which helps control blood sugar and fat free dairy which helps cut down food cravings. The researchers said that diabetic patients should continue the balanced diet which is recommended for overall healthy living however, they should watch out for their weight, cholesterol level and blood sugar.

In addition, they said that consuming fiber-rich foods are essential as they slow down the digestion process thus making the patients feel fuller for longer periods.

Monday, 21 June 2010

American Diabetes Month

American Diabetes Month

November is American Diabetes Month®—a time to shine a spotlight on a serious disease that leads to potentially life-threatening complications such as heart disease, stroke, kidney disease, blindness, and amputation.

Consider that:

  • 24 million children and adults in the United States live with diabetes
  • 57 million Americans are at risk for type 2 diabetes
  • 1 out of every 3 children born today will face a future with diabetes if current trends continue

Sunday, 20 June 2010

Amputation Adds to Pain of Diabetics

Amputation Adds to Pain of Diabetics

William Harris used to play ball with his grandchildren in the backyard, walk to the store with his wife, and every day he got behind the wheel of a big rig as a professional truck driver.

All that's changed now. The 54-year-old Simpsonville man had parts of both feet amputated as a result of diabetes. And there's no guarantee he won't have to endure more.

“It's devastating,” he said. “I went to the hospital on a Thursday and on Saturday I was having an amputation.”

Sadly, Harris's case isn't unusual. There is one major amputation in a diabetic every three days at Greenville Memorial Hospital, according to Dr. John York, a vascular surgeon who performs these operations.

“It's a cruel disease,” he said.

Diabetes is an illness that causes high blood glucose levels that can have serious complications, including blindness, kidney failure, heart attack, stroke and amputation, according to the state Department of Health and Environmental Control.

Nationally, South Carolina ranks 10th in diabetes, DHEC reports. It afflicts almost 10 percent of the population, or about 350,000 people, disproportionately affecting blacks. And it kills about 3,000 every year, reducing lifespan by five to 10 years.

Among the 25 million diabetics in the United States, there are a striking 80,000 amputations each year, York said.

This surgery is typically needed when a patient develops a foot sore that doesn't heal, he said.

Diabetics can develop nerve damage that limits sensation in their feet. They don't heal well either. So when they get a sore, they might not notice it until it's gone so far that it puts them at risk for systemic infection and even death, York said.

It can happen to anyone with the condition, but is most common in those with Type 2 diabetes who “walk a hole in their foot,” he said. And those with poorly controlled diabetes are more prone to develop infections, he said.

But controlling diabetes can be complicated and inconvenient, requiring frequent blood glucose testing, dietary changes, exercise, regular foot care and medications, which can include insulin injections. And DHEC reports that half of all diabetics in the state check their blood glucose less than once a day.

“It's hard to get people to really be compliant,” said York, medical director of GHS's Institute for Vascular Health wound care center. “It's very challenging and frustrating too.”

And treating diabetes can be costly, forcing some patients to go without regular doctor visits or expensive drugs.

Diabetes runs the nation $116 billion in health care costs a year, accounting for about $1 of every $10 health care dollars spent, according to the American Diabetes Association. Medicare pays for more than half the cost, DHEC reports.

Harris' problems started with a couple of bruised toes.

Knowing he had a strong family history of diabetes, he'd seen the doctor and was diagnosed as pre-diabetic and prescribed medication. But he'd never heard anything about amputation as a possible consequence of the disease, and was shocked when it happened to him.

“I never thought this would happen,” he says. “No one in my family had anything like this.”

His infection also spread quickly, causing so much pain he couldn't sleep, and changed the appearance of his toes. He showed them to his wife of 35 years, Juanita.

“They were hurting me,” he says. “Two days later, they kind of turned to jelly on both feet.”

Surgeons wound up amputating his right foot almost to the ankle and a good portion of his left foot as well. He spent three months in the hospital, including 38 days in a hyperbaric chamber to promote healing.

It's limited his mobility, affecting his ability to take care of basic needs. And not being able to work has been an emotional struggle.

“I worked 21 years in the textile industry and when that folded, I got into truck driving. I worked all my life. Now everything has changed,” says the father of three and grandfather of three.

Though he mainly uses a wheelchair, Harris can walk a bit with a cane and prosthetic shoes. He's on 17 different medications and doesn't think the pain will ever disappear.

While his condition is under control now, he says it could flare up at any time. And after what he's been through, he says the number of amputations at the hospital is no longer a shock.

“I've met a lot of people who are a lot worse off than I am,” he says. “I'll just continue on and do the best I can.”

York said the hospital hopes to open a new center within the next year that's aimed at averting these infections in patients, and consequently, the amputations.

“Across the county, this has led to a decrease in amputation rates of up to 60 percent annually,” he said. “The only way we're going to impact this is on the front end with preventive measures.”

Cut Your Risk for Diabetes

Cut Your Risk for Diabetes - Switch to Brown Rice

Harvard scientists were interested in looking at the connection between rice and diabetes because different forms of the grain have a very different “glycemic index.” That index is a measure of how quickly the body can break starches down into simple sugars, which can raise the body’s blood-sugar level, possibly contributing to diabetes. The body generally turns milled grains, such as white rice or white flour, into sugars more quickly than whole grains, such as brown rice or whole-wheat flour.

