Study Tests Oral Insulin to Prevent Type 1 Diabetes
January 31, 2007 (NIDDK) - Researchers have begun a clinical study of oral insulin to prevent or delay type 1 diabetes in at-risk people, the National Institutes of Health (NIH) announced today. Type 1 Diabetes TrialNet, an NIH-funded network of researchers dedicated to the understanding, prevention, and early treatment of type 1 diabetes, is conducting the study in more than 100 medical centers across the United States, Canada, Europe, and Australia.
"Our goal is to prevent type 1 diabetes or to delay it as long as possible. If diabetes can be delayed, even for several years, those at risk will be spared the difficult challenges of controlling glucose and the development of complications for that much longer," said TrialNet study chair Jay Skyler, M.D., of the University of Miami.
In the study, researchers are testing whether an insulin capsule taken by mouth once a day can prevent or delay diabetes in a specific group of people at risk for type 1 diabetes. An earlier trial suggested that oral insulin might delay type 1 diabetes for about four years in some people with autoantibodies to insulin in their blood. Animal studies have also suggested that insulin taken orally may prevent type 1 diabetes. Some scientists think that introducing insulin via the digestive tract induces tolerance, or a quieting of the immune system. Insulin taken orally has no side effects because the digestive system breaks it down quickly. To lower blood glucose, insulin must be injected or administered by an insulin pump.
In type 1 diabetes, a person's own immune cells destroy the beta cells of the pancreas. Beta cells sense blood glucose and produce the hormone insulin, which regulates glucose and converts it to energy. The immune attack on beta cells begins well before a person develops diabetes and continues long after the disease is diagnosed. In the early stages of autoimmunity, up to 10 years before diabetes is diagnosed, autoantibodies may appear in the blood. These autoantibodies to glutamate decarboxylase (GAD), IA-2, and to insulin itself indicate a greater risk for developing type 1 diabetes. For a person with high-risk genes and all three antibodies, the risk of developing diabetes in the next 5 years is greater than 50 percent.
First- and second-degree relatives of people with type 1 diabetes who may be at risk are being screened through TrialNet's natural history study, which is examining the immune and metabolic events that precede diabetes symptoms. Screening involves a simple blood test for the autoantibodies that signify diabetes risk. Individuals enrolled in the natural history study are closely monitored for diabetes development and may be eligible to participate in the oral insulin trial or future studies that try to arrest the autoimmune process.
STUDIES FOR THE NEWLY DIAGNOSED
TrialNet studies are also aimed at safely preserving insulin production in people recently diagnosed with type 1 diabetes. In the few months after diagnosis, most patients still have a supply of functioning beta cells that, with the help of insulin injections, contribute to good control of blood glucose. If beta cells can be protected, more patients would be able to tightly control their blood glucose, which prevents or delays damage to the eyes, nerves, kidneys, heart, and blood vessels.
One TrialNet study seeks to turn off the immune attack on beta cells with Rituximab, a monoclonal antibody that binds to and temporarily destroys a specific class of immune cells. The Rituximab trial is recruiting patients with type 1 diabetes diagnosed within the previous 3 months. Rituximab is approved by the Food and Drug Administration (FDA) to treat specific forms of lymphoma and moderate to severe rheumatoid arthritis. It is not approved for the prevention of type 1 diabetes.
Also under way is a study testing whether mycophenolate mofetil (MMF) or MMF plus daclizumab (DZB), drugs approved by FDA to prevent rejection after an organ transplant, can slow or arrest the autoimmunity of type 1 diabetes. This study has recruited the needed number of patients.
STUDY FOR NEWBORNS AT RISK FOR TYPE 1 DIABETES The "Nutritional Intervention to Prevent Type 1 Diabetes (NIP) Trial" is a pilot study of docosahexaenoic acid (DHA), an omega-3 fatty acid that may have anti-inflammatory benefits that prevent development of the autoimmunity that leads to type 1 diabetes. The NIP study is being conducted in:
-- babies less than 5 months old who have immediate family members with type 1 diabetes, and
-- pregnant mothers in their third trimester whose babies are at risk for type 1 diabetes, either because the mother has type 1 diabetes herself or other immediate relatives have the disease.
About 5 to 10 percent of the nearly 21 million people with diabetes have type 1, formerly known as juvenile onset diabetes or insulin-dependent diabetes. Type 1 diabetes tends to arise in children and young adults but is also diagnosed in older people. Patients need three or more insulin injections a day or treatment with an insulin pump to maintain blood glucose control. To prevent complications, they must regularly monitor their blood glucose, striving for a range that is as close to normal as possible. The constant challenge of managing the disease poses an enormous burden on patients and their families.
The Type 1 Diabetes TrialNet studies are funded by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Child Health and Human Development, and the National Institute of Allergy and Infectious Diseases within the NIH. The Juvenile Diabetes Research Foundation International and the American Diabetes Association also support the initiative.
For more information about TrialNet studies, see
The NIDDK, a component of the NIH, conducts and supports research in diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe, and disabling conditions affecting Americans. For more information about NIDDK and its programs, see
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
Posted by dlife at 03:32 PM | Comments (3)
Testing for Insulin Without the Pitter-Patter of Little Feet
Journal article outlines mouse-free and animal-serum-free method of producing cruelty-free ELISA for human insulin
January 31, 2007 (EurekAlert) -- In the January issue of Clinical Biochemistry, scientists and physicians with the Physicians Committee for Responsible Medicine (PCRM) outline the method used to develop a cruelty-free ELISA for human insulin that uses monoclonal antibodies produced by cells cultured in an animal-serum-free medium. PCRM's insulin ELISA, the first of its kind, provides precision and reliability equal to methods currently used in clinical research. PCRM's insulin ELISA is now commercially available for research purposes from Millipore of St. Charles, Mo., which reports that it is selling briskly. The new ELISA also serves as a guide for the development of serum-free immunoassays for other hormones and bio-markers.
The ELISA, or enzyme-linked immunosorbant assay, is a method of detecting specific proteins in complex protein mixtures--in this case, for detecting insulin in human blood. Laboratories traditionally detect human insulin using antibodies produced by cells that had been placed into the abdomens of living mice. The procedure, called the ascites method, is so cruel that it is banned in some European countries. Even when the antibodies are produced from cells in test tubes, fetal bovine serum is commonly used to grow live cells. The serum is obtained from bovine fetuses by puncturing their hearts with a needle without the use of anesthesia.
PCRM's insulin ELISA does not rely on the ascites method or fetal bovine serum. In addition to ethical advantages, growing cells without animal serum ensures that fewer variables are introduced into experiments, meaning that results are easily reproducible by different laboratories. The method outlined in Clinical Biochemistry, the official journal of the Canadian Society of Clinical Chemists, permits the growth of antibody-producing cells in a medium free of animal serum, enabling scientists to make cell culture safer and more humane.
"The ethical and scientific advantages of avoiding fetal calf serum and the ascites method are clear, and we hope the methodology used to produce our ELISA serves as a guide for developing other animal-serum-free immunoassays," says Chad Sandusky, Ph.D., a co-author of the paper and PCRM's director of research and toxicology.
Posted by dlife at 09:10 AM | Comments (0)
Joslin Researchers Discover Protein that Causes Blood Vessel Leakage and Swelling in Eyes with Diabetic Retinopathy
Discovery one day could lead to new treatments for eye diseases and brain swelling caused by head injury, stroke and other conditions
January 29, 2007 (Joslin) - Although health professionals have had success in treating diabetic retinopathy, two forms of the disease - proliferative diabetic retinopathy and diabetic macular edema -- still are the leading causes of vision loss and blindness among working age adults in the developed world. Now a Joslin Diabetes Center-led team of investigators has compiled the most complete inventory yet available of the proteins present in a part of the human eye known as the vitreous and has identified a group of proteins that may play critical roles in causing blood vessel leakage in the eyes of people with this common form of diabetic eye disease.
