Study Questions Glycemic Index as Diet Tool

U of South Carolina study has found that the Glycemic Index may not help people lose weight or improve their health.

February 28, 2006 (Newswise) - One of the hottest diet trends focuses on the Glycemic Index, which ranks carbohydrates according to their ability to affect blood glucose. The premise is that a diet of carbs with a low Glycemic Index will help people lose weight and reduce their risks for heart disease and diabetes.

But a study by a researcher at the University of South Carolina's Arnold School of Public Health has found that the Glycemic Index may not help people determine the foods that they should eat - or avoid - to improve their health.

The findings, published in the February issue of the British Journal of Nutrition, show that people should exercise caution with the Glycemic Index diet, says Dr. Elizabeth Mayer-Davis, a noted diabetes researcher and the study's lead author.

"There are valid reasons to question the Glycemic Index scientifically," Mayer-Davis says. "This is an area in the field of nutrition that is controversial. It turns out that despite all of the interest in the Glycemic Index, the scientific literature is very mixed."

Some studies show beneficial effects of low Glycemic Index diets on diabetes or other conditions, and other studies show no effect, she says.

The basis for the Glycemic Index is this: When a specific carbohydrate is eaten, its effect on the body is consistent among individuals. Therefore, a specific number can be attached to it. Apples, plums and oranges, for example, have a low Glycemic Index, while french fries, watermelon and dried dates have a high Glycemic Index.

The limitation of the Glycemic Index, Mayer-Davis says, is that the numbers in the index are based on blood-sugar levels recorded two hours after the ingestion of test foods, in a controlled experimental setting and after a person has fasted overnight.

"However, many factors can affect the impact of food on glucose levels in a 'real life' setting, including the length of time that food is cooked, your body's hormones and other foods that are eaten at the same time," she says.

"In scientific literature, the Glycemic Index of foods is based on fasting. This is unrealistic because we eat throughout the day, and a certain food eaten at lunchtime can have a different impact on blood-glucose levels compared to eating that same food for breakfast after fasting overnight."

The USC study, funded by the National Institutes of Health and conducted over five years, followed more than 1,000 people at four clinical sites. Participants included African Americans, Hispanics and Caucasians.

The researchers wanted to determine whether study participants with a relatively low Glycemic Index diet had lower overall blood-glucose levels compared to participants with a relatively high Glycemic Index diet. Using several different measures of blood-glucose levels, the researchers found that the Glycemic Index of the diet was not related to any of the measures of blood glucose.

This means that the Glycemic Index is probably not picking up the specific effects of food on blood glucose, Mayer-Davis says.

"Several recent studies show that dietary fiber is important to heart disease, diabetes and obesity," she says. "Typically, foods high in fiber have a relatively low Glycemic Index."

This means that, in some studies, the Glycemic Index may have been related to good health because of dietary fiber, not because of a unique characteristic of food called the Glycemic Index, Mayer-Davis says.

"In general, the Glycemic Index does not seem to be useful in understanding how diet impacts health, and use of the Glycemic Index may not be an effective way to identify foods for optimal health," she says.

Many of the chronic diseases that have been related to diets with high Glycemic Index, including diabetes and heart disease, are much more strongly related to obesity than to other aspects of diet. The key to losing weight and lowering the risk for diabetes, heart disease and obesity, in simple terms, is this: Consume fewer calories and burn more calories through physical activity.

"A diet that is low in saturated fat and includes whole grains, fiber, fruits and vegetables will support weight management as long as the total calories are reduced," she says. "And, moderate physical activity is key to improving health."

The Glycemic Index only makes life more complicated for those trying to adopt a healthier lifestyle, she says.

Posted by dlife at 11:23 AM | Comments (0)

HHS and VA to Target Diabetes, Obesity Among American Veterans

February 27, 2006 (HHS) - With obesity and deadly diabetes at higher levels among America's veterans, the Department of Health and Human Services (HHS) and Department of Veterans Affairs (VA) have announced a coordinated campaign to educate veterans and their families about ways to combat these health issues.

"Central to our goal of controlling the cost of heath care is the promotion of wellness, fitness and the prevention of chronic disease," HHS Secretary Mike Leavitt said. "We are working to encourage Americans to adopt healthy lifestyles and to take the responsibility for making wise choices to improve their fitness and health."

Veterans are nearly three times as likely as the general population to have diabetes, one of the major complications associated with being overweight. According to the National Institute of Diabetes and Digestive and Kidney Disease (part of the National Institutes of Health), 7 percent of the U.S. population has diabetes. Among veterans receiving VA health care, the rate is 20 percent.

"Inactive lifestyles and unhealthy eating habits can cause needless suffering for America's veterans," VA Secretary R. James Nicholson said. "Obesity and diabetes are major threats to the health and lifestyles of our veterans, who are deserving of a robust campaign to educate them on healthy habits."

In a news conference here today, Secretary Leavitt, VA Secretary Nicholson, VA Under Secretary for Health Dr. Jonathan B. Perlin and Surgeon General Richard H. Carmona announced the start of a campaign called “HealthierUS Veterans” -- a multi-pronged educational effort to encourage healthy eating and physical activity among veterans, their families and members of their communities. VA medical centers will be the hubs of the program where they will promote nutrition and exercise with participating “Steps to a Healthier US” grantee organizations, throughout the country.

"Our service men and women are known for their extraordinarily high levels of fitness," Dr. Perlin said. "We want our veterans to be identified the same way."

Overweight patients receiving VA health care may participate in weight loss programs tailored to their needs. They may also receive pedometers, diet advisories and “prescriptions” suggesting how much to walk -- or, in the case of wheelchair users, how much to roll.

The two secretaries also plan to kick off regional educational campaigns this spring in four cities where VA medical centers and HHS Steps programs collaborate. Local celebrities and members of veterans’ service organizations will be invited to participate.

In May, the "HealthierUS Veterans" program will participate with the President's Council on Physical Fitness during the council's annual rally in Washington.

Posted by dlife at 11:26 AM | Comments (0)

National Kidney Disease Education Program (NKDEP) Launches New Spanish-Language Initiative

February 27, 2006 (NIH News) - A new Spanish-language initiative of the National Kidney Disease Education Program (NKDEP), National Institutes of Health, includes a website and brochure that highlight the connection between kidney disease and its primary risk factors — diabetes and hypertension. The NKDEP is launching this national effort to raise awareness of kidney disease among Hispanic Americans.

“Many people who have been diagnosed with diabetes or high blood pressure don’t know that these conditions put them at risk for kidney disease,” said Josephine P. Briggs, M.D., a kidney specialist and director of NIDDK’s Division of Kidney, Urologic, and Hematologic Diseases. “These new resources help make that connection. We want people at risk to know that there are steps they can take to help protect their kidneys.”