Sifting data on the health and eating habits of close to 200,000 doctors and nurses, the researchers found that people who ate five or more servings of white rice per week had a 17 percent higher risk of developing diabetes than people who rarely eat white rice. Eating at least two weekly servings of brown rice cut diabetes risk by 11 percent, compared to people who rarely eat the whole grain. Combining the two findings, the scientists estimate in the Archives of Internal Medicine that people who commonly eat white rice could cut their diabetes risk by 36 percent if they switched entirely to brown rice.

Friday, 18 June 2010

Diabetes Diagnoses Expected to Surge

Diabetes Diagnoses Expected to Surge

About 1.9 million Canadians could develop diabetes between 2007 and 2017, according to a new report.

The Institute for Clinical Evaluative Sciences led the report, released Wednesday. The projections work out to about nine out of 100 Canadians predicted to get diagnosed with diabetes during the 10-year period, based on their weight and other risk factors.

Using a body mass index (BMI) of between 25 and 30 to define overweight, the researchers said 712,000 cases of diabetes are predicted to develop among this group, while 247,000 cases are expected to develop among the very obese, with a BMI of more than 35.

Previously, it was thought that only highly obese people were at risk and needed to be targeted with prevention strategies. But the report shows new cases of diabetes will occur throughout society, said the study's principal investigator, Dr. Doug Manuel, a scientist at ICES and the Ottawa Hospital Research Institute.

"If we want to make an impact, a preventive strategy will need to involve all of society," said Manuel.

"We can't rely solely on our doctors and nurses to help us prevent diabetes. We need to reaffirm our commitment to making our communities a healthy place to live."

In healthier communities, it is safer and easier to walk and better food choices are more readily available and affordable.

If Canadians 20 and older could lower their weight by 3.3 per cent, the researchers estimated, 10 per cent of new cases of diabetes could be prevented, based on data from Ontario's population.

The study also found diabetes risk increases with age.

Sex, income risk differences

Men have a higher risk of diabetes compared to women. Women with lower incomes have both a higher diabetes rate and more estimated new cases compared to women with higher incomes, while in men, the difference was smaller across income groups.

"This pattern of diabetes risk is related to differences in obesity between income levels in men and women. Women with a low income are more likely to be obese or overweight than high-income women, whereas men have less difference in BMI across income groups," the researchers wrote.

People born in Canada have a lower diabetes risk than immigrants, but more newly diagnosed cases are expected among those born in Canada since they make up a larger proportion of the country's population than immigrants, according to the report.

Those with less than secondary education also had more than twice the diabetes risk compared to people with at least some post-secondary education.

In December, the Canadian Diabetes Association said the disease is expected to cost Canada nearly $17 billion by 2020, up from more than $10 billion in 2000, expressed in 2005 dollars.

The association's report predicted the number of people diagnosed with diabetes in Canada is also expected to nearly double between 2000 and 2010, from 1.3 million to 2.5 million.

Thursday, 17 June 2010

White Rice Raises Diabetes Risk

White Rice Raises Diabetes Risk

In a study of almost 200,000 people in the U.S., white rice consumption was linked to type 2 diabetes, researchers from Harvard University report in the Archives of Internal Medicine. According to them, brown rice and wholegrain foods release glucose more gradually, making them a better choice that white rice, which can cause a spike in blood sugar. In the study, people who ate five or more 150 g servings of white rice per week had a 17 per cent increased risk of diabetes compared to those who consumed less than one per month. Eating brown rice seemed to actually cut the risk for type 2 diabetes, the BBC reports, with people who ate two or more servings of it per week showing an 11 per cent reduced risk compared to those who ate less than one serving a month.

Wednesday, 16 June 2010

Worrying Rate of Increase for Diabetes

Worrying Rate of Increase for Diabetes

Instances of diabetes are increasing at a "worrying rate", it has been claimed by one health professional.
Dr Dawn Harper, a GP and health figure in the media, said that in addition to the 2.6 million recognised diabetics in the UK, there are "at least another half a million" who are yet to be diagnosed.

Her comments come after a survey from MSD revealed that 46 per cent of British people believe that injections are the main course of treatment for the disease if a healthy diet and lifestyle does not work.

However, Dr Harper claimed that "many Type 2 diabetics never need to inject themselves at all" because weight loss and an improved diet will work in a lot of cases.

But she warned: "What we're finding now is that Type 2 Diabetes is being diagnosed in younger and younger people and it is simply because as a nation we are getting fatter and fatter."

Tuesday, 15 June 2010

Mental Decline From Diabetes Can Start in Middle Age

Mental Decline From Diabetes Can Start in Middle Age

While the mental decline may be invisible to the individual, the fact that the drop-off starts accumulating in middle age puts diabetics at greater risk later on because of reduced "brain reserves," Dr. David Knopman, of the Mayo Clinic in Rochester, Minnesota, told Reuters Health.

"Like a bicycle tire that's been partially deflated -- you'll be OK riding around but if you develop another little leak you'll be much closer to a flat tire much faster," said Knopman, who was not involved in the Dutch study.