In the new study, published in the Jan. 28 online edition of the journal Nature Medicine, lead investigator Edward Feener, Ph.D., and his team also found that one of these molecules causes the leakage of retinal blood vessels, which contributes to the retinal swelling (diabetic macular edema or DME) that is often associated with advanced diabetic retinopathy. These findings suggest potential new therapeutic targets for the treatment of diabetic retinopathy and DME and also could provide new opportunities for treating cerebral swelling caused by head injury, stroke and other conditions.
"By analyzing the protein composition in the human vitreous (the gel fluid that fills the cavity of the eye between the lens and the retina), we have identified a new group of molecules that may improve our understanding of the disease processes that contribute to diabetic retinopathy. By studying the actions of these proteins in both the retina and the brain, we have shown that our findings may have broad relevance for neurovascular leakage and swelling," said Dr. Feener, Investigator in Joslin's Section on Vascular Cell Biology, Director of Joslin's Proteomics Core, which hosted the study, and Assistant Professor of Medicine at Harvard Medical School.
The work was funded by grants from the Juvenile Diabetes Research Foundation (JDRF), the Massachusetts Lions Eye Research Fund, the National Institutes of Health, the Adler Foundation, and the Air Force Office of Scientific Research Medical Free Electron Laser Program.
"Millions of people worldwide live with diabetic retinopathy and the accompanying threat of severe vision loss or blindness. While some treatment is available in the late stages of this condition, the incidence of proliferative diabetic retinopathy and diabetic macular edema still pose the serious threat of sight loss. Going forward, Dr. Feener's findings could provide new opportunities for the development of treatments for diabetes-related vision loss," said Dr. Helen Nickerson, Scientific Program Manager for Complications at JDRF.
Diabetic retinopathy, one of the most common complications of diabetes, is characterized by a range of abnormalities that develop from the damage caused by high blood glucose levels on the small blood vessels of the retina. Proliferative diabetic retinopathy (PDR) is diagnosed when the retina begins to form new blood vessels to counteract this damage, new vessels which in turn often bleed and blur or block vision. More than 700,000 patients in the United States have PDR, and more than 63,000 patients develop it annually. Diabetic macular edema occurs as the leaky blood vessels cause the macula (the central area in the retina responsible for sharp central vision) to swell. DME affects more than 500,000 patients in the U.S., with 56,000 new cases diagnosed yearly.
In the past, researchers have had difficulty studying the pathology of both of these diseases because rodents with diabetes, which investigators often use as a laboratory model to study diabetic eye disease, do not naturally produce many of the changes in the retina that health professionals observe in humans. Dr. Feener and his colleagues developed cutting edge proteomics mass spectroscopy (a high-speed protein analysis technology) and bioinformatics at Joslin to identify protein abnormalities in the vitreous of people with and without diabetic eye disease. Then, they introduced these same proteins in the vitreous of rodents and examined their effects on retinal blood vessels to gain better understanding of the actions that these proteins could have in the eyes of people with diabetes.
Working with a network of collaborators at Joslin's Beetham Eye Institute and the Santa Barbara Cottage Hospital Eye Center in California, they obtained samples from the vitreous of 25 people undergoing surgery for a variety of conditions: eight of the patients did not have diabetes and therefore no diabetic eye disease; four had diabetes, but no diabetic retinopathy; and 13 had PDR. Launching a large-scale survey of the proteins in the vitreous, they identified 117 proteins (earlier attempts to catalog vitreous proteins had succeeded in identifying only 20 to 50) and detected 31 proteins that were present in the vitreous of patients with diabetes but weren't present in people without the disease.
One of the proteins that was particularly interesting was carbonic anhydrase 1, or CA-1. "This is an enzyme that is normally found in red blood cells; however we suspected that high levels of this protein in the vitreous fluid might cause problems," said Dr. Feener. "When we tested it in the vitreous of rodents, we found a marked increase in blood vessel leakage, which is a fundamental process in diabetic retinopathy."
Margaret Dunn, President of the Massachusetts Lions Eye Research Fund, Inc., said, "On behalf of the Lions of Massachusetts and the Massachusetts Lions Eye Research Fund, Inc., we wish to congratulate the Joslin Diabetes Center on its important breakthrough. We pledge our full support now and in the future in the hope that we will be able to contribute to many future endeavors of the Joslin research team and applaud them on their wonderful accomplishments."
The mission of the Massachusetts Lions Eye Research Fund (MLERF) is to fund efforts in eye research that may one day lead to the prevention of blindness in the world. They play a unique role in eye research efforts, enabling avenues of research to be explored as preliminary studies that may ultimately lead to remarkable breakthroughs in our understanding of the causes of blindness. In this respect the research team at Joslin's Beetham Eye Institute led by Sven-Erik Bursell, Ph.D., and Allen Clermont, M.S., were able to use funding from the MLERF to conduct the necessary experiments to characterize the physiological effect of these proteins and how they were exerting these abnormal effects.
The researchers then investigated several different lines of study and found that CA-1 increased retinal edema -- the swelling of the retina. "This is the first evidence we have of a protein causing swelling, not just leakage, in the rodent at concentrations observed in human disease," said Dr. Feener.
Performing additional studies with CA-1, the researchers showed that their findings have even broader relevance. "The eye is a neurovascular tissue with certain features similar to those of the brain, and it is well known that hemorrhage in the brain, either from a hemorrhagic stroke or any cerebral bleeding, causes swelling," said Dr. Feener. "When we introduced CA-1 into the cerebral spinal fluid around the brain of rodent animal models we found that it also increased the swelling and the leakage of blood vessels in the brain." This discovery, he explained, could provide new opportunities for treating the cerebral swelling caused by head injury, stroke and other conditions.
"Proteomics of human vitreous fluid has generated new ideas about the effects of diabetes on the retina," said Dr. Feener. "Now we are in the process of exploring the role of the other proteins we have identified in the vitreous, which may provide additional insights into the mechanisms that contribute to diabetic retinopathy."
Others participating in the study included lead author, Ben-Bo Gao, Ph.D., of Joslin; additional collaborators from the Section on Eye Research and the Beetham Eye Institute at Joslin included Lloyd Paul Aiello, M.D., Ph.D., Susan Rook, Stephanie Fonda, Ph.D., Paul G. Arrigg, M.D.; Vivek Srinivasan, M.S., Maciej Wojtkowski, Ph.D., and James Fujimoto, Ph.D., of the Massachusetts Institute of Technology; and Robert Avery, M.D., of the Santa Barbara Cottage Hospital Eye Center.
Posted by dlife at 03:55 PM | Comments (1)
New Diabetes Research: Half of Americans Have Gene That Affects How Body Burns Sugar
January 29, 2007 (EurekAlert) -- A recent study by a Saint Louis University researcher confirms findings that about half of the U.S. population has a version of a gene that causes them to metabolize food differently, putting them at greater risk of developing diabetes.
Edward Weiss, Ph.D., assistant professor of nutrition and dietetics at Doisy College of Health Sciences at Saint Louis University, looked at a relatively common version of a gene called FABP2, which is involved in the absorption of fat from food.
Those people with the variant gene processed fat differently than those who don't have it. They burned more fat, which may have hindered their ability to remove sugar from the blood stream and burn it. Diabetes is characterized by too much sugar in the blood.