Hispanics are disproportionately affected by diabetes and hypertension, the two leading causes of kidney disease. Other risk factors for kidney disease include cardiovascular disease and a family history of kidney disease. Hispanics are nearly twice as likely to develop kidney failure as non-Hispanic whites.

The website and brochure provide science-based information on the risk factors for kidney disease, the basic principles of kidney function, as well as the importance of early testing. The materials also stress the availability of medications that can prevent or slow the disease progression. Both resources offer additional Spanish-language resources on diabetes, hypertension, and kidney disease.

“These materials provide critical information to people in the Hispanic community at high risk for kidney disease. Our goal is to encourage Hispanics at risk to talk to their healthcare provider about getting tested,” said Dr. Briggs. “The NKDEP will continue to expand its outreach to additional high-risk audiences.”

The new materials were developed in collaboration with kidney disease experts and community-based organizations serving the Hispanic community. To view the NKDEP Spanish-language website, and to download or order the brochure, visit www.nkdep.nih.gov/espanol. The brochure, along with additional information, is also available by calling the NKDEP toll free number at 1-866-4-KIDNEY (1-866-454-3639). Instructions are available in Spanish and English.

The National Kidney Disease Education Program is an initiative of the National Institute of Diabetes and Digestive and Kidney Disease, one of the National Institutes of Health. The NKDEP aims to raise awareness of the seriousness of kidney disease, the importance of testing those at high risk, and the availability of treatment to prevent or slow kidney failure for the public and providers.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary Federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

See All February 2006 dLife News Items

Posted by dlife at 11:18 AM | Comments (0)

Use of Statins Shows Improvement in Erectile Performance of Some Men

Researchers at the University of Pennsylvania School of Medicine say preliminary results of a small study show promise in improving erectile dysfunction (ED) in men who had shown minimal reaction to Viagra.

February 21, 2006, Newswise — Researchers at the University of Pennsylvania School of Medicine say preliminary results of a small study show promise in improving erectile dysfunction (ED) in men who had shown minimal reaction to Viagra. The study results are published in the March issue of the Journal of Sexual Medicine.

Erectile dysfunction is often a sign of a more severe vascular problem that involves abnormalities in the lining of the blood vessels. And often, endothelial dysfunction is an underlying problem for ED - it can be one of the first signs of atherosclerosis, a build-up of plaque and blockages in the arteries.

“It’s already known that there is a connection between erectile dysfunction and coronary disease. The risk factors are the same for both, and thus, ED can be a marker for coronary disease,” explains lead author Howard Herrmann, MD, Professor of Medicine and Director of the Interventional Cardiology and Cardiac Catheterization Laboratories at the Hospital of the University of Pennsylvania. “Normal erections are caused when nitric oxide is made, but with endothelial dysfunction, the body doesn’t make enough of it, causing the erectile dysfunction. Normally, Viagra prevents the breakdown of the little nitric oxide that is there, so that there is enough of it for an erection to occur.”

However, about 10-30 % of men are classified as “Viagra non-responders” - in these men, Viagra did not significantly help their erectile dysfunction. So in a small, double blind, randomized, placebo-controlled study at Penn, Herrmann looked at a dozen patients with ED who had not responded well to Viagra. He gave them either a high-dose Lipitor or a placebo. He then rechallenged them with Viagra and asked if the ED had improved.

“There did seem to be some improvement for those who received Lipitor versus the placebo,” said Herrmann. “We theorized that if you could make the edothelium healthier through the use of statins -- so that there is more nitric oxide available -- you would improve the endothelial dysfunction and Viagra would work better for the patient.”

And there are other potential benefits too. Stan Schwartz, MD, Director of the Diabetes Disease Management program at Penn and co-author, states, “Patients with Diabetes, both Type 1 and Type 2, are plagued with complications of the diabetic state that involve endothelial dysfunction. This research points us in a direction that says any drug class that improves endothelial dysfunction may also be beneficial to patients with diabetes.”

Additionally, Emile Mohler, MD, Director of Vascular Medicine at Penn and co-author, cautions, “ED is a sign that cholesterol plaque may be present in the heart, neck or leg arteries. Men with ED should be evaluated for vascular disease.”

“These preliminary results show promise,” adds Herrmann. “They support the hypothesis that erectile dysfunction may be one sign of a generalized vascular disorder characterized by endothelial dysfunction and that statin drugs may improve the endothelial dysfunction, even before altering the lipid profile. But the results are preliminary and warrant further testing in a larger clinical trial,” he cautions.

It should be noted that beyond endothelial dysfunction, there are other reasons Viagra may not work well for someone.

The results of this study were published in the March 2006 issue of the Journal of Sexual Medicine. Members can access the journal on-line at: http://jsm.issir.org. The article is titled, “Can Atorvastatin Improve the Response to Sildenafil in Men with Erectile Dysfunction Not Initially Responsive to Sildenafil? Hypothesis and Pilot Trial Results.”

This study was supported by an unrestricted medical center grant from Pfizer.

Editor’s Notes: Dr. Howard Herrmann has received honorarium from Pfizer and Lilly ICOS. Dr. Stan Schwartz is a consultant and has received a speaker’s honoraria from Lilly ICOS. Dr. Emile Mohler is part of the speaker’s bureau for Pfizer.

PENN Medicine is a $2.7 billion enterprise dedicated to the related missions of medical education, biomedical research, and high-quality patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System.

Penn's School of Medicine is ranked #2 in the nation for receipt of NIH research funds; and ranked #4 in the nation in U.S. News & World Report's most recent ranking of top research-oriented medical schools. Supporting 1,400 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

The University of Pennsylvania Health System includes three hospitals [Hospital of the University of Pennsylvania, which is consistently ranked one of the nation's few "Honor Roll" hospitals by U.S. News & World Report; Pennsylvania Hospital, the nation's first hospital; and Penn Presbyterian Medical Center]; a faculty practice plan; a primary-care provider network; two multispecialty satellite facilities; and home care and hospice.

Posted by dlife at 11:29 AM | Comments (0)

U of M Reaches Milestone in Diabetes Research Using Pig Islets

Research offers hope to increase islet supply to cure type 1 diabetes

MINNEAPOLIS, Febuary 20, 2006 - Researchers at the University of Minnesota’s Diabetes Institute for Immunology and Transplantation have successfully reversed diabetes in monkeys using transplanted islet cells from pigs.