Astrid Nooyens and colleagues at the National Institute for Public Health and the Environment in the Netherlands examined the health records and mental acuity scores of more than 2,600 men and women between the ages of 45 and 70 who enrolled in a large ongoing study into lifestyle effects on health.

At the five-year mark, of the 139 participants with type 2 diabetes, 61 were diabetics at the beginning of the study and 78 developed the chronic disease within the next five years.

The study confirmed the findings of earlier research, by Knopman and others, of an association between diabetes and declines in such mental functions as the ability to think quickly and recall words, but this is the first project to test memory and demonstrate how quickly the drop-off can occur.

Over a five-year period, decline in overall mental functioning in people with type 2 diabetes, while small, was nearly 3 times more pronounced than in non-diabetics.

But it didn't take many years for the impact to be felt. Even those who developed diabetes after beginning the study saw twice as much of a decline as their non-diabetic counterparts.

Compared to the "healthy" participants, participants who had long-term diabetes registered the largest declines in mental function. Those who developed diabetes during the trial saw less pronounced declines than their long-term counterparts in most areas except information processing, where they appeared to do a little better than the "healthy" people.

Type 2 diabetes is characterized by high blood sugar levels caused by the body's inability to process sugar properly. The illness can usually be controlled through diet and exercise but may also require drugs.

The Nooyens group found that while memory continues to decline for those with diabetes, the drop-off in thinking speed appears to occur in the first five years and then level off. That led the authors to suggest that early treatment and control of blood sugar levels could help thinking speed, but probably not memory, they note in the journal Diabetes Care.

The researchers found that for a small group of people who had lived with diabetes for nearly seven year, blood sugar levels did not explain the entire decline in mental function. In those people, they suspect other conditions related to diabetes such as high blood pressure and obesity.

The study did not look at whether patients with well-controlled diabetes experienced less mental decline compared to their poorly controlled counterparts, although the authors point out that there are other reasons, such as heart disease, to control sugar levels as well.

They also note that the random blood tests of both the long- and short-term diabetics suggested what treatment they were getting was "insufficient."

Monday, 14 June 2010

Vitamin D For Type 2 Diabetes

Vitamin D For Type 2 Diabetes

Many commentators on natural health and healing claim that taking supplemental vitamin D may do type 2 diabetics just as much good as the leading diabetes drug that actually works, metformin. Vitamin D is becoming the go-to remedy for a wide range of health conditions ranging from osteoporosis to breast cancer to heart disease. This sunshine vitamin that was once only thought to treat rickets… is now believed to have profound benefits in almost all aspects of human health.

As for the real benefits of vitamin D for type 2 diabetes, the original research was conducted in the 1980’s in Sweden. Fair-skinned Scandinavian men with type 2 diabetes were found to get better control over their blood sugar levels when given vitamin D supplements, but only if their vitamin D levels were already deficient. In a northerly location like Sweden, vitamin D deficiency has always been a problem. Type 2 diabetic men in the study who already had adequate levels of vitamin D, did not get a similar benefit, although their blood pressure levels went down slightly.

In 2010, scientists now know that people with different skin tones have different requirements for vitamin D. Persons of African or Australian aboriginal descent for instance, need less vitamin D than people from Iceland or Greenland. Giving people with black skin color supplemental vitamin D, can have the unwelcome side effect of storing calcium in the cholesterol plaques that may have formed in the linings of their arteries. For African-Americans and descendants of native Australian peoples, supplemental vitamin D may lower blood sugars but cause atherosclerosis.

If you have dark skin tones, it is best you take no more than 400 IU of vitamin D a day, even if you are on temporary assignment to Antarctica. People with dark skin tones usually also have genes that make vitamin D work very efficiently. If you have dark skin, only take vitamin D supplements when you don’t have any opportunity to get outdoors in the daytime at all, three days a week or more.

About Vitamin D:

Vitamin D is produced as a result of your skin being exposed to sunlight… it helps you to absorb calcium amongst other things. It is usually a good idea to spend 15 to 20 minutes daily outside. If you are able to do this, usually you do not need to take supplementation.

Another method to absorb vitamin D is through nutrition… vitamin D deficiency also results partly from poor nutrition. This is one of the challenges for people with type 2 diabetes.

Food sources include:

  • milk
  • juices fortified with vitamin D
  • soy milk, for example Silk
  • certain fortified cereals, for example Kix and Kellogg’s low-fat granola with raisins

Vitamin D strengthens bones and helps prevent osteoporosis: might lower the risk of colon cancer, multiple sclerosis, and rheumatoid arthritis. A study from Washington University School of Medicine in St Louis, Missouri found that vitamin D also played a part in the prevention of cholesterol buildup.
Maintaining a good supply of vitamin D will help in preventing those long-term complications that accompany type 2 diabetes.