"This study adds to what was previously known about this gene variant by showing that after consuming a very rich milkshake, people with the variant gene process the fat from the drink differently than other people," Weiss says.
That is not to say that half of U.S. residents are destined to get diabetes, he adds.
"While the variation of the gene appears to contribute to the diabetes risk, it does not cause diabetes by itself," Weiss says.
"Many other genes, some known and some unknown, are involved in a person's overall risk of developing diabetes. Those are things a person can't control. But there are risk factors for diabetes that a person can change -- lifestyle factors, such as diet and exercise."
Posted by dlife at 09:25 AM | Comments (0)
Joslin-led Study Uncovers Role of Appetite Hormone MCH in Insulin Production
Findings may lead to treatments that stimulate insulin production
January 25, 2007 (EurekAlert) -- A new Joslin Diabetes Center-led study has shown conclusively that a neuropeptide, melanin concentrating hormone (MCH), found in the brain and known for its role in increasing appetite in people, plays a role in the growth of insulin-producing beta cells and the secretion of insulin. This finding has the potential to spur the development of new treatments for diabetes that stimulate the production of insulin-producing beta cells in the pancreas. This latest research, conducted with researchers at Beth Israel Deaconess Medical Center in Boston and other institutions, will appear in the February 2007 issue of Diabetes.
An earlier Joslin-led study examined the connection between obesity and MCH, which plays a critical role in energy balance and appetite, observing an increase in the number of beta cells when MCH levels are high. This was a new finding that had not been observed before. Although MCH’s role in appetite control is well known, its effects on the secretion of endocrine hormones has not been fully understood.
“It’s a very logical connection,” says Rohit N. Kulkarni, M.D., Ph.D., investigator at Joslin Diabetes Center and Assistant Professor of Medicine at Harvard Medical School, who led the study. “Whenever you eat food, your body needs more insulin. When MCH induces appetite, it simultaneously increases insulin secretion from beta cells and enhances growth of beta cells. If the proteins that mediate the growth mechanism can be identified, it could lead to the development of new drugs that would enhance beta cell growth to treat type 1 and type 2 diabetes.”
In type 1 diabetes (insulin-dependent) diabetes, which accounts for 5 to 10 percent (between 700,000 and 1.4 million people) of diabetes cases in the United States, an autoimmune process has destroyed the insulin-producing islet cells in the pancreas. In type 2 diabetes, the far more common form of the disease, the body doesn’t produce enough insulin and/or can’t use insulin properly (insulin resistance).
Both diseases could benefit from treatments that stimulate beta cells in the pancreas to produce insulin.
In the first study, in which mice were genetically engineered to over-express MCH, Dr. Kulkarni and his colleagues observed changes in beta cell mass out of proportion with the degree of obesity, suggesting that MCH had a direct effect on islets. To build on these previous findings, the researchers focused this study on gaining a deeper understanding of how MCH and its receptors influence growth of beta cells.
The investigators first confirmed that MCH and its receptors are indeed expressed in islet cells of mice and humans. They then treated human donor or mouse pancreatic islet cells with MCH and found that it increased insulin secretion, compared to islet cells without MCH, which did not show the same effect.
In the next phase, the researchers examined genetically-engineered mice that did not produce MCH and consequently had abnormally small islets. “This indicated to us that MCH is important for growth of islets,” says Dr. Kulkarni.
The next step in the research process is to pinpoint exactly how MCH is regulating the growth of beta cells and identify which proteins are involved in this growth process. “We know MCH is having an effect on both growth and function likely by recruiting different proteins. It will be worth exploring which proteins are being activated by MCH to cause the growth effect,” Dr. Kulkarni explains.
A follow-up study has been designed and is currently awaiting funding. It will look at how MCH interacts with glucagon-like peptide 1 (GLP-1), a hormone involved in beta cell growth. An analogue of GLP-1 hormone has already been approved by the FDA for treating type 2 diabetes. The goal is to understand how GLP-1 and MCH can work together to promote beta cell growth.
Posted by dlife at 09:31 AM | Comments (0)
UCR Involved in Discovery of Diabetes Fighting Molecule
Bioengineering Professor Jiayu Liao is part of a team that discovered the molecule which could lead to a diabetes and obesity pill.
January 22, 2007, RIVERSIDE, Calif. – www.ucr.edu – University of California, Riverside Assistant Professor of Bioengineering, Jiayu Liao played a pivotal role in the discovery of a small molecule that has been shown to control diabetes in mice and may pave the way to the development of easier treatment for adult-onset diabetes.
This discovery was a collaboration between Liao at UC Riverside's Bourns College of Engineering and a team in the National Center for Drug Screening, Shanghai, which is part of the Chinese Academy of Science.
This key molecule, identified as Boc5, can stimulate insulin function in response to high levels of glucose as well as reduce body weight by 20 percent. The discovery of this molecule that stimulates the production of the intestinal hormone glucagon-like peptide1 (GLP1), which metabolizes glucose, has been an extremely difficult goal for researchers in both academics and the pharmaceutical industry.
Boc5 is the first small molecule activator for Class B GPCRs, which regulate hormones in many human physiological processes and are major targets for pharmaceutical companies. This discovery opened new revenue possibilities to support future research into small molecule interaction with Class B GPCRs in the future.
In the study, Liao and his colleagues were looking for ways to sensitize sugar-metabolizing insulin by stimulating production of GLP1. Synthetic versions of this peptide have proven effective but of short duration so it had been abandoned by drug researchers.
However, after Liao and his colleagues screened a library of more than 48,000 natural and synthetic compounds, they identified a molecule, Boc5, which mimics glucagon-like peptide1 in the blood leading to increases in insulin secretion in laboratory cultured rat pancreatic cells when exposed to high glucose levels. The molecule also worked when administered by injection and orally in experiments with laboratory mice.
Thus Boc5 behaved as full GLP1 mimic, both in the test tube and in the laboratory mice, the researchers reported in an article that appeared in the Jan. 16 edition of the Proceedings of the National Academies of Science titled “A nonpeptidic agonist of glucagon-like peptide 1 receptors with efficacy in diabetic db/db mice.”
The fact that the molecule also lowered appetite and promoted weight loss in mice, holds out the promise it may fuel more exploration of orally available insulin sensitizing drugs that can be used to control diabetes and obesity, the article’s authors wrote.
Posted by dlife at 05:16 PM | Comments (0)
Joslin Diabetes Center Names Ranch C. Kimball, Former Romney Chief Economic Advisor and Distinguished Business Veteran, as Seventh President
January 19, 2007 (Joslin) — Ranch C. Kimball, a distinguished leader in business who served as Secretary of Economic Development for the Commonwealth of Massachusetts under former Governor Mitt Romney, has been appointed the chief executive officer and seventh president of the world-renowned Joslin Diabetes Center. Kevin E. Conley, Chair of the Joslin Diabetes Center Board of Trustees, announced the appointment, following the Board’s unanimous approval. Kimball will assume the post effective February 1, 2007.
Kimball was selected following an international search conducted over five months by a committee of representatives from the institution, the Joslin Diabetes Center Board, Beth Israel Deaconess Medical Center and Harvard Medical School.
Located in Boston’s Longwood Medical Area, the Joslin Diabetes Center is the world’s largest diabetes research center, diabetes clinic, and provider of diabetes education. Founded in 1898 by Elliott P. Joslin, M.D., the Joslin is affiliated with Harvard Medical School and clinically affiliated with Beth Israel Deaconess Medical Center.
