Once-Diabetic Heart/Kidney/Pancreas Transplant Recipient Enjoys Life (And Eating Again)
December 28, 2006 (Newswise) — At holiday dinners this year, Calabasas, Calif., resident Jim Stavis, 52, was able to eat the same pumpkin pie and special desserts everyone else had, not the sugar-free variety. And when dinner was over, he didn’t have to reach for his insulin pump to try to compensate. A pancreas transplant performed at Cedars-Sinai Medical Center in late October cured him of diabetes, which had controlled his life for 35 years.
Oh, and a heart and kidney transplant performed at the same place and same time the year before saved his life.
Only about eight patients in the United States have received simultaneous transplants of a heart, kidney and pancreas since 1992, according to the Organ Procurement and Transplantation Network (OPTN), and the first European patient to receive this combination of organs simultaneously was reported to be in good health 11 years after the procedure. If a combination like Jim’s – heart and kidney, followed later by a pancreas transplant – has been performed, it does not appear to be documented in medical literature. In any case, Jim is among elite company worldwide.
Jim was diagnosed with diabetes when he was 17. “I was told, back in the early ’70s, that having diabetes meant a life of potential amputations, blindness, kidney disease and other problems.
He decided to adopt a positive outlook, managing his health as best he could, and accepting life and its challenges as they came. He remained relatively healthy for about 20 years but began to encounter diabetes-related complications – such as a blocked coronary artery – in the late 1990s. Under the care of cardiologist P.K. Shah, M.D., director of Cedars-Sinai’s Division of Cardiology and the Atherosclerosis Research Center, Jim was able to manage his heart problems conservatively until more serious problems emerged.
“In the winter of 2004, we went to visit my daughter at her college in Madison, Wisconsin for Parents’ Weekend and my kidneys shut down and I went into congestive heart failure,” Jim says. “That was a big signal that I needed to do something.”
After more than a week in a hospital in Madison, he came home and saw Shah, who said he would need a heart and kidney transplant, followed by a pancreas transplant.
“He described the heart and the kidneys as the targets of diabetes, and the pancreas as the trigger. Just addressing the target, without eliminating the trigger, would have created a situation that could jeopardize the new organs,” Jim recalls.
The first transplants were performed in November 2005. J. Louis Cohen, M.D., surgical director of Kidney Transplantation and medical director of Operating Room Services, headed the kidney transplant team. Alfredo Trento, M.D., chair of the Division of Cardiothoracic Surgery performed the heart transplant, and Lawrence S.C. Czer, medical director of the Heart Transplant Program and director of Transplantation Cardiology, served as Jim’s primary cardiologist.
Two specialists joining Cedars-Sinai, one in 2005 and one in 2006, also became members of Jim’s medical team: cardiologist Ernst R. Schwarz, M.D., Ph.D., who specializes in several aspects of cardiology, including cardiac transplantation; and Donald C. Dafoe, M.D., director of Pancreas Transplantation.
Pancreas transplantation is a relatively new development in the field. It is fairly uncommon and usually performed only in conjunction with a kidney transplant. Dafoe is one of the nation’s leading pancreas transplant surgeons.
Jim’s operations and recoveries have gone so well that he expects to be golfing and working out by January. Since November, he has returned to work two or three days a week.
“When Dr. Dafoe came out of surgery to talk to my family and friends in the waiting area, he said, ‘I’m happy to report that Jim Stavis is no longer a diabetic,’” says the owner of a metal fabricating and distributing company in Long Beach. “That in itself is quite a statement. When I was a teenager, I hoped there would someday be a cure for diabetes, but I never thought my cure would happen this way. Back then, we never imagined that pancreas transplants were possible.”
Some aspects of instantly becoming a non-diabetic have taken some adjustment while others have not, Jim says. It seems strange to be permitted to eat normally and enjoy traditional pumpkin pie after 35 years. But it was easy to give up the inconvenience that goes along with managing diabetes.
“I used to have an insulin pump, so when I would eat I would have to manually put in how much insulin I needed to take after a meal,” he says. “People have asked me, ‘Isn’t it weird to suddenly be able to eat and not reach for the pump?’ And the reality is that habit was broken in about a minute. I never for a moment looked back.”
One of seven hospitals in California whose nurses have been honored with the prestigious Magnet designation, Cedars-Sinai Medical Center is one of the largest nonprofit academic medical centers in the Western United States. For 19 consecutive years, it has been named Los Angeles’ most preferred hospital for all health needs in an independent survey of area residents. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities and its broad spectrum of programs and services, as well as breakthroughs in biomedical research and superlative medical education. It ranks among the top 10 non-university hospitals in the nation for its research activities and is fully accredited by the Association for the Accreditation of Human Research Protection Programs, Inc. (AAHRPP). Additional information is available at http://www.cedars-sinai.edu.
Posted by dlife at 02:02 PM | Comments (1)
FDA Approves BYETTA® (exenatide) Injection for Expanded Combination Use
Dec 22, 2006 (>PRNewswire-FirstCall via COMTEX News Network) -- Amylin Pharmaceuticals, Inc. (Nasdaq: AMLN) and Eli Lilly and Company (NYSE: LLY) announced today that the U.S. Food and Drug Administration (FDA) has approved BYETTA® (exenatide) injection as an add-on therapy to improve blood sugar control in people with type 2 diabetes who have not achieved adequate control on a thiazolidinedione (TZD). Healthcare professionals will be educated on this additional use for BYETTA in the coming weeks.
In a clinical trial designed to evaluate BYETTA for use in combination with a TZD, 62 percent of patients who added BYETTA to their existing medicines achieved an A1C (a measure of blood glucose levels over time) of 7 percent or less, compared to 16 percent of the patients on placebo. People taking BYETTA also lost an average of 3.3 pounds over 16 weeks, compared to an average weight reduction of 0.4 pounds in the other group. The most common adverse event associated with BYETTA was nausea (40 percent)(1)(2).
"Due to the progressive nature of type 2 diabetes, previous approaches to management frequently failed to achieve target levels of A1C, or resulted in subsequent failure over one to three years," said Dr. Robert Ratner, Vice President for Scientific Affairs at the MedStar Research Institute in Washington, DC. "The combination of exenatide with metformin, sulfonylureas, or TZDs not only expands our options to achieve optimal glycemic control, but does so with accompanying weight loss."