Saturday, 12 June 2010

Diabetes and Depression

Diabetes and Depression - Spotting the Signs

Are those plagued with Type 2 diabetes at greater risk for depression? Though there is no easy way to answer this, the clear cut consensus is: yes. Though, most folks with the disease do not have depression, studies do show that there is risk association involved. Scientific evidence points to additional stress that comes with diabetes, and it is possible to feel alienated if friends or family are unsympathetic, or simply do not understand. Diabetes, though manageable, can certainly put life into perspective. It can be a jolt of realization that a good diet and exercise are no longer preferred, but instead mandatory.

Poor diabetes management can showcase symptoms that mimic those of depression. Everyone has occasional ‘bad days’, but if life feels absolutely hopeless, it is imperative to see your doctor immediately. They can determine basics during a consultation, and if all signs point to depression, they can recommend further treatment.

Friday, 11 June 2010

Coffee May Reduce Risk of Diabetes

Coffee May Reduce Risk of Diabetes

There is new evidence coffee may help prevent diabetes, a study in the Journal of Agricultural and Food Chemistry says.

Fumihiko Horio and colleagues from Nagoya University in Japan gave coffee and water to lab mice used to study its affect on diabetes. Coffee consumption prevented the development of high-blood sugar in mice and improved their insulin sensitivity, which reduced their risk of diabetes.

"Our results indicated that caffeine is one of the most effective antidiabetic compounds in coffee," the researchers said in the study. "The present results suggest that coffee consumption may help to prevent type 2 diabetes and metabolic syndrome."

More than three million Canadians have diabetes, and approximately 90% of those have type 2 diabetes. Diabetes is a contributing factor in the deaths of approximately 41,500 Canadians each year and adults with diabetes are twice as likely to die prematurely, compared to people without diabetes.

Thursday, 10 June 2010

Link Found Between Diabetes and Schizophrenia

Link Found Between Diabetes and Schizophrenia

Defects in insulin action – which occur in diabetes and obesity – could directly contribute to psychiatric disorders like schizophrenia.

Vanderbilt University Medical Center investigators Aurelio Galli, Kevin Niswender, and colleagues have discovered a molecular link between impaired insulin signaling in the brain and schizophrenia-like behaviors in mice. The findings, publishing next week in the online, open-access journal PLoS Biology, offer a new perspective on the psychiatric and cognitive disorders that affect patients with diabetes and suggest new strategies for treating these conditions.

"We know that people with diabetes have an increased incidence of mood and other psychiatric disorders," said endocrinologist Niswender, M.D., Ph.D. "And we thought that those co-morbidities might explain why some patients have trouble taking care of their diabetes."

Galli's group was among the first to show that insulin – the hormone that governs glucose metabolism in the body – also regulates the brain's supply of dopamine – a neurotransmitter with roles in motor activity, attention and reward. Disrupted dopamine signaling has been implicated in brain disorders including depression, Parkinson's disease, schizophrenia and attention-deficit hyperactivity disorder.

Now, Galli, Niswender, and colleagues have pieced together the molecular pathway between perturbed insulin signaling in the brain and dopamine dysfunction leading to schizophrenia-like behaviors. The researchers developed mice with an insulin-signaling defect only in neurons. They found that the mice have behavioral abnormalities similar to those frequently seen in patients with schizophrenia. They also showed how defects in insulin signaling disrupt neurotransmitter levels in the brain – the mice have reduced dopamine and elevated norepinephrine in the prefrontal cortex, an important area for cognitive processes. These changes resulted from elevated levels of the transporter protein (NET) that removes norepinephrine and dopamine from the synaptic space between neurons.

By treating the mice with NET inhibitors (drugs that block NET activity), the investigators were able to restore normal dopamine levels and behaviors. Clinical trials of NET inhibitors in patients with schizophrenia are already under way and these new data provide mechanistic support for this approach. Understanding the molecular link between insulin action and dopamine balance offers the potential for novel therapeutic approaches.

"Dysregulation of this insulin-signaling pathway – because of type 1 diabetes, because of a high-fat diet, because of drugs of abuse, because of genetic variations – may put a person on the road to neuropsychiatric disorders," Galli said.

Wednesday, 9 June 2010

Effectively Managing Type 2 Diabetes

Effectively Managing Type 2 Diabetes

Effectively managing type 2 diabetes is imperative since most people know there is no cure for diabetes. Given that we are now a decade into the 2000’s this may seem like a failing, that the Medical Researchers and doctors haven’t yet come up with an absolute cure for diabetes, especially when you consider the degree to which diabetes is becoming a problem around the world.

However the word cure is probably a little off putting, because whilst it may be technically true that no diabetic will ever be cured of the disease, it can reach a stage where for all intents and purposes, you can be ‘cured’ meaning that your blood sugars become consistently within the normal range, and you are completely symptom free, and require no medication or insulin. That’s the ideal goal for all type 2 diabetics. There are several well respected and proven methods advocated as to how best to achieve (as close as possible) this goal.

To begin effectively managing Type 2 diabetes, you should begin by visiting your doctor, finding out as much as you can about diabetes, ensuring you understand what led to it, and knowing how your body is best able to respond to the measures you decide to put into place to control your type 2 diabetes. All diabetes management begins with controlling the glucose cycle.