Kimball will succeed C. Ronald Kahn, M.D., who in September announced his intention to step down as President to pursue his passion for research and new projects that can further our knowledge and work toward prevention and cure of diabetes. Dr. Kahn has served in major leadership roles at Joslin for 25 years and served as Executive Vice President and President for more than 11 years. Dr. Kahn was instrumental in assembling the broadest-based diabetes research team in the world and lifted the Joslin to a new level nationally and internationally.
Kimball brings to Joslin a distinguished record in state government where, among other accomplishments, he was responsible for attracting major biotechnology and pharmaceutical firms to establish operations in Massachusetts. His has a demonstrated ability to build strong connections between state government, business and academic medical organizations for the purpose of finding new and innovative support for biomedical research. In 2006, he received the national Biotech Industry Organization’s award for top state executive in the country. As Governor Romney’s chief economic leader and advisor, Kimball’s responsibilities included the oversight of 22 agencies, four cabinet secretaries and more than 2,500 employees ranging from those at the Department of Labor, the Department of Workforce Development, the Department of Business & Technology, to the Office of Consumer Affairs & Business Regulation. In 2004, Kimball created the “Business Resource Team,” the Commonwealth’s one-stop model for businesses seeking to grow in the state.
Widely known and respected in the business community, Kimball led major reforms in improving Massachusetts’ economic development and achieved a long record of legislative success. Reflecting his broad impact, Governor Deval Patrick noted, “Ranch was a great servant of the Commonwealth and is a superb choice for the Joslin Diabetes Center.”
“Ranch Kimball is known for his strategic thinking and get-it-done approach and most importantly, the ability to conceive and execute sweeping initiatives,” said Chairman Conley, who is also President & CEO of Conley & Company. “He is the ideal person to lead Joslin through a series of new opportunities so it can grow rapidly to meet the epidemic of diabetes head-on.”
“Diabetes is the growing healthcare epidemic of our time, and its consequences extract a terrible human cost,” said Kimball. “I am here to help the wonderful staff of the world’s leading diabetes center make an even more significant impact on this terrible epidemic that touches so many people in such personal ways.”
Kimball’s appointment has drawn supportive response from members of the Boston academic, medical, business and government communities:
“Ranch Kimball brings to the leadership of the Joslin Diabetes Center not only extensive experience in management and public policy but also a deep understanding of the role that medicine plays in our lives, society, and economy,” said Susan Hockfield, Ph.D., President, Massachusetts Institute of Technology. “Given his strong record of commitment to research and innovation, I know that he will work to ensure Joslin’s continued preeminence as a resource for our region, the nation, and the world.”
"I'm very excited that Ranch Kimball will be leading the Joslin," Boston Mayor Thomas Menino said. "He is one of the city's most respected and well-known business leaders, and it's a real success for the Joslin to have him as their CEO. Ranch has a proven track record at getting the most difficult things done while keeping a large coalition happy and engaged. He was a real star in the Romney administration, and he also has earned respect and friends across the board in both parties throughout the state."
“Ranch’s genuine enthusiasm for biomedical research and collaboration will make him a superb leader of the Joslin,” said Paul Levy, president and CEO of Beth Israel Deaconess Medical Center.
“Ranch is an outstanding choice for President of Joslin Diabetes Center,” said Jack Connors, Chairman of Hill Holliday and Chairman of the Board of Partners Healthcare. “The Joslin has a great heritage and now, with Ranch’s expertise in leadership, life sciences and his demonstrated ability to build relationships between legislative, business and academic communities, the Joslin will thrive and prosper.”
"We look forward to working closely with Ranch and his colleagues at the Joslin to support the important missions of advancement of education and research in the field of diabetes and related conditions," says Raphael Dolin, M.D., Harvard Medical School Dean for Academic and Clinical Programs.
Kimball is Chair of Mass Development and serves on the boards of several non-profits, including the Museum of Science, Wheelock College, the Museum of Fine Arts and WGBH-TV. Previously, Kimball spent 25 years in the private sector helping businesses grow. He ran a private equity firm for Kissinger McLarty Associates and was a partner at Boston Consulting Group. Kimball received an A.B. in Economics from Princeton University in 1980 and lives in Brookline with his wife and two sons.
Posted by dlife at 02:34 PM | Comments (0)
American Diabetes Association and Entelos Announce In Silico Research Funding Opportunity
Diabetes Research Center to Apply Biosimulation to Support Type 1 Diabetes Research
January 17, 2007 (ADA) -- The American Diabetes Association (ADA) and Entelos, Inc. (LSE: ENTL) announced today a funding opportunity to support basic research through the Diabetes Research Center (DRC), a joint initiative of the ADA and Entelos to enhance the understanding of diabetes and its treatment. Awardees will have access to the DRC's in silico modeling and biosimulation capabilities, allowing them an unparalleled ability to investigate the onset, progression, and treatment of diabetes.
The ADA and Entelos collaborated to develop the type 1dDiabetes PhysioLab® platform, a computer-based mathematical model of the non-obese diabetic (NOD) mouse, the primary animal model used to study type 1 diabetes. Research using the platform allows scientists to explore, for example, (1) the contribution of key cell types to disease pathogenesis and prevention, (2) the time- and dose-dependent effects of treatments on disease prevention or remission, and (3) different experimental approaches to identify the most productive research opportunities.
"The ADA is committed to finding new treatments and, ultimately, a cure for diabetes, in particular, type 1 diabetes, which primarily affects children and young adults," said Richard Kahn, Ph.D., chief scientific and medical officer, American Diabetes Association. "This funding opportunity achieves a major goal of the ADA, namely, to apply cutting-edge science to basic diabetes research. By combining the DRC's capabilities with the experimental capabilities of academic researchers, we hope that this initiative will accelerate understanding of the disease."
"With the availability of this research platform, academic researchers will for the first time be able to combine the benefits of in silico research with their own laboratory investigations," added Mikhail Gishizky, Ph.D., chief scientific officer of Entelos. "In fact, this combined approach has already uncovered insights regarding the pathophysiology of type 1 diabetes. Ultimately, this information will improve the rationale for taking novel interventions into humans."
The DRC is soliciting letters of intent (LOI) for in silico research projects to be conducted in the second half of 2007. LOI's will be reviewed by an ADA-sponsored scientific review committee. Applicable projects will be selected, and researchers will be invited to develop a detailed research plan in collaboration with DRC staff. The review committee will then award research grants.
Details regarding the DRC, the type 1 Diabetes PhysioLab platform, and how to respond to this solicitation can be found here.
Posted by dlife at 09:28 AM | Comments (0)
Red Sox Slugger Wily Mo Pena on Base for Joslin Diabetes Center
January 17, 2007 (Joslin) -- Boston Red Sox Wily Mo Pena is teaming up with Joslin Diabetes Center's Latino Diabetes Initiative for the Beisbol y Salud Diabetes Awareness Project. Pena will host this program in the Dominican Republic on Jan. 20-21 and in Boston this spring to raise diabetes awareness in the Latino population. Several other Major League Baseball players will join Pena in the Dominican Republic for the project, which includes a softball game that is sure to be a highlight of the event. The two-day program is being coordinated by Wily Mo Pena's newly formed MoPeace Foundation, which aims to give back to those in need. This particular project will focus on the Latino community, which is at an increased risk of developing type 2 diabetes.
The goal of the Beisbol y Salud Diabetes Awareness Project is to educate Latino men, women and children about type 2 diabetes and encourage them to improve their health through nutrition and exercise.
During the event, Enrique Caballero, M.D., Director of Joslin's Latino Diabetes Initiative (LDI), will talk about type 2 diabetes management and prevention in the Latino community. Several other staff members from Joslin's Latino Diabetes Initiative will travel to the Dominican Republic to participate in the project.