BYETTA improves blood sugar control by lowering both post-meal and fasting (early morning) glucose levels resulting in better long-term control as measured by A1C. BYETTA controls blood sugar through several physiologic actions, including the stimulation of insulin secretion only when blood sugar is high. BYETTA restores the first-phase insulin response (an activity of the cells in the pancreas that is lost in patients who have type 2 diabetes), decreases glucose output from the liver, regulates gastric emptying, and decreases food intake. The majority of patients in long-term BYETTA clinical studies also experienced weight loss.
"Almost half a million people with type 2 diabetes have used BYETTA to help reduce their blood sugar," said Ginger L. Graham, Chief Executive Officer, Amylin Pharmaceuticals. "Now, even more people -- those who use another common category of oral medicines, TZDs -- have a new treatment option and have the opportunity to benefit from the unique clinical benefits of BYETTA."
"There are two core defects to type 2 diabetes, beta cell failure and insulin resistance," said Vince Mihalik, Global Brand Development Leader for Diabetes and Endocrine, Lilly. "The ability of BYETTA to improve beta cell responsiveness and lower weight complements the TZD effect on insulin resistance very nicely."
Posted by dlife at 01:59 PM | Comments (0)
Resolution is a First for Non-Infectious Diseases
NEW YORK, December 21, 2006 (PRNewswire) - The United Nations General Assembly has today passed a landmark Resolution recognizing the global threat of the diabetes epidemic. For the first time, governments have acknowledged that a non-infectious disease poses as serious a threat to world health as infectious diseases like HIV/AIDS, Tuberculosis and Malaria.
The International Diabetes Federation (IDF) leads the Unite for Diabetes campaign, which aims to draw attention to the seriousness of diabetes and encourage action to fight the epidemic. Since its inception the campaign has aimed for a UN Resolution.
Professor Martin Silink, IDF President and Chair of the campaign, explained the importance of the Resolution: "Today a key battle has been won in the fight against diabetes. The significance is monumental. It will inspire, energize and empower the diabetes world. People said it couldn't be done, but only six months since launching our campaign we have achieved our first goal. The struggle will now focus on helping and encouraging governments worldwide to develop national policies to improve diabetes care and prevention. I couldn't think of a better gift for the millions of families affected by diabetes."
The Unite for Diabetes campaign has brought together the largest ever diabetes coalition, including patient organizations from over 150 countries, the majority of the world's scientific and professional diabetes societies, many charitable foundations, service organizations and industry.
The People's Republic of Bangladesh steered the diplomatic process that resulted in the passing of the Resolution. The cause was taken up by the G77 (a coalition of 133 developing and transitional countries at the UN led by the Republic of South Africa). The ownership of the Resolution by this majority voting bloc convinced the countries of the developed world to throw their support behind the Resolution.
The Resolution designates World Diabetes Day, November 14th, as a United Nations Day to be observed every year starting in 2007. It calls on all UN Member States to observe the day and on all nations to develop national policies for the prevention, treatment and care of diabetes.
Diabetes is a much-ignored but deadly disease, responsible for close to 4 million deaths every year. It is a leading cause of heart attack, stroke, blindness, kidney failure and amputation. The global diabetes community recently gathered in Cape Town, South Africa for its triennial World Diabetes Congress. Data released at the highly successful event show the serious extent of the epidemic and underscore the need for urgent action.
Over 380 million people will live with diabetes by 2025 if significant action is not taken. The vast majority, more than 300 million, will live in developing countries.
"If nothing is done, it is the developing world that will once again bear the brunt of the world's disease burden,". said Jean-Claude Mbanya, IDF President-Elect. "Governments worldwide must work with the diabetes community and society to tackle the problem. People with diabetes must be part of the solution. It is our hope that, with the recognition of the United Nations, the diabetes epidemic can now emerge from the shadows."
Posted by dlife at 02:33 PM | Comments (0)
Relative Abundance of Common Microbes Living in the Gut May Contribute to Obesity
December 21, 2006 (Newswise) — A link between obesity and the microbial communities living in our guts is suggested by new research at Washington University School of Medicine in St. Louis. The findings indicate that our gut microbes are biomarkers, mediators and potential therapeutic targets in the war against the worldwide obesity epidemic.
In two studies published this week in the journal Nature, the scientists report that the relative abundance of two of the most common groups of gut bacteria is altered in both obese humans and mice. By sequencing the genes present in gut microbial communities of obese and lean mice, and by observing the effects of transplanting these communities into germ-free mice, the researchers showed that the obese microbial community has an increased capacity to harvest calories from the diet.
"The amount of calories you consume by eating, and the amount of calories you expend by exercising are key determinants of your tendency to be obese or lean," says lead investigator Jeffrey Gordon, M.D., director of the Center for Genome Sciences and the Dr. Robert J. Glaser Distinguished University Professor. "Our studies imply that differences in our gut microbial ecology may determine how many calories we are able to extract and absorb from our diet and deposit in our fat cells."
That is, not every bowl of cereal may yield the same number calories for each person. People could extract slightly more or slightly less energy from a serving depending upon their collection of gut microbes. "The differences don't have to be great, but over the course of a year the effects can add up," Gordon says.
Trillions of friendly microbes reside in the intestine, where they help to digest food that the body can't on its own, such as the complex sugars found in grains, fruits and vegetables. As part of the digestive process, the microbes break down nutrients to extract calories that can be stored as fat.
The researchers focused on two major groups of bacteria - the Bacteroidetes and the Firmicutes - that together make up more than 90 percent of microbes found in the intestines of mice and humans. In an earlier study, they compared genetically obese mice and their lean littermates. The obese mice had 50 percent fewer Bacteroidetes and proportionately more Firmicutes. Moreover, the differences were not due to a bloom of one species in the Firmicutes or a diminution of a single or a few species of Bacteroidetes: virtually all members of each group were altered.
In one of this week's Nature articles, Ruth Ley, Ph.D., a microbial ecologist in Gordon's group, reports on her investigation into whether these findings also held true among obese humans. She followed 12 obese patients at a Washington University weight loss clinic over a one-year period. Half the patients were on a low-calorie, low-fat diet and half were on a low-calorie, low carbohydrate diet.
At the outset of the study, the obese patients had the same type of depletion of Bacteroidetes and relative enhancement of Firmicutes as the obese mice. As the patients lost weight, the abundance of the Bacteroidetes increased and the abundance of Firmicutes decreased, irrespective of the diet they were on. Moreover, not one particular species of Bacteroidetes but the entire group increased as patients lost weight.
In a companion paper in the same journal, Peter Turnbaugh, a Ph.D. student in Gordon's lab, compared the genes present in the gut microbial communities of the obese and lean mice using the newest generation of massively parallel DNA sequencers.