Survival of pig islet transplants was made possible with a novel immunosuppressive protocol. Graft survival did not require genetic modification of donor pigs or coating or encapsulation of donor islets.

Researchers have already had success reversing type 1 diabetes in humans through islet transplantation, however, the demand for islet cells grossly outweighs the supply. In order to make islet transplantation a viable solution for the tens of thousands of people with difficult-to-manage diabetes, a safe and reliable source of islet cells must be found.

“These results suggest it is feasible to use pig islet cells as a path to a far-reaching cure for diabetes,” said Bernhard J. Hering, M.D., associate professor of surgery and lead investigator. “Now that we have identified critical pathways involved in immune recognition and rejection of pig islet transplants, we can begin working on better and safer immunosuppressant therapies with the eventual goal of bringing the treatment to people.”

This unprecedented progress on islet xenotransplantation was released online Feb. 19, 2006 in the medical journal, Nature Medicine. If research continues to be successful, Hering believes it may be possible to start clinical trials in humans in the next three years.

To begin working toward the goal of using this technology to help people, Spring Point Project, a non-profit corporation, has taken concrete steps to build and operate biosecure barrier facilities to raise high-health pigs for planned pig islet transplant trials in humans.

Since it will take time to build biosecure facilities that meet the federal requirements for using animal tissues in humans, the Spring Point Project will proceed on a parallel track with the research at the University. The goal is to have suitable donor pigs available by the time the University has refined the immunosuppressive treatment to a point that makes it safe for clinical trials to begin.

Islet transplants seek to address an unmet medical need in people with type 1 and possibly type 2 diabetes who suffer frequent acute and severe chronic complications. The process is performed by isolating islet cells from a donor pancreas and transplanting them into the portal vein of the liver in people with diabetes. If successful, transplanted islets will sense blood glucose levels on a minute-to-minute basis and release the appropriate amount of insulin to achieve tight blood glucose control. Insulin injections are no longer needed in recipients of successful transplants.

Transplantation also offers hope in reducing the risk of developing debilitating secondary complications of diabetes, such as damage to the heart and blood vessels, eyes, nerves, and kidneys.

Posted by dlife at 11:32 AM | Comments (0)

FDA Provides Guidance on 'Whole Grain' for Manufacturers

February 15, 2005 (FDA) -The Food and Drug Administration has issued draft guidance on what the term "whole grain" may include. The guidance will assist manufacturers with what the FDA considers appropriate for food label statements related to "whole grain" content. Consumers will now be able to make dietary choices based on a term that is consistent and reliable.

"One of the most important decisions people can make about their health is the choice of foods they eat," said Dr. Scott Gottlieb, FDA's Deputy Commissioner for Medical and Scientific Affairs. "A top priority at FDA is finding additional ways to clearly communicate the health benefits found in food."

The FDA document clarifies that the agency considers "whole grain" to include cereal grains that consist of the intact, ground, cracked or flaked fruit of the grains whose principal components -- the starchy endosperm, germ and bran -- are present in the same relative proportions as they exist in the intact grain. Such grains may include barley, buckwheat, bulgur, corn, millet, rice, rye, oats, sorghum, wheat and wild rice.

In contrast, in the grain refining process some of the bran and germ is removed resulting in a loss of dietary fiber, vitamins and minerals.

The draft guidance states that although rolled and "quick oats" can be called "whole grains" because they contain all of their bran, germ and endosperm, other widely used food products may not meet the "whole grain" definition. For example, FDA does not consider products derived from legumes (soybeans), oilseeds (sunflower seeds) and roots (arrowroot) as "whole grains." The draft guidance specifically recommends that pizza only be labeled as "whole grain" or "whole wheat" when its crust is made entirely from whole grain flours or whole wheat flour, respectively.

"The food label is the best tool we have to help consumers choose a healthy diet, which includes whole grain products," said Dr. Robert E. Brackett, director of FDA's Center for Food Safety and Applied Nutrition.

The draft guidance is part of the federal government's long-standing effort to advise consumers about healthy food choices. The 2005 Dietary Guidelines for Americans recommend that half of the grain that consumers eat should be whole grains. Eat at least 3 ounces of whole-grain cereals, breads, crackers, rice or pasta every day. One ounce is about 1 slice of bread, 1 cup of breakfast cereal or 1/2 cup of cooked rice or pasta. Consumers should also look to see that grains such as wheat, rice, oats or corn are referred to as "whole" in the list of ingredients.

Currently, manufacturers can also make factual statements about whole grains on food labels such as "10 grams of whole grains" or "1/2 ounce of whole grains."

Posted by dlife at 11:34 AM | Comments (0)

Low-Carbohydrate Diets Appear Effective, But May Raise Cholesterol Levels

A synthesis of data from five previous clinical trials suggests that both low-fat and low-carbohydrate diets appear to be effective for weight loss up to one year, but low-carbohydrate diets may be linked to higher overall and LDL or “bad” cholesterol levels, according to a study.

February 13, 2006 (Newswise) — A synthesis of data from five previous clinical trials suggests that both low-fat and low-carbohydrate diets appear to be effective for weight loss up to one year, but low-carbohydrate diets may be linked to higher overall and LDL or “bad” cholesterol levels, according to a study in the February 13 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

As obesity levels increase, more American adults are dieting—at any one time, 45 percent of women and 30 percent of men are trying to lose weight, according to background information in the article. Those who succeed may reduce their risk of type 2 diabetes, control their hypertension and decrease their chances of cardiovascular disease and related death. Low-carbohydrate, high-protein diets have become a popular alternative to the generally recommended low-fat, calorie-restricted diet, the authors report. However, because these diets contain large amounts of protein and fat, concern remains about their effect on cholesterol levels and the cardiovascular system, they write.

Alain J. Nordmann, M.D., M.Sc., University Hospital Basel, Switzerland, and colleagues analyzed five previous clinical trials that compared low-fat to low-carbohydrate diets. A total of 447 individuals with an average age ranging from 42 to 49 years participated in the studies—222 on low-carbohydrate diets and 225 on low-fat diets.

After six months, those on low-carbohydrate diets were more likely to remain on the diet and had lost more weight than those on low-fat diets. However, after 12 months, blood pressure, completion rates and weight loss were the same for both groups. After six and 12 months, individuals on low-carbohydrate diets had increased total cholesterol levels and LDL levels. However, they also had lower triglyceride levels and higher HDL or “good” cholesterol levels.

“We believe there is still insufficient evidence to make recommendations for or against the use of low-carbohydrate diets to induce weight loss, especially for durations longer than six months,” the authors write. “The differences in weight loss between low-carbohydrate and low-fat diets after 12 months were minor and not clinically relevant.”