They will conduct workshops for adults and children affected by diabetes, as well as training sessions for Dominican providers about the latest in diabetes research and treatment. Spanish-language diabetes education materials, including Joslin's recently produced educational CD, the audio-novella Rosa's Story, will be available for participants.
"Combating diabetes is a cause close to my heart and to my family's because so many of us have been touched negatively by this horrible disease," said Wily Mo Pena. "Any strength we can lend to the fight is our privilege, and we are honored to work with Joslin Diabetes Center."
Other Major League Baseball players scheduled to participate in the two-day event, including the softball game, are Rafael Soriano (Atlanta Braves), Robinson Cano (New York Yankees), Alfonso Soriano (Chicago Cubs), Melky Cabrera (New York Yankees), T.J. Pena (Atlanta Braves), Edwin Encarnacion (Cincinnati Reds), Sendy Rleal (Baltimore Orioles) and Joel Guzman (Tampa Bay Devil Rays).
Joslin's Latino Diabetes Initiative is thrilled to collaborate with Wily Mo Pena and The MoPeace Foundation on such a significant program for a population at an increased risk of developing type 2 diabetes," said Dr. Caballero. "At Joslin, the LDI provides culturally competent diabetes care, research and education to its patients, and we look forward to bringing this to Latino patients and providers in the Dominican Republic."
This project was made possible through the generosity of Abbott Laboratories. Additional sponsorship has been provided by the Fireman Foundation, Majestic Uniforms, Roche Diagnostics and GlaxoSmithKline.
Posted by dlife at 09:03 AM | Comments (1)
Joslin Diabetes Center Launches National Clinical Trial To Explore If Anti-Inflammatory Drug Can Improve Glucose Control in Type 2 Diabetes
Adults with Poorly Controlled Type 2 Diabetes Sought to Participate in Multi-Center Clinical Trial Funded by NIDDK
January 16, 2007 (Joslin) - BOSTON -- Joslin Diabetes Center scientists are taking their groundbreaking research on the role of inflammation in type 2 diabetes to a new level this month with the launch of a national clinical trial to investigate whether salsalate, an anti-inflammatory drug used for years to manage arthritis pain, can reduce blood glucose levels in people with type 2 diabetes. If successful, the trial could lead one day to an inexpensive way to treat this most common form of diabetes, which has been increasing at epidemic rates in recent years.
About 800 adults with poorly controlled blood glucose levels are being sought to participate in the three-year study, referred to as Targeting Inflammation with Salsalate in Type 2 Diabetes (TINSAL-T2D). The study is being funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The study will be conducted at Joslin in Boston and at 15 other medical institutions across the nation.
"This is the first large-scale study in patients that tests whether reducing inflammation can actually be used to treat diabetes," says principal investigator Steven E. Shoelson, M.D., Ph.D., the Helen and Morton Adler Chair and Associate Director of Research at Joslin Diabetes Center and Professor of Medicine at Harvard Medical School (HMS). "Given what we are learning about how type 2 diabetes develops, we think this might be getting at an underlying cause. We hope the study shows that targeting inflammation is a safe and inexpensive way to treat type 2 diabetes. We also hope that reducing inflammation decreases risk for coronary heart disease, which is another theory that we will be testing in a separate clinical study osliin the coming months."
In the United States, nearly 21 million people have diabetes. Type 2 diabetes accounts for about 90 to 95 percent of diagnosed cases, representing nearly 10 percent of the adult population. Type 2 diabetes, previously called adult onset or non-insulin dependent diabetes, is a disorder in which muscle and fat cells do not use insulin properly. Type 2 diabetes is closely linked to obesity and puts people who have the disease at greater risk for complications, including cardiovascular disease, blindness, kidney disease and amputations. People with type 2 diabetes die at rates two-to-four times higher than those who do not have diabetes.
"Sedentary lifestyle and western diet have been associated with obesity and diabetes," says co-principal investigator Allison B. Goldfine, M.D., Assistant Director of Clinical Research at Joslin and Assistant Professor of Medicine at HMS. "The study medication, salsalate, which is chemically similar to aspirin but has fewer side effects, has been used for more than 40 years in people to treat pain associated with arthritis. Recent studies in people show that salsalate may also lower blood glucose, but further testing needs to be done."
"The outcome of this study has the potential for significant public health benefit," said Dr. Myrlene Staten, NIDDK's Senior Advisor for Diabetes Translational Research. "If salsalate improves the control of type 2 diabetes, we would have an inexpensive addition to our arsenal of drug options."
In previous studies Drs. Shoelson and Goldfine and their collaborators found that inflammation -- an immune system response that normally fights infection and promotes healing -- plays a major role in the development of insulin resistance and type 2 diabetes. These researchers were the first to show that a major trigger of inflammation -- the transcription factor NF-kB -- is activated in fat and liver, perhaps providing the "missing link" between obesity and diabetes. In a real bench-to-bedside victory, the researchers built on these discoveries by conducting clinical trials in patients with diabetes, testing anti-inflammatory salicylates, which inhibit NF-kB, as insulin sensitizers. In these patients, blood glucose and lipid levels substantially decreased, glucose uptake and utilization improved, and liver glucose production increased. These studies laid the groundwork for the new clinical trial.
For the TINSAL-T2D study, the researchers are seeking adults ages 18 to 75 whose glucose levels are not in good control and who don't take insulin. Participants must be using no medication or be taking only one oral medication, or a low-dose combination of oral medications, among other criteria. Most participants can expect their involvement to last about six months.
Those volunteering to participate in the TINSAL-T2D study will undergo a variety of tests to determine if they are eligible. Participants selected for the study may receive either the study drug or a placebo. A placebo is an inactive pill that looks like the study drug, but a placebo contains no active medication. Placebos are used to determine if the results of the study are truly from the study drug. TINSAL-T2D study participants will receive all medication and treatments related to the study free of charge, and will continue to see their personal physician for all of their healthcare needs.
For more information about the study, please contact Allison B. Goldfine, M.D., via phone at 617-732-2643 or via e-mail at Allison.Goldfine@joslin.harvard.edu or visit the clinical research part of Joslin's Web site.
Posted by dlife at 11:56 AM | Comments (1)
No Breakfast and Frequent Fast Food Leads to Extra Pounds in Aging Teens
Study finds teens entering adulthood increase breakfast skipping and consumption of fast food
January 9, 2007 (EurekAlert) Providence, RI – The old phrase "breakfast is the most important meal of the day" has taken on new meaning for teenagers. A new study suggests that as teens enter adulthood, they are more likely to skip breakfast and increase their fast food consumption, and that both behaviors lead to an increased risk of weight gain. This is the finding of an article appearing in the December 2006 issue of the Journal of Adolescent Health by researchers at The Weight Control and Diabetes Research Center at The Miriam Hospital and Brown Medical School.
"Since the transition from adolescence to adulthood appears to be a particularly high-risk period for weight gain, we wanted to investigate what role skipping breakfast and fast food consumption had on weight during this important time," says lead author Heather Niemeier, PhD, a psychologist at The Miriam Hospital.
Researchers analyzed data drawn from Add Health, a school-based study of over 20,000 adolescents in grades 7 through 12 in the United States. The current study used information from two "Waves" of data that consisted of a total of 9,919 adolescents. Wave 2 data was collected from the adolescents (ages 11 to 21) during the period of April to August 1996. Wave 3 data was collected from the same group of adolescents from August 2001 to April 2002, when they were between the ages of 18 and 27. Fast food and breakfast consumption was measured throughout both waves, in addition to Body Mass Index (BMI).