The results of these so-called comparative metagenomic studies revealed that the obese animals' microbial community genome (microbiome) had a greater capacity to digest polysaccharides, or complex carbohydrates. By transferring the gut microbial communities of obese and lean mice to mice that had been raised in a sterile environment (germ-free animals), he confirmed that the obese microbial community prompted a significantly greater gain in fat in the recipients.
Gordon notes that these findings represent steps in a long journey designed to understand the contributions of our microbial self to our health. "Our microbial cells outnumber our human cells by as much as 10 fold and, and they may contain 100 times more genes than our own human genome," Gordon says.
These studies raise a number of questions, according to Gordon. "Are some adults predisposed to obesity because they 'start out' with fewer Bacteroidetes and more Firmicutes in their guts?" he asks. "Can features of a reduced Bacteroidetes-Firmicutes enriched microbial community become part of our definition of an obese state or a diagnostic marker for an increased risk for obesity? And can we intentionally manipulate our gut microbial communities in safe and beneficial ways to regulate energy balance?"
Posted by dlife at 08:58 AM | Comments (0)
Less Sugary Drinks During Childhood May Cut Disease Risk
December 19, 2006 (EurekAlert) - Symptoms of heart disease and diabetes usually seen in adults are increasingly being found in adolescents according to a longitudinal study, which suggests that reducing the intake of sugar-sweetened beverages during childhood may lessen the risk of chronic disease in later life.
"Research on obesity and associated problems such as hypertension and type-2 diabetes has largely dealt with adults," says Alison Ventura, doctoral candidate at Penn State's Center for Childhood Obesity Research. "But with increasing rates of obesity in children, we are seeing these problems at much younger ages."
Ventura and her colleagues Eric Loken, assistant professor of human development and family studies, and Leann Birch, professor of human development and family studies, are studying the clustering of traits such as insulin resistance, abdominal obesity, hypertension, and high triglycerides combined with low HDL – good cholesterol – that are thought to be related to cardiovascular disease and diabetes in adults.
The clustering of these traits, otherwise known as metabolic syndrome, is a strong indicator for chronic disease, and is being diagnosed in an increasing number of U.S adults and adolescents.
"Researchers think insulin resistance is the underlying trait that leads to the other metabolic abnormalities," says Ventura. "It is now thought that obesity may be a trigger for insulin resistance, thus creating a cascade of risk."
However, the Penn State researcher adds there is little data on the prevalence of metabolic syndrome in children since they are not routinely screened. Her team is trying to find a risk profile for later disease among children having the symptoms for metabolic syndrome.
The current study, funded by the National Institutes of Health, looked at different traits such as blood pressure, waist circumference, and levels of HDL cholesterol, triglycerides, and glucose in 154 white non-Hispanic 13-year-old girls and their parents, from central Pennsylvania. This study also had data on the girls and their parents' dietary, activity and lifestyle patterns starting from when the girls were five-years-old.
"We first looked for different profiles for the indicators of metabolic syndrome when the girls were 13, then worked backwards to see what was causing them in the first place," says Ventura, whose findings appear this month (December) in the Journal of American Academy of Pediatrics.
The study found statistical support was the greatest for the presence of four different groups within the sample: These groups included girls with higher blood pressure and waist circumference values; girls with higher levels of triglycerides and lower levels of HDL cholesterol; girls with more desirable values on all of the metabolic syndrome indicators, and girls with more undesirable values on all of the indicators.
"We wanted to see if we could find higher and lower risk profiles in the sample," explains Ventura. "Next we wanted to see if there were certain characteristics across ages 5 to 11 that predicted having a higher or lower risk profile."
Results from the study further suggest that girls within the risk groups for hypertension and metabolic syndrome also had significantly greater increases in weight and fat mass between the ages of 5 and 13 compared to the other two groups. Those at higher risk for metabolic syndrome were also found to be consuming significantly more servings of sugary beverages between the ages of 5 and 9 compared to the other three groups.
The Penn State researcher , however, cautions on making general interpretations from the study.
"We do not have future data on these girls and so we can only speculate that girls in the high risk group might develop metabolic syndrome, heart disease or type-2 diabetes," she adds.
Though the study cannot definitely pinpoint which children will develop chronic diseases, Ventura says the results show evidence for metabolic syndrome in early adolescence. They also illustrate several possible disease trajectories that may be avoided by certain measures during early childhood. The researchers also point out that only girls were included in the study.
"Family history does play a role, but it appears that we can prevent the development of metabolic syndrome in children by taking certain actions in early life. Controlling weight gain and the intake of sugar-sweetened drinks may prevent a child from the risk of disease later in life," Ventura adds.
Posted by dlife at 05:15 PM | Comments (1)
Drug Treatment Slows Macular Vision Loss in Diabetics
December 18, 2006 (Newswise) — A drug commonly used to slow the loss of central vision has shown promise in stemming a common precursor of blindness in diabetics, which involves the same central light-sensitive area of retina, Johns Hopkins Wilmer Eye Institute scientists report.
Encouraged by the effect of ranibuzumab in people with macular degeneration, the Hopkins researchers injected the drug into the eyes of 10 people losing their sight from macular edema, one of many complications of diabetes and a first stage of diabetic retinopathy.
Over the course of several months of therapy, every patient in the preliminary Hopkins study could read at least two more lines on the standard eye chart, the researchers said. Moreover, the thickness of the patients’ maculae, the central part of the retina responsible for seeing fine details, decreased an average of 85 percent. The American Journal of Ophthalmology published the team’s findings in their December issue.
“The results are impressive,” says Quan Dong Nguyen, M.D., M.Sc., an assistant professor of ophthalmology at the Wilmer Eye Institute at Johns Hopkins, “although we will not know until we begin a larger clinical trial what the long-term benefits of the drug might be.”
The Hopkins group believes that ranibuzumab interferes with a protein that spurs the growth of unwanted blood vessels in the back of the eye. Vascular endothelial growth factor, or VEGF, is released when the oxygen supply in the eye is restricted by blood vessel damage related to diabetes.
In a self-preserving attempt to acquire more oxygen, the VEGF signals for the creation of new blood vessels, which almost always damage, rather than improve, vision by blocking light’s entry onto the retina.
“We’ve suspected for awhile that ranibuzumab’s ability to shut down VEGF’s signaling would do the trick because it’s highly likely that VEGF is the culprit when it comes to diabetic macular edema,” says Nguyen.
More than 4 million diabetics in the United States have diabetic retinopathy and, according to the National Eye Institute, one in 12 of those experience at least some vision loss.