Because no trials have yet examined the risk of heart attack or death in people on low-carbohydrate diets, it’s unclear whether the beneficial effects low-carbohydrate diets appear to have on HDL and triglyceride levels cancel out their apparent negative effects on overall and LDL cholesterol levels, the authors write. “In the absence of evidence that low-carbohydrate diets reduce cardiovascular morbidity and mortality, such diets currently cannot be recommended for prevention of cardiovascular disease,” they conclude.

Posted by dlife at 11:36 AM | Comments (0)

Language Barrier Just One Roadblock to Diabetes Control for Chinese-Speaking Immigrants, Joslin Diabetes Center Study Shows

Study from Joslin's Asian American Diabetes Initiative Among the First to Highlight Cultural Contributors to the Diabetes Epidemic

BOSTON, February 7, 2006 — Health providers helping Chinese-speaking Asian American immigrants with diabetes better control their disease to avoid complications need to do more than just have translators and bi-lingual staff in hospitals or doctors' offices. While that's a start, these patients also need comprehensive patient education materials written in Chinese and a medical staff thoroughly versed in the customs and cultural issues that may impede their diabetes care, according to a new study by researchers at Joslin Diabetes Center.

The Chinese-speaking immigrants who were surveyed at community health centers in Boston, New York City and Oakland, Calif., were found to have less knowledge of how to manage their diabetes - and generally had a trend toward poor blood glucose control - compared with Asian American immigrants who preferred to speak English, according to William C. Hsu, M.D., who led the pilot study along with his colleagues in Joslin's Asian American Diabetes Initiative (AADI). But after being given a bilingual diabetes education book, the participants showed improved understanding of their disease and a trend toward improved blood glucose control in laboratory tests.

The study, which appears in the February issue of the American Diabetes Association's journal, Diabetes Care, is among the first of its kind to explore language barriers to diabetes management among Chinese-speaking immigrant populations.

"The study is particularly important because Asian Americans have at least a 50 percent greater risk of developing type 2 diabetes and pre-diabetes than Caucasian Americans," says Dr. Hsu, Co-director of Joslin's AADI. This fact is little known among both Asian Americans and physicians because Asian Americans are less likely to be overweight or obese. More than 10 percent of Asian Americans have diabetes. If poorly controlled, diabetes can lead to costly and devastating complications, especially stroke and kidney disease in Asian Americans.

"The health policy implications of the study are broad for immigrants and other non-English speaking people and should be explored in other populations as well," Dr. Hsu says. "Even in culturally competent healthcare settings like community health centers, our study shows the importance of having materials written in the native language to improve non-English speaking patients' understanding of the disease and reduce disparities in healthcare."

Translators Not Enough

In the Joslin study, the researchers surveyed 52 Asian American immigrants with type 2 diabetes at three community health centers. The patients, aged 18 to 70, had diabetes for at least a year and were taking oral medications or insulin. They were asked if they preferred to speak Chinese or English and then were quizzed by the researchers about their diabetes knowledge. Twenty-two of the patients preferred to speak English, having immigrated at an early age or been born in the United States; the remaining 30 preferred Chinese. The Chinese-speaking group scored an average of nearly 63 percent vs. 85 percent for the English-speaking patients on a test of diabetes knowledge. In their dealings with healthcare professionals, the Chinese-speaking group reported requiring translation 35 percent of the time. The 11 patients that required translation scored lower than the others on the diabetes knowledge test.

The investigators then provided both groups with a book on diabetes written in English and Chinese. After reading the book, only the Chinese-preferring group showed an increased knowledge of diabetes. The researchers concluded that the English-speaking group already understood this information better than the Chinese speakers due to more access to diabetes information from their health providers and from newspapers, magazines and Web sites. The researchers found differences in diabetes control occurred despite the fact that both groups followed standard diabetes self-management recommendations and received competent care in a culturally appropriate setting. They found a trend toward higher A1C levels in those who preferred to speak Chinese than among the English-speaking group.

"The traditional thinking that we just have to hire translators for non-English speaking patients is challenged by our study," says Dr. Hsu, Instructor of Medicine at Harvard Medical School. "Even if the physician is culturally competent, other staff members, such as nurses or dietitians, may not be. For instance, a dietitian not familiar with the food preferences of Asian Americans may recommend that the patient eat foods that Asians don't eat, such as cheese, cereals and pasta and not address other foods more central to the Asian diet.

"Even in a model setting like community health centers, which provide culturally competent care, their mission can advance to a higher level if they consider the importance of adopting more written diabetes education resources in Chinese," he adds. Doctors spend an average of 15 minutes with diabetes patients, so having written educational materials in the patients' language is paramount. "There is a general paucity of any culturally-focused educational materials written in the Chinese language. If any materials exist, it is often materials translated from other English literature without modifications specific to the reader's culture," Dr. Hsu says.

Other customs and cultural factors contribute to the mix. Asians often are reluctant to talk about diabetes with family, friends or co-workers. "If you are a person with diabetes in 'hiding,' you are not going to ask around for resources," Dr. Hsu says. The same prejudice discourages Asians from seeking care. "This problem is complicated by the fact that diabetes is not one of those diseases where you just take a pill," says Dr. Hsu. "Treatment involves modifying the lifestyle of the whole family."

Other researchers participating in the study include George L. King, M.D., Director of Research at Joslin and Co-director of the Asian American Diabetes Initiative; Sophia Cheung, M.S., R.D.; Emmelyn Ong, M.A.; Kathy Wong, M.S.P.H.; Susan Lin; Kenneth Leon; and Katie Weinger, Ed.D., R.N., Director of Joslin's Center for Innovation in Diabetes Education.

About Diabetes in Asian Americans

According to Census 2000, the Asian American population increased by 3.3 million, or 48 percent, between 1990 and 2000, which is a faster rate of increase than the general U.S. population experienced during the same period of time. Type 2 diabetes, the most common form of the disease, now affects 10 percent of this population in the United States and, in some cities, its prevalence has skyrocketed to 20 percent. According to World Health Organization (WHO) estimates, roughly half of the more than 300 million individuals with diabetes in the year 2025 will be of Asian decent. WHO predicts that diabetes will increase most significantly in India, followed closely by China.

A recent series of newspaper articles shed light on the plight of Asian American immigrants with type 2 diabetes in New York City. According to the article, Asians are the fastest growing ethnic population in that city. The article highlighted what happens when these immigrants switch from a traditional Eastern diet, where food may have been scarce, to a Western diet laden with plentiful inexpensive fast food. The article stated 14 percent of Asian children in New York City are obese and developing type 2 diabetes-traditionally considered a disease of middle-aged and older adults-at more than double the rate of their parents. Other issues spotlighted in the series ranged from impact of the more sedentary American lifestyle, increased exposure to television and advertising, and reduced physical education programs in schools.