"We found that both fast food consumption and breakfast skipping significantly increased between Waves 2 and 3. More importantly, both behaviors were associated with increased weight gain during this time," says Niemeier.
During the five-year interval between Waves 2 and 3, signifying the transition from adolescence to adulthood, the number of participants considered overweight increased from 29 percent to 47 percent. Fast food consumption increased from 2 days a week as adolescents to about 2.5 days per week as young adults, and although participants reported that they consumed breakfast 4 to 5 days per week during adolescence - this decreased to 3 days per week by young adulthood.
The increase in fast food and breakfast skipping could be due to the increased independence and responsibility for food preparation that adolescents face during this developmental transition the authors note.
"Fast food is a quick, easy, and tasty option for aging adolescents who may be used to relying on Mom or Dad to prepare their meals," says Niemeier. "As adolescents enter the workforce or college, breakfast may be looked at as an unnecessary hassle and easily skipped. However, skipping breakfast can lead to greater levels of hunger later in the day, causing overeating, or the choosing of heavy foods that fill you up faster, but may not be very nutritious."
The authors write that since adolescent obesity is a significant predictor of overweight status in adulthood and poses a risk for adult morbidity and mortality, it is important to identify dietary behaviors early on that are associated with unhealthy weight gain in order to create effective interventions.
"This study highlights the importance of encouraging adolescents who are entering adulthood to eat breakfast regularly and to make healthy food choices, limiting their fast food consumption," says Niemeier.
The prevalence of obesity in adolescents and adults in the United States has increased dramatically over the past decade with the Surgeon General referring to it as a public health epidemic. Unhealthy weight increases during adolescence have been associated with fasting insulin, increased levels of HDL-cholesterol and risk factors for heart disease, and systolic blood pressure in young adulthood.
Future research should look at obtaining more detailed dietary information to better understand the mechanisms by which they influence weight gain.
"Including measures about specific types of fast food or breakfast alternatives consumed, and how they relate to the adolescent's overall energy intake and the percent of energy from fat – may be able to help create targeted interventions aimed at prevention of weight gain in this age group, "says Niemeier.
Posted by dlife at 09:33 AM | Comments (1)
Antibody Therapy Prevents Type 1 Diabetes in Mice
January 9, 2007 (EurekAlert) – University of Pittsburgh investigators have successfully prevented the onset of type 1 diabetes in mice prone to developing the disease using an antibody against a receptor on the surface of immune T-cells. According to the investigators, these findings, which are being published in the January issue of the journal Diabetes, have significant implications for the prevention of type 1 diabetes.
More than 700,000 Americans have type 1 diabetes, an autoimmune disorder in which the body errantly attacks the insulin-producing cells of the pancreas, causing chronically elevated levels of sugar in the blood, leading to blindness, kidney failure, heart disease and nerve damage. Previously known as juvenile diabetes, type 1 diabetes is usually diagnosed at a very early age, but in some cases it can be diagnosed in adulthood.
In this study, the Pitt researchers treated non-obese diabetic (NOD) mice with an antibody -- a type of protein produced by the immune system that recognizes and helps fight infections and other foreign substances in the body -- directed against a receptor known as CD137 on the surface of a type of immune cell called T-cells. Treating NOD mice with the anti-CD137 antibodies significantly suppressed the development of diabetes, whereas most of the control mice developed diabetes by the time they were six months old.
Interestingly, the antibody therapy did not appear to cure the NOD mice because the researchers were still able to see lymphocytes in their pancreatic islets, a tell-tale sign of pancreatic inflammation and autoimmunity. In addition, when the researchers isolated cells from the spleens of the antibody-treated mice and injected these cells into immune-deficient NOD mice, seven of the nine recipient mice developed type 1 diabetes, indicating that the donor mice still harbored pathogenic T-cells. On the other hand, when the researchers transferred a certain subset of T-cells from anti-CD137-treated mice that expressed two other receptors known as CD4 and CD25 to other immune-deficient NOD mice, it prevented the onset of diabetes in the recipient mice.
According to senior author William M. Ridgway, M.D., assistant professor in the University of Pittsburgh School of Medicine's department of rheumatology and clinical immunology, this therapy, if given early enough, may offer a viable method for preventing the onset of type 1 diabetes in genetically at-risk people.
"Our studies and others suggest that CD137 plays a significant role in the development of and genetic predisposition to type 1 diabetes. In this study, for the first time, we have demonstrated that CD137 antibody therapy can suppress the development of type 1 diabetes in mice and that the effect is dependent on the induction of a certain subset of regulatory T-cells. If we can demonstrate this same genetic predisposition and therapeutic effect in human type 1 diabetes patients, then this may prove to be a significant step toward preventing this disease before it can take hold," he explained.
Posted by dlife at 09:28 AM | Comments (1)
Scientists Discover New, Readily Available Source of Stem Cells
January 8, 2007 (EurekAlert) WINSTON-SALEM, N.C. -- Scientists have discovered a new source of stems cells and have used them to create muscle, bone, fat, blood vessel, nerve and liver cells in the laboratory. The first report showing the isolation of broad potential stem cells from the amniotic fluid that surrounds developing embryos was published today in Nature Biotechnology.
"Our hope is that these cells will provide a valuable resource for tissue repair and for engineered organs as well," said Anthony Atala, M.D., senior researcher and director of the Institute for Regenerative Medicine at Wake Forest University School of Medicine.
Atala announced the breakthrough with colleagues from Wake Forest University School of Medicine and Harvard Medical School.
"It has been known for decades that both the placenta and amniotic fluid contain multiple progenitor cell types from the developing embryo, including fat, bone, and muscle," said Atala. "We asked the question, 'Is there a possibility that within this cell population we can capture true stem cells?' The answer is yes."
Atala and colleagues discovered a small number of stem cells in amniotic fluid – estimated at 1 percent – that can give rise to many of the specialized cell types found in the human body. The scientists believe the newly discovered stem cells, which they have named amniotic fluid-derived stem (AFS) cells, may represent an intermediate stage between embryonic stem cells and adult stem cells. They have markers consistent with both cell types.
"It took this long to verify that we had a true stem cell," said Atala, who began the work seven years ago. "These cells are capable of extensive self-renewal, a defining property of stem cells. They also can be used to produce a broad range of cells that may be valuable for therapy."
An advantage of the AFS cells for potential medical applications is their ready availability. The report describes how the cells were harvested from backup amniotic fluid specimens obtained for amniocentesis, a procedure that examines cells in this fluid for prenatal diagnosis of certain genetic disorders. Similar stem cells were isolated from "afterbirth," the placenta and other membranes that are expelled after delivery.
Atala said a bank with 100,000 specimens theoretically could supply 99 percent of the U.S. population with perfect genetic matches for transplantation. There are more than 4 million live births each year in the United States.
In addition to being easily obtainable, the AFS cells can be grown in large quantities because they typically double every 36 hours. They also do not require guidance from other cells (termed "feeders") and they do not produce tumors, which can occur with certain other types of stem cells. The scientists noted that specialized cells generated from the AFS cells included all three classes of cells found in the developing embryo - termed ectoderm, mesoderm, and endoderm. In their high degree of flexibility and growth potential, the AFS cells resemble human embryonic stem cells, which are believed capable of generating every type of adult cell.
"The full range of cells that AFS cells can give rise to remains to be determined," said Atala. "So far, we've been successful with every cell type we've attempted to produce from these stem cells. The AFS cells can also produce mature cells that meet tests of function, which suggests their therapeutic value."