Macular edema, a first stage of retinopathy, occurs when, over time, excess uncontrolled blood sugar damages the tiny blood vessels in the eye, causing fluid and fat to leak onto the retina at the back of the eye. The swelling interferes with focus and blurs vision. Making matters worse, a lack of oxygen often then triggers VEGF’s production cycle.
All 10 subjects in the study had some vision loss at the start of the clinical trial, in which ranibuzumab was administered at the one, two, four and six month marks. The thickness of each patient’s macula was also measured at each point in the study using an advanced digital imaging technique.
“Within a week, several patients experienced dramatic reductions in the thickness of their maculas, and there were further improvements with each injection,” says Peter Campochiaro, M.D., the Dolores and George Eccles Professor of Ophthalmology at The Johns Hopkins University School of Medicine, who is also an investigator in the study.
Ranibuzumab is marketed for treatment of neovascular macular degeneration by Genentech Inc. under the brand name of Lucentis
Posted by dlife at 09:35 AM | Comments (2)
Obesity Cited Number-One Kids’ Health Issue: Americans Split on Who’s Responsible
December 14, 2006 (>Newswise) — Obesity or being overweight is seen as the most important health issue for U.S. children, according to a new poll commissioned by Research!America and The Endocrine Society. More than a quarter of Americans (27 percent) named obesity as the top health issue for kids, followed by lack of health care/insurance (16 percent) and nutrition/unhealthy diet (9 percent).
Americans are divided on whether addressing obesity is an individual or societal issue. According to the poll, 52 percent think obesity is a public health issue that society should help solve; 46 percent say it is a private issue that people should deal with on their own. When asked who should be responsible in addressing obesity, Americans say it should be an individual and community effort. They say responsibility to help address obesity lies to some or a great extent with parents (98 percent agree), individuals (96 percent), schools (87 percent), health care providers (84 percent), the food industry (81 percent) and government (67 percent).
More than half (57 percent) of Americans say most adults in the United States are overweight or obese, and more than a third (35 percent) say most children are. Perceptions are close to reality: 66 percent of American adults (ages 20-74) are overweight or obese, although only about 17 percent of children (ages 2-19) are, according to the National Center for Health Statistics at the Centers for Disease Control and Prevention.
“Clearly, Americans recognize the obesity epidemic facing this country and our children,” said Dr. Leonard Wartofsky, president of The Endocrine Society. “However, the poll shows that the public thinks we should address obesity as a public health issue to bolster the actions of individuals and families. Health care professionals and researchers need to help convey the importance of a stronger public health response to this epidemic.”
When asked about the most important health issue for all ages, 24 percent cited health insurance/health care costs, followed by cancer (15 percent), access to health care (11 percent) and obesity/nutrition (9 percent).
Other key findings in the poll include:
• Most Americans (92 percent) say their school required participation in physical education (PE) when they were children;
• 68 percent think PE is now required daily in elementary school, when actually fewer than one-fourth of the nation’s elementary schools provide daily physical education (U.S. Dept. of Education, National Center for Education Statistics);
• 81 percent say it is important for the U.S. government to invest in obesity research, and 84 percent say it is important to invest in public health and prevention programs to help reduce obesity among Americans; and
• 67 percent would be willing to pay $1 per week more in taxes if they were certain the money would fund research to improve health.
“Research is the answer to many of the health issues we face, including obesity,” said Mary Woolley, Research!America president. “Americans understand that and clearly want adequate funding for research that can improve their health and the health of their families.”
What Should Americans Know About Obesity Research
Research is attempting to determine the root causes of obesity and define the most effective measures to prevent and combat it. Pivotal research is being conducted to:
• Define the hormonal control of fat, carbohydrate and protein metabolism;
• Identify the hormones involved in appetite regulation;
• Examine and assess the genetics of obesity; and
• Unravel the control of lipids.
According to The Endocrine Society, most obesity is caused by an energy imbalance—consuming more energy than the body expends. However, there are many genetic, hormonal, and environmental factors that can affect this imbalance. In general, a patient should see an endocrinologist if:
• Behavior modifications, such as exercise and diet, are not effective for weight loss;
• The patient has an endocrine disorder, such as diabetes, that can be aggravated by obesity; or
• The patient has an underlying endocrine condition that increases their risk for obesity, such as Cushing’s syndrome or hypothyroidism.
Specialists in metabolism, endocrinologists are actively engaged in the research, management, and treatment of obesity and related diseases. Endocrinologists also study how hormones regulate appetite, metabolism, and energy balance. They also evaluate obese patients to determine if there is a primary reason for obesity; treat the medical conditions associated with obesity, including insulin resistance, reproductive difficulties, metabolic syndrome and genetic problems; and educate their patients and the public about obesity and its consequences
Posted by dlife at 03:53 PM | Comments (0)
OSI Pharmaceuticals Grants License to Bristol-Myers Squibb under Dipeptidyl Peptidase IV (DPIV) Patent Portfolio for the Treatment of Type 2 Diabetes
December 14, 2006 (BIOWIRE) - OSI Pharmaceuticals, Inc. announced today that its diabetes and obesity subsidiary, (OSI) Prosidion, has granted Bristol-Myers Squibb Company a worldwide non-exclusive license under its DPIV patent portfolio for the development and commercialization of DPIV inhibitors for the treatment of type 2 diabetes and related indications. OSI will receive an upfront payment, as well as potential future milestone and royalty payments. Additional financial terms were not disclosed.
"We are pleased to see the expanded use of this patent estate as new products in the significant emerging market for DPIV inhibitors are being brought forward," stated Anker Lundemose, M.D., Ph.D., President of (OSI) Prosidion. "A number of non-exclusive licenses to our DPIV technology have now been granted and OSI expects to grant additional non-exclusive licenses in the future."
OSI's DPIV patents which are the subject of the license, include issued patents and pending patent applications corresponding to WO 97/40832, WO 99/38501, WO 01/72290, WO03/015775 and WO 04/017989, with claims covering DPIV as a target for anti-diabetes therapy and the use of combinations of DPIV inhibitors with other anti-diabetes drugs such as metformin. Saxagliptin, an investigational compound currently in Phase III development by Bristol-Myers Squibb for the treatment of type 2 diabetes, is included within the scope of this license.
Posted by dlife at 10:10 AM | Comments (0)
Discovery of a Critical Role for Sensory Nerves in Diabetes Opens Door to New Treatment Strategies
December 14, 2006 (Newswire) - TORONTO - Researchers at The Hospital for Sick Children (SickKids), the University of Calgary and The Jackson Laboratory, Bar Harbor, Maine have found that diabetes is controlled by abnormalities in the sensory nociceptor (pain-related) nerve endings in the pancreatic islet cells that produce insulin. This discovery, a breakthrough that has long been the elusive goal of diabetes research, has led to new treatment strategies for diabetes, achieving reversal of the disease without severe, toxic immunosuppression. This research is reported in the December 15 issue of the journal Cell.