About Joslin's Asian American Diabetes Initiative

Joslin's Asian American Diabetes Initiative (AADI), co-directed by Drs. King and Hsu, was established in 2000 by Dr. King and Joslin supporters who were concerned about the increasing incidence of diabetes among Asian Americans. In addition to Joslin's Asian Clinic in Boston, the AADI includes local and national educational presentations for health professionals and outreach programs for the public and conducts research into insulin resistance, blood vessel disease and other factors related to diabetes in this population. One of the centerpieces of the AADI is a colorful, interactive Chinese-English diabetes Web site. The AADI site, featuring content from Joslin's Web site (www.joslin.org) translated into traditional and simplified Chinese, is believed to be one of the most extensive of its type devoted to helping Chinese-speaking individuals manage their diabetes. In addition, Drs. King and Hsu and dietitian/diabetes educator Sophia Cheung are the authors of a Joslin publication, Staying Healthy With Diabetes: A Guide for the Chinese American Community, available for purchase on Joslin's Store. For more information about AADI programs, please call (617) 732-2606.

About Joslin Diabetes Center

Joslin Diabetes Center, dedicated to conquering diabetes in all of its forms, is the global leader in diabetes research, care and education. Founded in 1898, Joslin is an independent nonprofit institution affiliated with Harvard Medical School. Joslin research is a team of more than 300 people at the forefront of discovery aimed at preventing and curing diabetes. Joslin Clinic, affiliated with Beth Israel Deaconess Medical Center in Boston, the nationwide network of Joslin Affiliated Programs, and the hundreds of Joslin educational programs offered each year for clinicians, researchers and patients, enable Joslin to develop, implement and share innovations that immeasurably improve the lives of people with diabetes. As a nonprofit, Joslin benefits from the generosity of donors in advancing its mission. For more information on Joslin, call 1-800-JOSLIN-1 or visit www.joslin.org.

Posted by dlife at 11:38 AM | Comments (0)

Older Adults May Reduce Risk of Metabolic Syndrome by Eating More Whole Grains

Research from the Friedman School of Nutrition Science and Policy at Tufts University

February 6, 2006 (Eurekalert) -With the recent revision of the Food Guide Pyramid, the Dietary Guidelines for Americans have for the first time provided the public with a quantitative recommendation for whole-grain intake. In a study published in the January issue of American Journal of Clinical Nutrition, researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University (HNRCA) found that consuming a diet rich in whole-grain foods may lower an elderly person's risk for cardiovascular disease and reduce the onset of metabolic syndrome. Metabolic syndrome, which is a collection of risk factors, puts people at an increased risk of cardiovascular disease and type 2 diabetes.

The study, a collaborative effort that included Paul Jacques, DSc, director of the Nutritional Epidemiology Program at the HNRCA, Nicola McKeown, PhD, scientist in the same program, and others, examined the relationship between whole-grain intake and cardiovascular disease risk factors, metabolic syndrome, and the incidence of death due to cardiovascular disease in the elderly.

"Previous studies have found a link between whole-grain intake and reduced risk of metabolic syndrome in middle-aged populations. What's unique about our study," says McKeown, "is that we went back to data that was collected 20 years ago, using diet records that captured food intake, and found that whole-grain foods had a subsequent benefit in the elderly." The ability of researchers to differentiate whole grains from refined grains more accurately through the use of diet records is a major advantage when assessing dietary intake. "In past studies," states McKeown, "fixed food categories have made it difficult to accurately separate whole and refined grains for some food items – such as breads."

According to Jacques, who is also a professor at the Friedman School of Nutrition Science and Policy at Tufts, "consuming a high whole-grain diet is likely to have positive metabolic effects in elderly individuals, who are prone to greater insulin resistance and impaired glucose tolerance."

McKeown and Jacques found that, indeed, as whole-grain intake increased, fasting blood sugar levels were lower in these subjects. Refined grain intake, on the other hand, was associated with higher fasting blood sugar levels. Elevated fasting blood sugar levels can indicate impaired glucose tolerance and the presence of diabetes. In addition, people who consumed high amounts of refined grains had twice the risk of having metabolic syndrome than those people who consumed the fewest servings of refined grains.

"It is important to note," cautions McKeown, "that the subjects in the study were not a representative sample of the elderly, so we do not know the implications of applying these results to other populations. Based on the research, whole-grain intake is one modifiable dietary risk factor that may lead to substantial health benefits at the population level, even among an older population. Older adults should be encouraged to increase their daily intake of whole grain foods to three or more servings a day by substituting whole grains for refined grains."

Posted by dlife at 11:40 AM | Comments (0)

Diabetic Hearts Make Unhealthy Switch to High-Fat Diet

February 3, 2006 (Eurekalert) - The high-fat "diet" that diabetic heart muscle consumes helps make cardiovascular disease the most common killer of diabetic patients, according to a study done at Washington University School of Medicine in St. Louis. The study will appear in the February 7 issue of the Journal of the American College of Cardiology and is now available online.

Sixty-five percent of people with diabetes die from heart attack or stroke. When the researchers investigated fuel consumption in heart muscle, they found that heart muscle of type 1 diabetic patients relies heavily on fat and very little on sugar for its energy needs. In contrast, heart muscle in non-diabetics doesn't have this strong preference for fat and can use either sugar (glucose) or fat for energy, depending on blood composition, hormone levels or how hard the heart is working.

"The diabetic heart's overdependence on fat could partly explain why diabetic patients suffer more pronounced manifestations of coronary artery disease," says senior author Robert J. Gropler, M.D., professor of radiology, medicine and biomedical engineering and director of the Cardiovascular Imaging Laboratory at the Mallinckrodt Institute of Radiology at the School of Medicine. "The heart needs to use much more oxygen to metabolize fats than glucose, making the diabetic heart more sensitive to drops in oxygen levels that occur with coronary artery blockage."

Compared to non-diabetics, diabetic patients often have larger infarctions and suffer more heart failure and sudden death when the heart experiences an ischemic (low-oxygen) event.

In addition, when the diabetic heart burns fat, it accumulates reactive oxygen molecules that interfere with the fuel consumption mechanism and encourage the accumulation of fats in the muscle cells. This can lead to increased inflammation, cell death and heart dysfunction.