The functional tests included implanting neural cells created from AFS cells into mice with a degenerative brain disease. The cells grew and "re-populated" the diseased areas. In addition, bone cells produced from the stem cells were successfully used to grow bony tissue in mice, and liver cells were able to secrete urea, which the liver produces from ammonia.
The potential to generate a broad range of mature cell types is why many scientists believe stem cells have promise to replace damaged cells and tissue in conditions such as spinal cord injuries, diabetes, Alzheimer's disease and stroke.
Posted by dlife at 11:05 AM | Comments (1)
Diabetech To Transform Global Diabetes Care In 2007 With Launch Of GlucoMON2 Wireless Glucose Meter
January 8, 2007 (Medical News Today) - Since the landmark Diabetes Control & Complications Trial (DCCT) in the early 90's we've all known that average blood sugar levels and tight glycemic control are improved through frequent blood glucose testing and team management with a knowledgeable remote caregiver. Unfortunately, today's blood glucose meters lack the connectivity to facilitate this remote teaming interaction. The result is millions of people left to manage their diabetes in isolation, especially the newly diagnosed. Even with all of the increased sales of diabetes testing supplies, blood sugar control and physician adherence to established standards of care worldwide remain unacceptable by every diabetes organization worldwide including the American Diabetes Association, American Association of Clinical Endocrinologists, American Association of Diabetes Educators and the International Diabetes Federation.
Direct costs of diabetes care in the USA have more than doubled in recent years, according to the Centers for Disease Control & Prevention. "Without any practical means of enjoying the benefits of team management, costs from the current paradigm of test and forget self-care will bankrupt our global economy," says Kevin McMahon, President & CEO of Diabetech. Clinical inefficiencies also stem from this lack of connectivity further driving up costs. Even the recently introduced continuous glucose monitoring devices are not capable of supporting communication with knowledgeable remote caregivers.
Diabetech offers a better answer to patients and the healthcare industry when it comes to an effective model for diabetes care including control for spiralling costs. Diabetech's GlucoMON blood glucose connectivity device ensures glucose meter accuracy and automates the collection and analysis of blood glucose data for use in the team management of diabetes. People typically report drops in their average blood glucose (haemoglobin A1c) levels from 10% - 30% when they use a GlucoMON and even more in some cases. Advanced technology simplifying the process is the key. As Stephen Ponder, MD CDE and Diabetech's Chief Medical Officer likes to say, 'Diabetech makes improvements to self-care and remote patient interventions ridiculously easy'.
Representatives from health plans, self-insured employers and individual participants and their families involved in our various Institutional Review Board approved research trials have been providing feedback culminating in support for the development of a new commercial version of the GlucoMON upgraded for the global market. Based on interim clinical trial results from GlucoMON-enabled intervention programs, payers are already acknowledging a clear path to their Return On Investment (ROI); a pivotal metric that has been difficult for generalist disease management firms to demonstrate.
GlucoMON2 is approximately 80% smaller than the previous GlucoMON making it the smallest and lightest GlucoMON ever. GlucoMON2 also makes the world's easiest way to share blood glucose levels even easier with even more automation designed into the device itself. GlucoMON2 availability is planned for Q3 '2007 and is capable of operating anywhere in the world where there is support for GSM/GPRS networks. The bundled device, airtime and service will be available through payer-sponsored and direct- to-consumer programs. Not only is GlucoMON2 more advanced; it's also more personalized with a variety of designer colors available based on local preferences. Companies interested in distribution and/or establishing programs leveraging GlucoMON2 should contact Diabetech immediately for more information.
Previous generation GlucoMONs have generated over 70 patient-years of device usability and safety data. The original GlucoMON broke new ground in December of 2002 supporting the first end-to-end wireless diabetes management system in the world connecting patients and their extended care teams in real-time. To this day, Diabetech remains the only provider anywhere offering a comprehensive solution encompassing the glucose meter, supplies, long-range wireless management device, wireless network transport, remote control, stored patient records and active informatics including trend identification and feedback - all under one roof.
Our current GlucoMON supports LifeScan®'s Ultra® glucose meter across many clinical trials throughout North America and will continue in its role as a research device. Prior to the launch of the Ultra®2, Diabetech had been evaluating usability of newer glucose meters as candidates for GlucoMON2 integration. We arrived at our decision to support the Ultra2 as the first glucose meter integration to our GlucoMON2 mobile telemetry platform due to its broad patient adoption, unsurpassed quality and the fact that its OneTouch® blood glucose test strips are the most widely reimbursed strip on the market. Likewise, we selected GSM/GPRS as our wireless network backbone due to its broad global footprint and support for high speed data applications in our fourth generation wireless data, voice and video dedicated medical handhelds targeting availability in 2008.
Posted by dlife at 10:57 AM | Comments (3)
Vision Loss Can Be Prevented in People with Diabetes
January 8, 2007 (Newswise) — The millions of Americans afflicted with Type 1 and 2 Diabetes face many potential complications, including: heart and kidney disease; nerve damage and stroke; foot and skin problems; and gastrointestinal disorders and hypoglycemia.
Another major complication, affecting up to 24,000 new people per year, is permanent blindness due to diabetic retinopathy, a degenerative disease of the retina (the sensitive area at the back of the eye). Overall, diabetic retinopathy affects 5.3 million Americans 18 and older.
But there’s hope. The American Academy of Ophthalmology wants Americans to know that even though diabetes is the leading cause of new cases of blindness, vision loss can be prevented if the disease is diagnosed and treated in time.
“Only 50 to 60 percent of those with diabetes get the recommended yearly eye examinations,” said Jose S. Pulido, MD, Academy clinical correspondent and professor of ophthalmology at the Mayo Clinic in Rochester, Minn. “Studies show effective treatments, including an annual dilated eye exam, can reduce severe vision loss by up to 94 percent.”
According to the American Diabetes Association, there are 20.8 million people in the United States, or 7 percent of the population, who have diabetes. While an estimated 14.6 million have been diagnosed, 6.2 million people (or nearly one-third) are unaware that they have the disease.
“This is a tragedy waiting to happen because people who are unaware they have the disease are at a substantially greater risk for vision loss and other complications,” said Dr. Pulido. “The first step in preventing complications is finding out if you have the disease. It’s important for all healthy adults over the age of 45 to have a blood sugar test once every three years.”
Dr. Pulido said that the longer a person has diabetes, the greater the risk for developing diabetic retinopathy.
“Diabetic retinopathy does not only affect people who have had diabetes for many years, it can also appear within the first year or two after the onset of the disease,” he said. “For some people, diabetic retinopathy is one of the first signs of the disease.”
Anatomy of Diabetic Retinopathy
High blood sugar levels weaken blood vessels in the eye's retina, causing them to leak blood or fluid. This causes the retina to swell and can lead to vision loss.
Blood sugar fluctuations can also promote growth of new, fragile blood vessels on the retina, which can easily break and leak blood into the vitreous (the clear, jelly-like substance that fills the center of the eye). This can blur vision and lead to permanent blindness.
In its earliest stages diabetic retinopathy may not affect vision, but over time it can cause vision loss and even blindness in both eyes.
What are the Signs of Diabetic Retinopathy?
“Fluctuations in blood sugar levels can temporarily affect vision, so it's sometimes difficult to know if a serious eye problem is developing," said Dr. Pulido. "That's one of the reasons strict control of your blood sugar is so important. If you notice a vision change in one eye, a change that lasts more than a day or two, or changes not associated with fluctuations in blood sugar, contact your Eye M.D. immediately."