Paediatrics and Immunology at the University of Toronto. "These nerves secrete insufficient neuropeptides which sustain normal islet function, creating a vicious circle of progressive islet stress."
Using diabetes-prone NOD mice, the gold-standard diabetes model, the research group learned how to treat the abnormality by supplying neuropeptides and even reversed established diabetes.
"The major discovery was that removal of sensory neurons expressing the receptor TRPV1 neurons in NOD mice prevented islet cell inflammation and diabetes in most animals, which led us to fundamentally new insights into the
mechanisms of this disease," said Dr. Michael Salter, co-principal investigator, senior scientist at SickKids, professor of Physiology and director of the Centre for the Study of Pain at the University of Toronto. "Disease protection occurred despite the fact that autoimmunity continues in the animals. This helped us to focus our studies on finding the new control circuit in the islets."
Strikingly, injection of the neuropeptide substance P cleared islet inflammation in NOD mice within a day and independently normalized the elevated insulin resistance normally associated with the disease. The two effects synergized to reverse diabetes without severely toxic immunosuppression.
The studies were extended to Type 2 (obesity-associated) diabetes, in which insulin resistance is even more severe, using a number of additional model systems, thus generating strong evidence that treating the islet-sensory
nerve circuit can work to dramatically normalize insulin resistance in models of type 2 diabetes.
"This discovery opens up an entirely new field of investigations in type 1 and possibly type 2 diabetes, as well as tissue selective autoimmunity in general," said Dr. Pere Santamaria, study collaborator and professor of Microbiology and Infectious Diseases at the University of Calgary. "We have created a better understanding of both type 1 and type 2 diabetes, with new therapeutic targets and approaches derived for both diseases."
"We are now working hard to extend our studies to patients, where many have sensory nerve abnormalities, but we don't yet know if these abnormalities start early in life and if they contribute to disease development," added
Dosch.
Posted by dlife at 09:13 AM | Comments (5)
From Managing Sugar to Managing Healing
Why applying insulin to wounds significantly enhances healing
December 11, 2006 (EurekAlert) - Insulin is a hormone known primarily for regulating sugar levels in the blood, yet researchers at the University of California, Riverside, recently found that applying insulin directly to skin wounds significantly enhanced the healing process.
Skin wounds in rats treated topically with insulin healed faster"surface cells in the epidermis covered the wound more quickly and cells in the dermis, the deeper part of the skin, were faster in rebuilding blood vessels.
In follow-up studies of human skin cells in culture, Manuela Martins-Green and colleagues explored the molecular impact of topical insulin on keratinocytes, the cells that regenerate the epidermis after wounding, and on microvascular endothelial cells, the cells that restore blood flow.
Using various cell and molecular techniques, the researchers discovered that insulin stimulates human keratinocytes in culture to proliferate and migrate. In cultured human microvascular endothelial cells, the insulin stimulates only migration into the wound tissue. The insulin works by switching on cellular signaling proteins called kinases (specifically Src, PI3K, and Akt) and a protein (SREBP) that binds elements in DNA that regulate the production of cholesterol and its relatives.
Chronic or nonhealing wounds take an immense toll on American health and on health care systems. It particularly affects millions of patients with impaired mobility, as well as those with diabetes. Because diabetes is a disease caused by impaired production or utilization of insulin, this work may help explain the connection between diabetes and poor healing.
Says Martins-Green, "This work is important because when we know which cells respond to insulin and which molecules are involved, we may be able to develop ways in which we can make insulin work even better or find ways in which more affordable molecules that mimic these functions of insulin can be developed to treat people who suffer from poor healing."
Posted by dlife at 01:41 PM | Comments (1)
Obesity Linked to Increased Kidney Disease Risk in Type 1 Diabetes
December 7, 2006 (Newswise) — For patients with type 1 diabetes, obesity is an important risk factor for the development of diabetic kidney disease, reports a study in the January Journal of the American Society of Nephrology.
"Our results suggest that weight control is important in type 1 diabetes and that overweight patients with type 1 diabetes may need further evaluation and treatment," comments Dr. Ian H. de Boer of University of Washington, Seattle, lead author of the new study. "For these patients, lifestyle interventions such as exercise and diet may be useful in preventing kidney and heart disease."
Dr. de Boer and colleagues analyzed long-term follow-up data on nearly 1,300 patients with type 1 diabetes from the Diabetes Control and Complications Trial (DCCT). The DCCT was a landmark study showing that intensive insulin therapy, keeping blood sugar levels as close to normal as possible, lowers the risk of kidney disease and other diabetic complications. The current study focused on how obesity—specifically "central obesity," measured in terms of waist circumference—affected the risk of kidney disease.
During an average of nearly 6 years' follow-up, 8.4 percent of patients developed microalbuminuria—small amounts of the protein albumin in urine, the first sign of diabetic kidney disease. Risk was 4.5 percent for patients receiving intensive insulin therapy, compared to 12.8 percent for those receiving conventional insulin treatment.
The risk of microalbuminuria was significantly higher for patients with central obesity. The bigger the waist measurement, the higher the risk— for each ten-centimeter (four-inch) increase in waist circumference, risk of microalbuminuria increased by 34 percent. This relationship remained significant after adjustment for other risk factors, including intensive insulin therapy.
Obesity did not affect the rate of decline in kidney function, based on a test called creatinine clearance. Other risk factors for faster declines in creatinine clearance were older age, conventional insulin therapy, smoking, and poorer control of blood sugar levels.
"Obesity is a growing problem for people with type 1 diabetes, but little was previously known about whether it affects risk for kidney disease in this group," says Dr. de Boer. "Our research shows that central obesity is associated with an increased risk of developing microalbuminuria, which is not only an important sign of kidney disease but also a marker of increased risk for cardiovascular disease." The results suggest that losing weight might help to reduce the risk of kidney and heart disease in obese patients with type 1 diabetes, although further study would be needed to confirm this.
The new report also provides an interesting follow-up to the DCCT and other studies showing the value of intensive insulin therapy. "Although intensive insulin therapy is associated with weight gain, our study showed again that, overall, intensive insulin therapy is protective against kidney disease in type 1 diabetes," Dr. de Boer adds. "In fact, intensive insulin therapy was associated with preservation of creatinine clearance over time, a benefit that had not been previously described."