The diabetic heart's reliance on fat molecules for energy was previously observed in experiments using diabetic animals. But this is the first time researchers have confirmed that burning of fatty acids in the heart muscle is increased in humans with diabetes. In this study, 11 healthy, non-diabetic people were compared to 11 otherwise healthy people with type 1 diabetes. The researchers found that the diabetic patients had much higher levels of fats in their blood and had an increased uptake of fatty acids into heart muscle cells.

The cells of diabetic hearts not only absorbed more fat, they also burned a higher percentage of the fats they took in. As a result, diabetic heart muscle used about half as much glucose and four times more fat for energy than the hearts of non-diabetics.

The researchers are now engaged in a larger study of heart muscle metabolism in type 2 diabetics. Patients in the study are divided into two groups with one group receiving standard therapies to normalize blood glucose levels and the other group receiving additional therapies designed to decrease the amount of fat in the blood. The study is still accruing patients, and people with type 2 diabetes who would like to participate can call 314-362-8608.

If the increased blood-fat levels are confirmed to be responsible for the dysfunctional metabolism of diabetic heart muscle, reducing fat levels may become an important way to decrease illness and death from cardiovascular disease in diabetics, according to the authors.

Posted by dlife at 11:16 AM | Comments (0)

Team Care for Older Adults with Diabetes, Depression Improves Health

Older diabetic patients with depression who received a new type of team care had more depression-free days, better physical functioning, and lower medical costs than patients treated with a standard model of care.

February 2, 2006 (Newswise) — Older diabetic patients with depression who received a new type of team care had more depression-free days, better physical functioning, and lower medical costs than patients treated with a standard model of care. The findings are the result of a University of Washington-led study, published in the Feb. 6 issue of the journal Diabetes Care.

Depression affects an estimated 3 million older adults in the United States, including 15 percent of patients with Diabetes. In a new team care approach, called IMPACT (Improving Mood – Promoting Access to Collaborative Treatment for Late Life Depression), a depression care manager (usually a nurse, social worker or psychologist) works closely with the patient’s primary care physician and a consulting psychiatrist to treat depression in the patient’s regular primary care clinic. Previous studies have shown the IMPACT program provides powerful health benefits, including decreased depression and pain, improved physical functioning and better quality of life for up to two years (http://www.impact.ucla.edu).

This study examined the cost-effectiveness of the IMPACT program in 418 depressed older adults with diabetes who participated in the IMPACT trial. Depression in diabetic patients is associated with increased symptoms of diabetes, impaired functioning, higher medical costs, and increased mortality. In addition, patients with depression often have poor self-care, a behavior that can lead to diabetes complications and even death.

The researchers found that the IMPACT model of depression care helped patients have an average of 115 more depression-free days than patients receiving standard care for depression. Patients in the IMPACT program also had improved functioning and quality of life and lower overall medical costs over 2 years, more than offsetting the cost of providing IMPACT care.

“These older adults with diabetes were able to enjoy nearly four more months free of depression under the IMPACT model,” said Dr. Wayne Katon, professor and vice-chair of psychiatry and lead author of the study. “In addition, the cost of implementing this model was offset by the savings we saw due to patients having lower overall medical costs.”

Diabetes treatment requires a complex regimen of self-care, including increased exercise, altered diet, checking blood sugar, and altering medication based on blood sugar readings. This study indicates that reducing the effects of depression in diabetic patients – not only improves quality of life but helps to cut medical costs associated with diabetes care.

“Patients with depression struggle with self-care, and that can present a big problem for diabetics who have to follow a complex program of self care that includes changes in diet, exercise, and frequent blood sugar adjustments,” said Dr. Jürgen Unützer, professor and vice chair of psychiatry at the UW and director of the IMPACT Coordinating Center. “The IMPACT team care model not only reduced depression symptoms; it also gave patients the hope and energy they needed to participate in their self-care. Over two years, this resulted not only in better quality of life but also in a reduction in patient’s overall health service utilization.”

Based on its cost-effectiveness, several major health organizations have already implemented the IMPACT model for depression care, including Kaiser Permanente of Southern California, which serves more than 3 million members in its 12 regional medical centers. The John A. Hartford Foundation is supporting the efforts of Katon and Unützer to help other health systems take up the IMPACT model.

The cost of using the IMPACT model of depression care treatment is only about $580 per year for each patient – a modest investment compared to the total medical costs of about $9,000 per year for an older adult with depression and diabetes. When the cost of the IMPACT model is spread out over an entire population of older adults, the cost amounts to less than $1 per month for each member.

A more effective method of treating clinical depression in late life has become more important in recent years, as physicians have learned that the condition affects many older adults and helps drive up health care costs. Studies estimate that 5 to 10 percent of older adults seen in primary care suffer from clinical depression. The condition is associated with a variety of other medical problems, including more suffering and physical pain, decreases in physical ability and self-care of chronic illnesses, and a high potential for suicide. It also can significantly increase medical costs.

Background: IMPACT
The IMPACT study, which began in 1999, randomly assigned 1,801 depressed older adults from 18 primary care clinics affiliated with eight diverse health care organizations in five states to usual depression care or to the IMPACT program. In IMPACT care, a depression care manager (a nurse or psychologist) with consultation from a psychiatrist and an expert primary care physician helped patients and their primary care doctors treat depression in the primary care setting. The care managers helped educate patients about depression, closely tracked depressive symptoms and side effects, helped make changes in treatment when necessary, supported patients on anti-depressant medications, and offered a brief course of psychotherapy to help patients make changes in their lives. The IMPACT program did not replace the patient’s regular primary care physician, but instead supported these physicians to help them provide higher quality depression care. An independent evaluation of the study outcome was done at baseline 3, 6, 12, and 24 months to compare IMPACT to usual care.

The 18 study sites that were part of the IMPACT Project are located at Duke University, South Texas Veterans Health Care System, Central Texas Veterans Health Care System, San Antonio Preventive and Diagnostic Medicine Clinic, Indiana University School of Medicine, Health and Hospital Corporation of Marion County in Indiana, Group Health Cooperative of Puget Sound in cooperation with the University of Washington, Kaiser Permanente of Northern California, Kaiser Permanente of Southern California, and Desert Medical Group in Palm Springs, California.

The IMPACT study was supported primarily by a grant from the John. A. Hartford Foundation with additional support from the California Healthcare Foundation, the Hogg Foundation, and the Robert Wood Johnson Foundation. The John A. Hartford Foundation (http://www.jhartfound.org) is dedicated to improving health care for older Americans.

The IMPACT Coordinating Center, where physicians and health care professionals can learn more about implementing the IMPACT model in their organizations, can be found at http://www.impact.ucla.edu/.