Diabetes is effectively the inability by your body to deal with the glucose that enters your bloodstream from the foods you digest. Normally this glucose would be dealt with by your body’s insulin, and the blood glucose levels would then normalize. However in diabetics this becomes difficult due to either poor insulin productivity, or insulin sensitivity, consequently your body cannot get rid of the glucose in the blood effectively. Over time this constant high blood sugar levels damages nerves, and vital organs, often resulting in adverse health problems like stroke, kidney damage, blindness, and loss of circulation and feeling in extremities, (leading to possible amputation)

It, therefore becomes imperative for managing type 2 diabetes to control the production of glucose in the body through careful choice of the correct foods (Low glycemic index foods) as well as the consumption of the glucose by the body, hence why regular exercise is strongly advocated for type 2 diabetics, as this helps to burn up the available glucose in the bloodstream.

Proper type 2 diabetes management often requires a complete lifestyle change and this in turn can require frequent, sometimes multi-daily checks of glucose in the blood. This is often achieved with the use of a personal blood glucose meter. Glucose meters are readily available and are quite easy to use with a little practice and patience. A prick to a finger and a drop of blood will reveal whether or not the user know requires a dose of insulin.

Managing type 2 diabetes is essential to minimize the damage high blood sugar can do to your body. It’s not rocket science, but from the time become diagnosed as a type 2 diabetic, it becomes important to take a concerted and focussed awareness of most things you eat and do in life. Having type 2 diabetes is definitely a life changing disease, but it needn’t be a life sentence, because it really does provide the opportunity for you to start living a healthy, fulfilling life. If you want to get on top of your type 2 diabetes naturally, there are natural ways to control and normalize your blood sugar levels that definitely work.

Tuesday, 8 June 2010

Prevention of Type 2 Diabetes

Prevention of Type 2 Diabetes

Several studies using therapeutic lifestyle changes and pharmacologic intervention have documented 'prevention' of Diabetes from the prediabetic state. as classified by recurrently changing diagnstic criteria established by various organizations. i.e American Diabetes Association. The truth of the matter is that many of these subjects have diabetes if the diagnostic criteria established prior to 1980 are used. Infact almost 1400 subjects in UKPDS were 'Prediabetes' according to the present diagnostic criteria and the progression of the disease was delayed by any of the three pharmacologic therapy used. In fact , the best outcome in this regard was achieved bu SUs in this study. e.g. Glycemic control lapsed after only 4 years with Metformin whereat it lapsed after 7 years following therapy with Chlorpropamide.Alternatively, 25 % of subjects treated with SU were HbA1c less than 76 % at 9 years whereas the numbers for Metformin were 13% and 11 % for conventional arm. The data thus suggest that early therapy with SU would provide a similar if not additional benefit as compared to intervention.s with Metformin. Moreover 'DREAM' trial clearly showed that benefit is lost and the delaying trend is reversed on discontinuing the intervention. Therefore, it is distinctly apparent that early treatment with antihyperglycemic drugs delays the progression of abnormal glucose metabolism and not 'prevent' the disease.Finally, in the similar context these intervention may delay 'progression to 'Prediabetes' from the state of normal glucose toelerance.Does this mean that every subject with predilection to develop Diabetes i.e Obese , extensive family history, high risk ethnic population etc should be a candidate fir pharmacologic intervention?

Monday, 7 June 2010

Meat Preservatives May Increase the Risk for Diabetes

Meat Preservatives May Increase the Risk for Diabetes

Over the past few decades, some medical researchers have pointed the finger at meat consumption as a major factor in the development of heart disease and diabetes. However, a meta-analysis conducted by the Harvard School of Medical Health has concluded that it may be the salt and chemical preservatives used in processed meats that lead to health problems, not the meats themselves.

In a meta-analysis, researchers look through many pre-existing studies that are related to a particular question or problem. In this case, the Harvard researchers wanted to determine if meat by itself-pork, beef, or lamb-was a factor in the onset of cardiovascular problems and type 2 diabetes. Alternatively, could the way meat is processed be a factor?

After examining 1,600 studies, the researchers found that the consumption of unprocessed meats-meats that have not been cured, salted, or marinated, but are simply butchered and sold quickly for immediate consumption-did not lead to increased risk of heart attack or diabetes. However, the daily consumption of even small amounts of processed meats (1.8 oz/50 grams) such as bacon, salami, franks, sausages, and deli meats, was associated with a 42 percent higher risk of heart disease and a 19 percent increased chance of developing type 2.

The researchers did not look at studies that covered high blood pressure or cancer, two other medical outcomes that some research has associated with meat consumption. The effect of eating poultry, which does not contain the same amount of fat as beef, lamb, and pork, was also excluded from the study.

The researchers noted that although processed and unprocessed meats contain similar amounts of saturated fat and cholesterol, processed meats have four times more sodium and 50 percent more nitrate preservatives than unprocessed meats.

Because the study was weighted to compare people who ate similar amounts of meat per week, whether processed or not, the researchers recommended that for best results, people restrict their consumption of processed meats to one serving a week.