The study entitled, “Central Obesity, Incident Microalbuminuria, and Change in Creatinine Clearance in the Epidemiology of Diabetes Interventions and Complications Study,” will be available online at http://www.jasn.org beginning on Wednesday, December 6 and in print in the January issue of the Journal of the American Society of Nephrology.
The ASN is a not-for-profit organization of 9,500 physicians and scientists dedicated to the study of nephrology and committed to providing a forum for the promulgation of information regarding the latest research and clinical findings on kidney diseases.
Posted by dlife at 11:27 AM | Comments (1)
New Data Shows Rimonabant Benefited Patients with Type 2 Diabetes by Improving Blood Sugar Control, Reducing Weight and Acting on Other Cardiometabolic Risk Factors
First Rimonabant Trial with HbA1c as a Primary Endpoint
December 5, 2006 (PRNewswire-FirstCall) -- Sanofi-aventis announced today that new data on rimonabant, its first-in-class cannabinoid type 1 (CB1) receptor blocker, showed that patients with type 2 diabetes not currently treated with anti-diabetic medications experienced significant improvements in blood sugar control and weight as well as other risk factors such as HDL-cholesterol (good cholesterol) and triglycerides when compared to placebo. The study, called SERENADE, was presented today at the International Diabetes Federation (IDF) World Diabetes Congress in Cape Town, South Africa. SERENADE is the second study demonstrating that rimonabant significantly improved blood sugar levels in people with type 2 diabetes.
In the SERENADE study, treatment-naive type 2 diabetes patients receiving rimonabant 20mg per day for a duration of six months significantly lowered their HbA1c levels by 0.8% from a baseline value of 7.9 as compared to a reduction of 0.3% in the placebo group (p=0.002). In addition, patients with an HbA1c level greater than or equal to 8.5% at baseline, significantly reduced their HbA1c by 1.9% with rimonabant as compared to 0.7% with placebo (p<0.0009). Over 50% of patients in the rimonabant arm of the trial achieved HbA1c levels below 7%, the target for good glucose control as recommended by the American Diabetes Association (ADA).(i) Importantly, these improvements in blood glucose control were accompanied by significant and clinically meaningful reductions in body weight of 6.7 kg (14.8 lbs) in patients treated with rimonabant 20mg, while those patients on placebo lost only 2.7 kg (5.95 lbs) (p<0.0001).
"The management of type 2 diabetes should not only focus on controlling blood sugar levels but also improve other risk factors such as weight, good and bad cholesterol, triglycerides and blood pressure," said Julio Rosenstock, M.D., Director of the Dallas Diabetes and Endocrine Center at Medical City and also Clinical Professor of Medicine at the University of Texas Southwestern Medical School, Dallas, Texas who was an investigator in the SERENADE trial. "This study suggests that rimonabant can achieve improvement in blood glucose with the added benefit of significant weight loss and improvement in other risk factors."
Today, more than 194 million adults or 5% of adults worldwide have been diagnosed with diabetes, with type 2 diabetes constituting 85-95% of all diabetes in developed countries.(ii) Approximately 90 percent of type 2 diabetes is attributed to people being overweight or obese.(iii) Diabetes and obesity are often associated with other risk factors for cardiovascular disease including high blood pressure and unhealthy cholesterol. Worldwide, diabetes is among the leading causes of blindness, renal failure and lower limb amputation, as well as death through its effects on cardiovascular disease (70-80 percent of people with diabetes die of cardiovascular disease).(ii)
Accompanying the improvements in HbA1c and weight seen in the rimonabant arm of the SERENADE trial were improvements in multiple cardiometabolic risk factors. Patients in the rimonabant arm decreased their waist circumference (a measure of abdominal obesity) by 6.1 cm (2.34 in) compared to a 2.4 cm (0.93 in) decrease for patients on placebo (p<0.0001). HDL-cholesterol or "good" cholesterol increased by 10.1% compared to 3.2% for patients on placebo (p<0.0001). Triglyceride levels (bad fats in the blood) decreased by 16.3% compared to a 4.4% increase for placebo (p=0.0031). There was a trend toward reduction in systolic blood pressure by 5 mmHg and diastolic blood pressure by 1.2 mmHg in the rimonabant 20mg arm compared to a 2.2 mmHg decrease in systolic blood pressure and an increase of 0.1 mmHg in diastolic pressure in the placebo arm (p=NS). Fasting Plasma Glucose decreased by 0.9 mmol/L (16.2 mg/dL) in the rimonabant 20mg arm compared to a 0.1 mmol/L (1.8 mg/dL) increase in the placebo arm (p=0.0012). Adiponectin, a protein associated with reduced risk of diabetes and heart disease when present in high levels, increased by 1.6 micrograms/mL in the rimonabant 20 mg arm compared to a decrease of 0.2 micrograms/mL in the placebo arm (p=0.0001).
Approximately 57% of the improvements in HbA1c (p<0.001) were independent of the weight loss achieved, suggesting a direct effect of rimonabant on this parameter.
The overactivity of the Endocannabinoid System (ECS) in the fat tissue and muscle is found to promote fat accumulation and decrease glucose uptake, which can lead to an increased risk of developing insulin resistance and impaired glucose tolerance. By selectively blocking CB1 receptors of the ECS, which according to animal and human studies can be found in the brain, fat tissue, gastrointestinal tract, pancreas, liver and muscle, rimonabant results in a decrease in food intake, a loss of body weight, and direct improvements in blood sugars (HbA1c), HDL-cholesterol and triglycerides.
"Some current medications for type 2 diabetes are often associated with weight gain," said Julio Rosenstock. "The fact that blood sugar levels were reduced along with weight loss and improvements in HDL-cholesterol ("good" cholesterol) and triglycerides may further support the novel mechanism of action of rimonabant, which is different from the mode of action of current oral anti-diabetic medications."
The most common side effects with placebo and rimonabant 20mg reported in the SERENADE trial were dizziness (2.1% vs. 10.9%), nausea (3.6% vs. 8.7%), nasopharyngitis (7.9% vs. 7.2%), upper respiratory tract infection (2.7 % vs. 7.2%), anxiety (3.6% vs. 5.8%), depressed mood (0.7% vs. 5.8%), and headache (6.4% vs. 3.6%). The rate of serious adverse events was 3.6% for patients in the placebo arm versus 6.5% for patients in the rimonabant 20 mg.