Posted by dlife at 11:44 AM | Comments (0)

GlaxoSmithKline Announces the Approval and Availability of Avandaryl(TM) (rosiglitazone maleate and glimepiride): A New Fixed-Dose Combination Tablet to Treat Type 2 Diabetes

New product offers a convenient option that combines rosiglitazone, an insulin sensitizer, with a sulfonylurea to help patients improve blood sugar control

PHILADELPHIA, February 1, 2006 (PRNewswire-FirstCall) - GlaxoSmithKline announces the availability of Avandaryl(TM) (rosiglitazone maleate and glimepiride), a new fixed-dose combination product for type 2 diabetes. Recently approved by the U.S. Food and Drug Administration (FDA), Avandaryl is the first and only tablet to combine a thiazolidinedione (TZD), rosiglitazone maleate - separately marketed as Avandia(R) - with a sulfonylurea, glimepiride - separately marketed as Amaryl(R) - to help improve blood sugar control. As an adjunct to diet and exercise, Avandaryl is indicated to improve blood sugar control in patients with type 2 diabetes who are already treated with a combination of rosiglitazone and sulfonylurea or who are not adequately controlled on a sulfonylurea alone or for those patients who have initially responded to rosiglitazone alone and require additional blood sugar control.

cent of type 2 diabetes patients are not well controlled on their current therapy. According to the United Kingdom Prospective Diabetes Study (UKPDS), many monotherapy treatments may fail to maintain blood sugar control over time. Combination therapy is often needed to help reach and maintain patients' blood sugar goals over time," said Barry Goldstein, M.D., Ph.D., director, Division of Endocrinology, Diabetes and Metabolic Diseases, Jefferson Medical College of Thomas Jefferson University, Philadelphia. "Avandaryl, a combination of rosiglitazone and a sulfonylurea, provides two different, yet complementary, mechanisms of action to treat diabetes by improving blood sugar control in patients with type 2 diabetes. The patient's treatment regimen combines these two medicines into one convenient tablet."

Over 18 million Americans have type 2 diabetes, the most common form of diabetes. Type 2 diabetes is characterized by high blood sugar levels that occur when the body does not produce enough insulin or does not respond properly to its own natural insulin, a condition called insulin resistance. When sugar builds up in the blood instead of going into the cells, it can starve the cells of energy and over time, high blood sugar levels can cause diabetes-related complications, affecting the eyes, kidneys, nerves or heart. To reach recommended blood sugar levels, many people with type 2 diabetes may eventually need to take more than one medicine to help treat the disease in different ways.

To manage diabetes, it is important for patients, along with their physicians, to set and meet A1c goals. The A1c test is a blood sugar test that reflects a person's average blood sugar levels over the previous two to three months. An A1c goal of less than 7.0% has been recommended by the American Diabetes Association (ADA). Joint guidelines released by the American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE) recommend an A1c goal of 6.5% or lower. Lowering blood sugar levels can help reduce the risk of diabetes-related complications. Some complications of diabetes include heart disease, stroke, blindness, loss of limbs, and kidney disease.

Avandaryl: A New, Convenient Treatment Option

Avandaryl is the first fixed-dose combination tablet containing a TZD and a sulfonylurea. This medication combines rosiglitazone, the most widely prescribed TZD compound, with glimepiride, a second-generation member of the sulfonylurea class of oral diabetes therapies. As an adjunct to diet and exercise, Avandaryl is indicated to improve blood sugar control in patients with type 2 diabetes who are already treated with a combination of rosiglitazone and sulfonylurea or who are not adequately controlled on a sulfonylurea alone or for those patients who have initially responded to rosiglitazone alone and require additional blood sugar control.

Rosiglitazone directly targets insulin resistance, an underlying cause of type 2 diabetes, and helps the body respond better to its own natural insulin. Sulfonylureas work primarily by helping the body release more of its natural insulin.

Significant Improvements in Glycemic Control with Rosiglitazone Combination Therapy

Adding an insulin sensitizer, such as rosiglitazone, to patients not achieving blood sugar control on a sulfonylurea alone may help patients achieve blood sugar control. Data have shown that the addition of rosiglitazone (4 mg or 8 mg) to a sulfonylurea significantly improved A1c and fasting plasma glucose compared to a sulfonylurea alone. In a two-year double-blind study, the effect of rosiglitazone plus a sulfonylurea on A1c and fasting plasma glucose was durable over the two-year period.

Avandaryl, which offers convenient dosing, is available in three tablet strengths of rosiglitazone/glimepiride, respectively: 4 mg/1 mg, 4 mg/2 mg and 4 mg/4 mg.

"GlaxoSmithKline is committed to researching new options for the treatment of type 2 diabetes, a disease that impacts a significant and growing number of individuals and their families," said Brian A. Lortie, vice president, Anti-Infective, Metabolic and Endocrine Marketing for GlaxoSmithKline. "Avandaryl, the newest addition to GSK's diabetes franchise, offers an effective and convenient treatment option to help patients manage type 2 diabetes."

Important Safety Information for Avandaryl

Avandaryl, along with diet and exercise, helps improve blood sugar control. Avandaryl is a combination of two drugs - rosiglitazone maleate and glimepiride.

Avandaryl may cause low blood sugar. Lightheadedness, dizziness, shakiness or hunger may mean that your blood sugar is too low. If you have kidney problems, you may need a lower dose of Avandaryl to reduce problems with low blood sugar. Talk to your doctor if low blood sugar is a problem for you.

Some people may experience tiredness, weight gain or swelling with Avandaryl.

Avandaryl may cause fluid retention or swelling, which could lead to or worsen heart failure, so you should tell your doctor if you have a history of these conditions. If you experience an unusually rapid increase in weight, swelling or shortness of breath while taking Avandaryl, talk to your doctor immediately.

In combination with insulin, rosiglitazone, one of the components of Avandaryl, may increase the risk of other heart problems. Avandaryl is not approved for use with insulin. Avandaryl is not recommended for patients with NYHA Class 3 and 4 cardiac status or active liver disease.

Blood tests should be used to check for liver problems before starting and while taking Avandaryl. Tell your doctor if you have liver disease, or if you experience unexplained tiredness, stomach problems, dark urine or yellowing of skin while taking Avandaryl.

If you are nursing, pregnant or thinking about becoming pregnant, talk to your doctor before taking Avandaryl. Avandaryl may increase your risk of pregnancy.

Your doctor should check your eyes regularly. Very rarely, some patients have experienced vision changes due to swelling in the back of the eye while taking rosiglitazone, a component of Avandaryl.

The GSK diabetes franchise includes Avandia(R) (rosiglitazone maleate), Avandamet(R) (rosiglitazone maleate and metformin HCl) and the newly approved Avandaryl.