Sunday, 6 June 2010

Women At Risk For Developing Type II Diabetes

Women At Risk For Developing Type II Diabetes

Developing Gestational Diabetes during pregnancy carries a 15 to 60 percent chance of developing Non-Insulin Dependent (Type II) after pregnancy within a 5 to15 year period of time. It is important to determine the significant risk factors that lead to Type II diabetes as this disease has reached epidemic proportions around the world. From 1994 to 2002, the incidence of gestational diabetes doubled to now involve 7 percent of pregnancies. This has an increased maternal and neonatal morbidity which includes but is not limited to elevated blood pressure, preeclampsia, eclampsia, placental abruption, maternal kidney disease, increased susceptibility to premature delivery, increased incidence of C-sections, uterine infection, bacteria in the blood, maternal death, fetal macrosomia (large infant) hypoglycemia of the infant, prematurity of the lungs even late in the third trimester, increased risk or neonatal infection, hyperbilirubenemia, intrauterine fetal death, and perinatal mortality.

By knowing the risk factors that lead to a higher incidence of gestational diabetes, there is hope to be able to prevent them before, during, or after the pregnancy in order to reduce the complications mentioned above associated with the immediate problems with gestational diabetes.

When patients are diagnosed with Non-insulin dependent diabetes, there are a host of complications and risk factors that occur: increased risk of heart, peripheral vascular, kidney, eye, and neurologic diseases such as heart attacks, angina, pain in legs when walking (claudication , kidney failure, blindness, stroke, transient ischemic attack, loss of balance when walking and unable to feel feet due to peripheral nerve damage.

Several studies show three factors that lead to highest risk for women developing Type II diabetes after having gestational diabetes in pregnancy:

1) BMI (Basal Metabolic Index) > 27

Patients have a 4 to 8 fold chance of developing Type II diabetes whose BMI is greater than 27

2) Developing gestational diabetes before 24 weeks gestation

Patients who develop gestational diabetes after 24 weeks have less chance of developing Type II diabetes. The fetal placenta is responsible for abnormal glucose intolerance after 24 weeks

3) Use of insulin to control the blood sugars in pregnancy

Insulin use in pregnancy means the mother has less ability to produce an adequate amount of insulin during stress (excessive sugar loads, viral or bacterial infections, ect.)

Measures must be in place to prevent, reduce, and or treat each risk factor.

Regarding prevention, reduction, or treating a BMI of greater than 27 requires a comprehensive approach involving psychological, environmental, nutritional, and exercise.

1) Eating minimal amounts of calories is noted to increase longevity. This is because obesity leads to chronic diseases such as cancer, hypertension, heart disease, diabetes, and arthritis. One must learn to eat frequent small meals. Eating 5 to 7 small meals throughout the day will increase the metabolism by 10 to 12 percent. Increasing the portion of protein and reducing the amount of carbohydrates will reduce insulin demand that is needed to metabolize sugars in the body. Patients must reduce breads, pasta, and sweets. Patients must increase fiber intake, brown rice, sweet potatoes, nuts, and non-starchy vegetables.

2) Exercise. One must engage is some form of exercise 30 minutes to 1 hour a day. Swimming, walking, riding bicycles, stationary bicycle, treadmill, weightlifting, rowing, stair climber, etc, are examples of exercises that will build muscle and help increase the uptake of sugars into muscle which in turn decreases the demand for insulin and reduces glucose resistance. Increase in one pound of muscle leads to an increase of 50 calories a day being burned.

3) Supplements known to increase glucose utilization in diets.

a. Cinnamon

b. Bitter melon

c. Cane sugar

d. Alpha Lipoic Acid

e. Chromium Piccolinate

In summary, Type II diabetes leads to serious illness and disease left untreated. Gestational Diabetes during pregnancy predicts a high incidence of developing Type II Diabetes within a few years. Knowing the risk factors that lead to Type II diabetes after Gestational Diabetes and the ways to reduce or prevent these factors from occurring, will help to reduce the incidence of this detrimental disease.

Saturday, 5 June 2010

Diabetes Symptoms to Never Ignore

Diabetes Symptoms to Never Ignore

People living with diabetes learn to manage their disease with proper diet, regular exercise, and medication. Success is measured by how well you can control your blood sugar.

However, many factors can affect blood sugar besides diet and activity. Illness, stress, social drinking, and women’s menstrual cycles can all influence blood sugar levels and upset your normal routine.

If you have diabetes, you may know that and make adjustments accordingly. But some symptoms of trouble are always reasons to seek medical advice, whether it’s a call to your doctor or a trip to the emergency room.

“Truthfully, with the ability of people to test their blood sugar at home, we can treat many more things at home than we used to be able to,” says Andrew Drexler MD, who directs UCLA's Gonda Diabetes Center.

This does not mean you should problem solve without your doctor’s help, he adds, but rather, that you might be able to substitute a phone call for a trip to the emergency room.

Frequent Urination, Extreme Thirst or Hunger and Blurry Vision

These are three common warning signs of uncontrolled blood sugar.

With any of these symptoms, you should test your blood sugar and call your doctor. Depending on how high your blood sugar is, medication may fix the problem or you may have to seek medical care to replace fluids and electrolytes and to get blood sugar back under control.