Overall, discontinuation rates due to adverse events in the trial were 2.1% in placebo-treated patients versus 9.4% for patients on rimonabant 20mg. The most common adverse events leading to discontinuation for the placebo and rimonabant 20mg patients, respectively, were nausea (0% vs. 2.2%), depressed mood disorder (0% vs. 2.2%) and paraesthesia (0% vs. 2.2%).
Posted by dlife at 01:31 PM | Comments (0)
New Data Show Significant Reductions in Both Post-Meal and Fasting Blood Sugar Levels with Sitagliptin Phosphate Plus Metformin as Initial Therapy in Patients with Type 2 Diabetes
Data Support JANUMET™, an Investigational Combination Therapy of Sitagliptin Phosphate Plus Metformin for Type 2 Diabetes
December 5, 2006 (BUSINESS WIRE) - CAPE TOWN, South Africa --Initial treatment with sitagliptin phosphate 50 mg twice daily in combination with metformin 1,000 mg twice daily provided substantial reductions of post prandial, or post-meal, glucose (PPG) levels and fasting plasma glucose (FPG) levels in patients with type 2 diabetes, according to new data presented for the first time today at the 19th World Diabetes Congress in Cape Town. Patients with a mean baseline 2-hour PPG of 287 mg/dL (n=152) achieved reductions of 117 mg/dL, and patients with a mean baseline FPG of 197 mg/dL (n=180) achieved reductions of 70 mg/dL, compared to placebo (primary analysis of all patients treated, p<0.001).
"Typically, oral medications for type 2 diabetes principally either reduce post-meal glucose levels or reduce fasting blood glucose levels. These study data are important because they showed substantial reductions in both measures of blood glucose levels, PPG and FPG, with sitagliptin phosphate plus metformin," said John Amatruda, M.D., vice president, clinical research, Merck & Co., Inc. "These study results provide further support for the efficacy of sitagliptin phosphate."
The American Diabetes Association (ADA) recommends that post prandial (PPG) levels should be below 180 mg/dL, and pre-prandial (FPG) levels should not rise above 130 mg/dL in patients with type 2 diabetes. Blood glucose levels both after meals and after fasting contribute to the A1C level, which is a commonly used measure of a person’s average blood glucose over a two- to three-month period.
This study is part of the clinical program supporting JANUMET, an investigational therapy combining Merck’s sitagliptin phosphate with metformin. In the study, combination treatment with sitagliptin phosphate plus metformin was generally well tolerated and showed no meaningful differences in tolerability compared to metformin alone. Side effects of combination treatment with sitagliptin phosphate 50 mg twice daily plus metformin 1,000 mg twice daily compared to metformin 1,000 mg twice daily alone included diarrhea (9 percent vs. 10 percent, respectively), nausea (6 percent vs. 8 percent, respectively), abdominal pain/discomfort (3 percent vs. 5 percent, respectively) and vomiting (3 percent vs. 1 percent, respectively).
In other studies of sitagliptin phosphate administered in combination with metformin, the most common side effects reported include nasopharyngitis, back pain, arthralgia and cough.
A1C efficacy results of sitagliptin phosphate plus metformin as initial therapy
This 24-week, randomized, double-blind, placebo-controlled study involved 1,091 untreated patients with type 2 diabetes (mean baseline A1C = 8.8 percent). After a run-in period of diet, exercise and/or placebo, patients were randomized to receive one of six daily treatments: sitagliptin phosphate 50 mg/metformin 500 mg twice daily (n=190), sitagliptin phosphate 50 mg/metformin 1,000 mg twice daily (n=182), metformin 500 mg twice daily (n=182), metformin 1,000 mg twice daily (n=182), sitagliptin phosphate 100 mg once daily (n=179), and placebo (n=176).
As previously disclosed at a meeting of the European Association for the Study of Diabetes (EASD) in September, this study demonstrated a significant mean placebo-subtracted reduction in A1C of 2.1 percent from a mean baseline A1C of 8.7 percent (primary analysis of all patients treated, p>0.001) in the patients treated with sitagliptin phosphate 50 mg twice daily combined with metformin 1,000 mg twice daily, as initial therapy.
Posted by dlife at 01:26 PM | Comments (1)
Research Yields New Insights Into the Cause of Diabetes
December 5, 2006 (EurekAlert) - The cause of insulin-dependent, permanent, diabetes in newborn babies may be a deficiency in the enzyme Pancreatic Endoplasmic Reticulum Kinase (PERK) during a critical period of development before birth, according to a new hypothesis put forward by a team of researchers from Penn State University. In this most severe type of diabetes, individuals are unable to regulate glucose normally because they have few insulin-producing beta cells in their pancreas and the remaining cells do not produce enough insulin. Using special strains of mice bred to be PERK-deficient, the researchers demonstrated that the lack of this enzyme blocked the proliferation of beta cells, hampered the normal functioning of beta cells, and also kept beta cells from clustering into islets. "What happens during fetal development predisposes people either to be able to maintain glucose levels normally or to have diabetes," says team leader Douglas Cavener, professor and head of the Department of Biology. The research results will be published in the journal Cell Metabolism on 6 December 2006.
The team, consisting of graduate students Wei Zhang, Yulin Li and Kaori Iida, Postdoctoral Fellow Daorong Feng, and Research Assistant Professor Barbara McGrath, made use of the lab's earlier discovery that mice deficient in PERK show many parallels to human sufferers of Walcott-Rallison Syndrome (WRS), in which diabetes is combined with skeletal and growth abnormalities. The research provided an experimental model for investigating the cause of permanent neonatal diabetes that was more revealing than cell culture studies.
"Being able to develop special strains of mice that are PERK-deficient in specific organs or tissues was vital to our research," says Cavener. "These mice allowed us to discover exactly how PERK participates in the development and growth of the beta cells in the pancreas that secrete insulin. Using genetics in this way lets the organism tell you what is important to normal function."
Normally, the beta cells of the pancreas respond to high levels of glucose in the blood by producing the precursor of insulin -- proinsulin -- in the endoplasmic reticulum. Inside this and other organelles, the proinsulin is assembled and modified into insulin. Then the hormone is exported from the cell to stimulate other tissues to take up glucose and generate energy.
PERK-deficient mice differ significantly from normal mice. At birth, PERK-deficient mice have only about one-half the mass of beta cells that normal mice have. During the first few weeks after birth,
PERK-deficient mice have fewer and fewer beta cells compared to normal mice and the remaining cells do not function normally in producing insulin. By three weeks after birth, the PERK-deficient mice are fully diabetic and have only one-tenth the mass of beta cells as normal mice.