For more information about Avandaryl, and other products in the GSK diabetes franchise, please visit http://www.avandia.com or call 1-888-825-5249.

About GlaxoSmithKline

GlaxoSmithKline, one of the world's leading research-based pharmaceutical and healthcare companies, is committed to improving the quality of human life by enabling people to do more, feel better and live longer.

Additional information about GlaxoSmithKline can be found online at http://www.gsk.com.

Amaryl is a registered trademark of the group sanofi-aventis

Posted by dlife at 11:50 AM | Comments (0)

Researchers Studying Diabetes Find a Possible Cause of Infertility

February 1, 2006 (NIH) - For about one in 10 couples that cannot conceive a child, their reproductive problem falls under the broad category of “idiopathic infertility,” meaning the cause remains to be determined. But these idiopathic problems are gradually giving way to discovery and, in the February issue of the journal Endocrinology, scientists at the National Institutes of Health and colleagues report that in the course of animal studies to understand diabetes, they may have uncovered a previously unknown cause of infertility in women.

The scientists report that some female reproductive problems might involve the so-called dense core vesicles, the protein packaging that encases insulin and other secreted hormones. Whereas researchers traditionally have been most interested in the hormonal content of the vesicles, the team discovered the structural components of the vesicles play a subtle and until now overlooked role in the secretion of reproductive hormones from the pituitary gland that stimulate the release of eggs from the ovaries, or ovulation.

The researchers said this finding is potentially important because, when they deleted genes that encode two major proteins in the protective outer membrane of these vesicles, female mice were born infertile. “What’s particularly interesting is the deleted proteins, called IA-2 and IA-2 beta, also are structurally important for dense core vesicles in people,” said Dr. Abner Notkins, a scientist at NIH’s National Institute of Dental and Craniofacial Research (NIDCR) and senior author on the paper. “That’s why it’s very likely that alterations in these and possibly other genes that are needed to produce well functioning dense core vesicles would have similar effects in people.”

Dense core vesicles are key components of our neuroendocrine cells, or cells that secrete hormones and other signaling proteins into the bloodstream. Under a laboratory microscope, these hormone-containing vesicles look like tiny granular specks that shuttle from the cytoplasm to the cell membrane. There, the vesicles aggregate until the appropriate signal arrives to stimulate the release of their hormone content into the circulation. The release of hormones from these vesicles marks an important, tightly controlled event in regulating a variety of biological processes, including blood glucose and reproductive cycles.

This month’s finding is a classic case of an experiment taking an unexpected scientific twist. According to Notkins, his laboratory has a longstanding research interest in the IA-2 and IA-2 beta proteins. In the mid 1990s, his group first reported that increased levels of autoantibodies against IA-2 in particular are strongly associated with an increased risk for Type I diabetes. Today, research laboratories around the world use the measurement of autoantibobies, including those to IA-2, to predict a person’s likelihood of developing Type I diabetes.

However, the precise function of these proteins has remained unclear. To solve this issue, Notkins and colleagues created “knockout” mice, a standard laboratory strategy in which a specific gene of choice is inactivated. In this case, they created litters of mice that lacked the IA-2 gene, IA-2 beta gene, or both. The hope was the mice would have some obvious visual manifestation of what happens when the gene is lacking, offering a clue into each gene’s normal function in the body.

“When knockout mice are born, we routinely examine them for a variety of biological features, including fertility,” said Dr. Atsutaka Kubosaki, an NIDCR scientist and lead author on the paper. “We found most of the female mice that lacked both the 1A-2 and IA-2 beta genes not only had some characteristics of disordered glucose metabolism, they failed to ovulate and were essentially infertile. That’s when we decided to halt some of our other studies and try to find out why the knockout mice produced so few offspring.”

In collaboration with Drs. Anne Clark and John Morris, scientists at Oxford University in England and authors on the paper, the NIH researchers found these mice had totally abnormal reproductive cycles and could not ovulate. This raised the possibility that changes in the dense core vesicle caused the pituitary gland to secrete insufficient luteinizing hormone to trigger ovulation. They soon found this was the case and, when they treated the knockout mice with luteinizing hormone, ovulation did occur.

“Although we need to define further the roles of IA-2 and IA-2 beta in the secretion of dense core vesicles in the pituitary gland, our results do suggest an important role for these proteins in the control of ovulation, which should be considered in women with an unsolved reproductive problem” said Dr. John Morris.

The National Institute of Dental and Craniofacial Research is the nation's leading funder of research on oral, dental, and craniofacial health.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary Federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

Posted by dlife at 11:48 AM | Comments (0)

Major Medical Associations Call For Better Blood Glucose Management in Hospitalized Patients

WASHINGTON, February 1, 2006 (U.S. Newswire) - The American Association of Clinical Endocrinologists (AACE), American College of Endocrinology (ACE – the scientific and educational arm of AACE) and the American Diabetes Association (ADA) have joined forces to develop strategies for management of adult patients with high blood glucose (sugar) in hospitals. Co-sponsored by ten other major medical associations, AACE and ADA released a new position statement today on improving inpatient glycemic control at a joint consensus conference.

Awareness about the importance of glycemic control in the hospital setting has increased as result of the ACE Consensus Development Conference on Inpatient Diabetes and Metabolic Control in 2003. In order to suggest a plan for better care, AACE and ADA came together to conduct the "Improving Inpatient Diabetes Care: A Call to Action Conference - Consensus Development Conference," Jan. 30 and 31, in Washington, D.C.

Conference Background

Leading endocrinologists and other medical specialists along with health care organizations and allied health professionals reviewed research on blood glucose management and recommended principles and strategies for improving patient care. Other organizations that participated in this landmark conference included American Association of Critical-Care Nurses, American Association of Diabetes Educators, American College of Cardiology, American College of Endocrinology, American Heart Association, American Society of Anesthesiologists, Joint Commission on Accreditation of Healthcare Organizations, Society of Critical Care Medicine, Society of Hospital Medicine and Veterans Health Administration.

"The 2003 conference launched a dialogue among leading organizations who agreed that the problem of inpatient blood glucose control needed to be addressed," stated Etie S. Moghissi, MD, FACE, AACE co-chair. "We convened this meeting to further develop strategies and eliminate the roadblocks for implementation of intensive glycemic control."

"This week's conference reviewed recent data, looked at multiple inpatient programs and new technologies that are achieving success and made recommendations for improved patient care," stated Vivian Fonseca, MD, FACE, ADA co-chair. "This conference also increased awareness of the importance of glycemic control among various stakeholders."

Posted by dlife at 11:46 AM | Comments (0)