If left unchecked, high blood sugar can lead to serious, life-threatening conditions. Type 1 diabetes patients can develop diabetic ketoacidosis, which happens when the body starts breaking down fats instead of sugars and a dangerous buildup of ketones (byproducts of fat metabolism) occurs.

In type 2 diabetes patients, hyperosmolar coma can occur. “It’s essentially uncontrolled diabetes, which leads to dehydration and altered consciousness and which could be fatal if untreated,” says endocrinologist Adrian Vella, MD, of the Mayo Clinic in Rochester, Minn.

Acting Drunk

Strange behavior can also signal low blood sugar. This can happen when a person’s medication works too well and overshoots the target.

Drinking some juice or eating a snack usually is enough to raise sugar levels and normalize behavior. Often, however, the diabetic patient is not in the state of mind to recognize that something is wrong. If no one else is around to prompt you, your blood sugar may sink low enough to cause you to lose consciousness.

Most of the time, patients will recover on their own, but if they are taking certain medications, emergency medical treatment may be required.

Infections, Swollen or Bloody Gums, Foot Sores

Have your doctor check a cut that’s infected, swollen or bloody gums, or a wound that won’t heal. And watch out for a sore on the foot, which may be the first sign of a diabetic foot ulcer.

All diabetes patients should get regular foot exams by a health care professional -- and check their own feet on a daily basis -- even if sores are not present. And remember to bathe your feet daily in warm (but not hot) water, following up with a moisturizer, to prevent dry skin, which may crack and lead to infection.

“Infections in diabetics can get out of control and they need to be taken very seriously,” says Drexler.

Fungal infections occur more frequently in diabetes patients, Vella tells WebMD. “Fungal infections of the skin are more likely to occur when your blood sugar is consistently above the magic number of about 180-200 [mg/dL],” he says. “That’s because hyperglycemia itself actually interferes with the white blood cells’ ability to respond to such infections.”

A red, itchy rash -- especially in moist areas such as skin folds -- can signal a fungal infection.

Eye Problems, Including "Floaters"

If you develop sudden changes in vision, experience eye pain, or see spots or lights floating in your field of vision, call your doctor. You may need to see an ophthalmologist. People with diabetes are at increased risk of an eye condition called retinopathy, which can lead to vision loss.

Even without eye symptoms, diabetes patients should see an ophthalmologist yearly for a routine eye exam.

Heart Disease Symptoms -- and Not Just Chest Pain

Patients with diabetes have an increased risk of cardiovascular disease and twice the normal rate of related emergency events, such as heart attack and stroke.

So get any potential heart disease symptoms checked out.And keep in mind that heart symptomsaren't always predictable.

“It can sometimes be shoulder pain, it can sometimes present just as nausea," Drexler says. "But if there’s any suspicion that it’s cardiac in origin, it’s very important to go to the ER."

It's also possible to have heart disease that doesn't have obvious symptoms, so make sure you see your doctor regularly and have your cardiovascular risk factors evaluated.

Friday, 4 June 2010

Child Weight Loss Reduces Diabetes Risk

Child Weight Loss Reduces Diabetes Risk

U.S. researchers found overweight girls who lose weight before adulthood reduced their risk of diabetes.

Researchers at the National Institutes of Health in Bethesda, Md., and Boston's Harvard University found nurses who reported being overweight at age 5 were twice as likely to develop diabetes as those who remembered being normal weight.

Those reported being obese at age 18 were almost nine times more likely to develop diabetes than their normal-weight counterparts.

The study, published in Diabetes Care, also examined the combined effect of extra weight at various ages. Compared with women who were not overweight at ages 5, 10 and 20, those who reported being overweight at all three ages were 15 times more likely to develop diabetes. However, women who recalled being overweight at age 10 but not overweight as adults were no more likely to become diabetic than peers who had been normal-weight as children.

"These findings suggest that ensuring that overweight kids reverse their weight gain is critical to limiting their future risk of diabetes as adults," study author Edwina Yeung of the National Institutes of Health said in a statement.

Yeung and colleagues tracked 109,172 female nurses from 1989 to 2005 and found 3,307 cases of type 2 diabetes.

Thursday, 3 June 2010

Treating Diabetes Wounds

Treating Diabetes Wounds

No matter how small or superficial a wound is, you should not ignore it if you have diabetes, says Daniel Cohen, DPM, a podiatrist with Medical Associates of Brevard in Brevard County, Fla. If you stub your toe, get a blister from tight shoes, or nick your chin while shaving, you probably give it little thought. But if you have diabetes, you should seek proper treatment.

Knowing how to treat minor wounds will help you avoid infection and speed healing.

Why Diabetic Wounds Can Cause Problems

Diabetes is a chronic disease where your body can't use glucose, or sugar, the way it should. It can cause a number of complications, including some that make it harder for wounds to heal. These include:

  • Nerve damage (neuropathy). When you have neuropathy, you may not feel the pain of a cut or blister until it has grown worse or become infected.
  • Weakened immune system. When the body's natural defenses are down, even a minor wound may become infected.
  • Narrow arteries. People with clogged arteries in their legs are more likely to develop wounds, have severe wound infections, and have problems healing. Narrowed arteries makes it harder for blood to get to the wound. Blood flow promotes healing, so anything that blocks it can make wounds more likely to become infected.