Until now, the dominant hypothesis of the cause of diabetes in mice and humans deficient in PERK was developed by Heather Harding and David Ron, of New York University Medical Center, in 2001. They suggested that too much proinsulin in the endoplasmic reticulum triggers a stress response and causes many beta cells to die. The shortage of beta cells in PERK-deficient mice was thought to be caused by a high death rate of those cells.
Data collected by the Cavener team casts doubt on this hypothesis. First, they found that mice deficient in PERK made new beta cells at a much lower rate than normal mice. The mass of beta cells in deficient mice only doubled during the first few weeks of life, while that in normal mice increased twenty-fold. Second, the Penn State group found the rate of beta-cell death in PERK-deficient mice was not significantly different from that in normal mice. Finally, the team did not detect molecular markers of endoplasmic reticulum stress in the beta cells of their PERK-deficient mice.
The alternative hypothesis of the Penn State Team is that PERK deficiency blocks both the proliferation of beta cells after birth and the differentiation of those cells into fully functioning units. They found that thirty to forty percent of the beta cells of PERK-deficient mice are physically unusual. The most obvious abnormality is that proinsulin is found the endoplasmic reticulum, instead of being found in or around the nucleus. Apparently, proinsulin is produced as usual, but the normal modification process is blocked, leaving large quantities of proinsulin trapped inside the enlarged and distended organelle.
Another important finding was that beta cells in these mice do not develop into organized clusters or islets within the pancreas. Normally, the protein GLUT2 transports glucose across plasma membranes among the islets, triggering the secretion of insulin in the beta cells. But without the islet architecture, communication among the beta cells breaks down and the cells fail to respond to glucose by secreting insulin. Thus, PERK-deficiency both hampers cell-to-cell signaling of glucose levels and greatly diminishes insulin production at the cellular level.
The Penn State team's understanding of the role of PERK was advanced by additional experiments to pinpoint the time during development when PERK is required. Cavener's team found that PERK must be expressed during a critical period between 13.5 fetal days and 4 days after birth if the beta cells of the pancreas are to regulate glucose normally for the rest of the animal's life. PERK may play an essential role in sensing fetal environment and modulating the development of beta cells in response to it.
"The genetic program of the fetus and the in-utero environment work together to set up the apparatus that regulates glucose in postnatal life," Cavener explains.
Posted by dlife at 01:19 PM | Comments (1)
New Diabetes Drug Improves Blood Sugar, Weight Loss
December 5, 2006 (HealthDay News) -- The new drug called rimonabant (brand name Acomplia) helped improve blood sugar control and promote weight loss in people with type 2 diabetes, according to study results released Tuesday by drug maker Sanofi-Aventis (nyse: SNY - news - people ).
The study of 278 patients at 56 centers in the United States and six other countries found that the drug also had an effect on other risk factors such as levels of good and bad cholesterol, blood pressure and triglycerides.
The patients in this study, called SERENADE (Study Evaluating Rimonabant Efficacy in Drug-Naive Diabetic Patients), were not taking any other medications for their diabetes. The findings were presented at the World Diabetes Congress in Cape Town, South Africa.
"The management of type 2 diabetes should not only focus on controlling blood sugar levels but also improve other risk factors such as weight, good and bad cholesterol, triglycerides and blood pressure," Dr. Julio Rosenstock, director of the Dallas Diabetes and Endocrine Center at Medical City and clinical professor of medicine at the University of Texas Southwestern Medical School at Dallas, said in a prepared statement.
"This study suggests that rimonabant can achieve improvement in blood glucose with the added benefit of significant weight loss and improvement in other risk factors," said Rosenstock, who was an investigator in the SERENADE study.
"Some current medications for type 2 diabetes are often associated with weight gain. The fact that blood sugar levels were reduced along with weight loss and improvements in HDL ("good") cholesterol and triglycerides may further support the novel mechanism of action of rimonabant, which is different from the mode of action of current oral anti-diabetic medications," Rosenstock said.
This is the second study to find that rimonabant improves blood sugar levels in people with type 2 diabetes. The previous study, funded by Sanofi-Aventis, was published online Oct. 27 in the journal The Lancet.
Rimonabant is approved in Europe but has not been approved in the United States.
Posted by dlife at 08:09 AM | Comments (3)
Treating Obesity Vital for Public Health, Physicians Say
December 4, 2006 (Newswise) — Physicians who once treated mainly elderly patients for health problems such as diabetes, heart disease and stroke are seeing increasingly younger patients who have the same ailments.
A review in the December issue of Mayo Clinic Proceedings focuses on the increasing prevalence of metabolic syndrome, a state characterized by cardiovascular risk factors such as obesity, high blood pressure and abnormal levels of glucose (sugar) and fats in the blood. Authors Lewis Johnson, M.D., and Ruth Weinstock, M.D., Ph.D., of SUNY Upstate Medical University in Syracuse, N.Y., say physicians and public institutions must work in tandem to curb the obesity epidemic.
“Unfortunately, as the population becomes less active and more obese, we’re seeing a rise in this constellation of risk factors for cardiovascular disease,” says Dr. Weinstock, chief of Endocrinology, Diabetes and Metabolism at the university. “That’s of great concern because of the increased risk for heart attack, stroke and diabetes, and we’re seeing this occur in younger and younger individuals.”
Cardiovascular disease is the leading cause of death and disability among adults in the United States. The number of U.S. adults who are overweight or obese increased from 47 percent of the adult population in 1976–1980 to 65 percent in 1999–2002.
An estimated 1 million U.S. adolescents meet the criteria for metabolic syndrome. Based on these and other numbers, Drs. Weinstock and Johnson say a major increase in cardiovascular disease could occur in the next two decades.
“Increase of heart disease and stroke is of particular concern,” says Dr. Weinstock. “If that tide can be reversed, then hopefully we can make an impact in terms of improving public health in the future.”
The obesity epidemic has been making headlines for years, authors note, and strides have been made to address the problem. Schools are serving healthier meals, health insurers are offering price reductions to members who exercise, and cities are being designed so that residents can leave their cars at home and safely traverse trails and paths.
But more needs to be done, physicians say, including further research on how to prevent metabolic syndrome. Dr. Weinstock says physicians agree that treatment should be aggressive and urge patients to modify their lifestyles to include weight loss, physical activity and a healthy diet. Medications are important in treating risk factors such as diabetes and high blood pressure.
Another important component is informing the public that becoming obese can bring serious health problems, Dr. Weinstock says. Ultimately, helping prevent people from becoming obese is the top goal for physicians and other health officials, she says, especially because maintaining weight loss is the toughest challenge for people who are obese.
Posted by dlife at 09:36 AM | Comments (0)