How to Treat a Diabetic Wound

If you have a wound, no matter how small, take the following steps to avoid infection and promote healing:

  • Take care of the wound immediately. Even a minor wound can become infected if bacteria are allowed to build up after injury.
  • Clean the wound. Rinse the wound under running water to remove dirt. Don't use soap, hydrogen peroxide, or iodine, which can irritate the injury. Then apply antibiotic ointment to prevent infection, and cover the wound with a sterile bandage. Change the bandage daily, and use soap to clean the skin around the wound. Inspect your wound daily for any signs of infection.
  • See your doctor. Don't take any chances -- have your doctor check minor skin problems or areas of redness before they turn into larger problems. Err on the side of caution, says podiatrist and wound specialist Robert Snyder, DPM, medical director of the Wound Healing Center at University Hospital in Tamarac, Fla., and incoming president of the American Academy of Wound Management in Washington, D.C. "It's far easier to treat a minor skin problem before it becomes serious," he says.
  • Keep pressure off the wound as it heals. For example, if your wound is on the bottom of the foot -- a common place for diabetic people to develop calluses and blisters -- stay off it as much as possible so it will have a better chance to heal, says Snyder.

Wednesday, 2 June 2010

Diabetes Cases Explode Nationwide

Diabetes cases explode nationwide

The number of Danish children suffering from type-1 diabetes has increased by 57 percent over the past 10 years, according to the national diabetes register.

Healthcare professionals have expressed particular concern because the majority of these new cases are young children. Among the under-five age group, there has been a 100 percent increase in the occurrence of type-1 diabetes over the past decade.

Experts in the field of diabetes research have been unable to provide an immediate explanation for the phenomenon.

Professor Allan Flyvbjerg, the president of the national diabetes association, believes the disease has got out of control.

‘We know how to treat the disease but unfortunately we don’t know how to prevent it,’ he told B.T. newspaper.

Just 10 years ago approximately 2,000 young people aged 19 years and below were diagnosed as having type-1 diabetes. Today that figure is around 3,200.

Type-1 diabetes is not hereditary and, in contrast to type-2 diabetes, has nothing to do with a person’s lifestyle. The disease causes an elevated blood sugar level and must be treated with insulin several times a day.

Flyvbjerg said the experts’ best guess at present is that the disease is caused by an external source in the environment, such as a pollutant, virus, infection or possibly a lack of vitamin D.

Tuesday, 1 June 2010

Helps Reduce The Risk For Type 2 Diabetes

Helps Reduce The Risk For Type 2 Diabetes

The 57 million Americans currently living with “pre-diabetes” could benefit from a group weight loss program, like Weight Watchers, according to a new study published in this month’s American Journal of Lifestyle Medicine. Researchers found that after a 6-month Weight Watchers group program, overweight or obese adults who attended at least two thirds of the weekly sessions, not only lost weight, but also significantly reduced fasting glucose and insulin levels – important indicators of diabetes risk.

Sixty-one overweight or obese men and women participated in a 6-month Weight Watchers study that included education on a lower calorie diet (a food plan), exercise (an activity plan) and weekly group support sessions. Not surprisingly, the researchers found that participants who attended the most sessions, had the most success, reinforcing the importance of group support in lifestyle change. In fact, those who attended at least twenty of the twenty-four sessions, lost an average of 14 pounds and had the most dramatic change in glucose and insulin levels associated with diabetes risk, compared to those who attended few sessions.

“We know that previous research programs have successfully reduced diabetes risk using intensive lifestyle treatment,” said Kathleen Melanson, PhD, RD, LD study co-author. “But what we didn’t know is that a program that costs appreciably much less than specially-designed diabetes prevention programs would have a profound impact on the same risk factors for type 2 diabetes. These findings could have important public health potential.”

Type 2 diabetes is closely tied to obesity – and both conditions have increased dramatically over the past 20 years. There are now more than 23 million Americans living with type 2 diabetes in this country. Combined with those who have pre-diabetes, a condition that will likely lead to diabetes without any intervention, the toll on our healthcare system is extensive. According to the Centers for Disease Control, the total cost of treatment of diabetes in the United States exceeds $200 billion, making treatment and prevention a priority for healthcare experts. Yet, the gold standard study on diabetes prevention, the Diabetes Prevention Program Trial (DPP), found that individual lifestyle interventions could reduce the risk of developing diabetes by more than fifty percent.

“Individual lifestyle intervention is obviously successful in reducing the risk for diabetes, but it comes at a high cost, and may not be realistic for all Americans,” said Karen Miller-Kovach, RD, chief scientific officer for Weight Watchers International. “We’re encouraged that the Weight Watchers program, already successful for helping millions of Americans lose weight, could also have the potential to reduce disease risk and even help reduce healthcare burden, for as little as about forty dollars per month, per person.”

According to the American Diabetes Association, “structured programs emphasizing lifestyle changes including moderate weight loss (7% body weight) and regular physical activity (150 min/week), with dietary strategies including reduced calories and reduced intake of dietary fat, can reduce the risk for developing diabetes.”