Other ways to reduce the risk of eye disease:
• Keep your blood glucose level as close to normal as possible through diet, exercise and, if needed, medication
• Keep your blood pressure under control
• Keep your cholesterol levels low
• Don’t smoke
• Make sure your hemoglobin A1c levels (a measure of good blood sugar control) are measured at least every four months and are less than 7.1.
Diabetic Retinopathy: A New Hope
Although incurable, diabetic retinopathy can be treated to retard its onset and progression. There’s hope for the development of new pharmacological treatments that would not require invasive laser surgery. These treatments might even restore the vision that the disease destroys.
These potential treatments signal a move away from laser photocoagulation to drugs injected into the eye, as well as oral treatments.
Many of these drugs block the pathways that contribute to the vascular disruptions that characterize diabetic retinopathy. Specifically, they aim to inhibit the growth of new blood vessels or the activity of proteins in the nerve cells of the retina.
These treatments hold promise of intervention at earlier, non-sight-threatening stages, but they will require renewed emphasis on early detection. The newest and best treatments will be most effective only when the underlying disease—diabetes—is under control.
Posted by dlife at 10:52 AM | Comments (1)
Published Study Shows Benefits of Diachrome for People with Type 2 Diabetes
Additional research presented at the 19th World Diabetes Congress Meeting supports the efficacy and safety of chromium picolinate in diabetes management
January 8, 2007 (EurekAlert) – Nutrition 21, Inc. (NASDAQ: NXXI) today announced the results of a recent placebo controlled, double-blind, randomized, single center study that demonstrated that Diachrome®, a patented combination of chromium picolinate and biotin, safely improves blood glucose levels and cholesterol metabolism in people with type 2 diabetes. Published in the December issue of Diabetes Technology and Therapeutics, the study supports the role of chromium picolinate – the most studied, highly absorbed and efficacious form of chromium – plus biotin as a safe and effective nutritional adjunct therapy in diabetes care.
The 30-day study examined thirty-six overweight or obese poorly controlled patients with type 2 diabetes taking Diachrome who were already receiving oral anti-diabetic drug(s). The results also showed a significantly greater reduction in the total area under the curve for glucose (AUCg) during the oral glucose tolerance test (OGTT) for the treatment group (mean change -9.7%) compared with the placebo group (mean change +5.1%). Mean fructosamine levels, a measure of the average blood glucose level during a period of three weeks, were also significantly reduced in the treatment group (-1.3 mmol/L) compared to the placebo group (0.7 mmol/L).
"Results from this pilot study promote the potential benefits of supplementing chromium picolinate and biotin with one's daily diabetes care regimen," said Gregory Singer, MD, lead author and cardiovascular medicine specialist at Yale University School of Medicine. "Chromium picolinate with biotin represents an adjunctive strategy to conventional oral diabetes therapy for improved blood sugar control and cholesterol metabolism."
A larger 400 patient, 90-day randomized placebo controlled study to determine the effects of chromium picolinate/biotin on hemoglobin A1c and other risk factors in type 2 diabetes is expected to be published next year.
"Previous studies have demonstrated that chromium picolinate can significantly impact A1c and other critical markers in people with type 2 diabetes," said Dr. Singer. "Additional research currently underway may provide us with further understanding of the supplement's role in the management of type 2 diabetes."
Another study released this month at the 19th World Diabetes Congress meeting in Cape Town, South Africa, demonstrated that supplementing with chromium picolinate, an active ingredient in Diachrome, led to significant improvements in blood sugar levels of people with type 2 diabetes over a six-year period. In addition to existing treatments, 1056 patients with diabetes ages 20 to 90 years old were observed among nine sites before and during supplementation with 500 mcg daily of chromium as chromium picolinate for one to six years. A significant decrease in fasting glucose levels of 4.67 mmol/L and postprandial glucose levels of 5.77 mmol/L was seen in patients taking chromium picolinate. The study showed that blood glucose levels continued to improve each year throughout the six years of the study.
"This study – one of the largest and longest clinical trials measuring chromium picolinate's effects on blood glucose levels – underscores the nutrition supplement's beneficial role in helping manage type 2 diabetes," said lead investigator Nancy Cheng, MD, PhD, Senior Director of Tang-An Diabetic Clinic and Education Center in Beijing.
Chromax® chromium picolinate, found in Diachrome and used in these studies, has been recognized as safe by many of the world's leading government and academic research institutions, including the U.S. Food & Drug Administration, the Institute of Medicine and the UK's Food Standards Agency. In addition, biotin has been deemed safe by the Food and Drug Administration and is also Generally Recognized as Safe (GRAS) for use in foods and supplements.
Posted by dlife at 09:23 AM | Comments (0)
Joslin’s Latino Diabetes Initiative Launches Its First Audio-Novella for Hispanics/Latinos with Diabetes and Their Families
January 8, 2007 (Joslin) — Rosa’s Story, an audio-novella from the Joslin Diabetes Center Latino Diabetes Initiative, uses the art of storytelling to educate listeners about the challenges of diabetes faced by the Hispanic/Latino population. The first-person accounts of a fictitious Latino woman with type 2 diabetes, and a teenager with pre-diabetes, are told in the new educational package. Designed for Spanish-speaking Latinos with diabetes and their families, the three-CD set is being launched on Nov. 14, World Diabetes Day, a day set aside by the International Diabetes Federation (IDF) and the World Health Organization to increase public awareness of the global diabetes epidemic.
The IDF estimates the number of people with diabetes will exceed 350 million by 2025. Ethnic minorities, including those of Latino or Hispanic heritage, are at greater risk for type 2 diabetes than the general population, making Rosa’s Story both important and timely. Latinos are the fastest growing and largest minority group in the United States. More than 10 percent of Latinos in the United States have diabetes, and one-third of them are undiagnosed. Their risk of developing diabetes is twice as high as non-Latino white Americans.
“Our goal with Rosa’s Story is to teach the Latino population, as well as their healthcare providers, about diabetes by addressing the basic knowledge that everyone needs, as well as the common myths and misconceptions associated with the disease,” said A. Enrique Caballero, M.D., Director of Joslin’s Latino Diabetes Initiative. “The concept behind this audio-novella is based on our years of patient care and research, which allowed us to identify a culturally appropriate way to convey important educational messages about diabetes.”
Rosa’s Story is a one-of-a-kind teaching tool making use of that method. Rosa’s Story includes: three Spanish-language audio CDs, a patient booklet written in Spanish and a healthcare provider manual written in English. Each chapter addresses a specific issue Rosa faces due to her type 2 diabetes.
The first chapter explains how Rosa deals with her diagnosis and how the language barrier and other cultural aspects affect her access to proper diabetes care. The second chapter addresses changes Rosa makes to her meal plan while maintaining her cultural preferences. The third chapter explains how she works physical activity into her daily life as she strives to adopt a healthier lifestyle. By presenting Rosa’s evolution with the disease, the fourth chapter discusses treatment options for people with type 2 diabetes. To address common misconceptions in the Latino community, this chapter also describes Rosa’s fears about oral medications and insulin. The fifth chapter is dedicated to pre-diabetes and focuses on a fictitious 18-year-old named Carolina, who describes her personal experiences with pre-diabetes.
To purchase a copy of Rosa’s Story and the companion materials, contact the Latino Diabetes Initiative by calling 617-264-2733 or click here to order from the online Joslin Store.
About Joslin’s Latino Diabetes Initiative
The Joslin Latino Diabetes Initiative (LDI) is a team of bilingual/bicultural providers, clinicians and administrative staff who provide culturally appropriate, state-of-the-art diabetes care and education, and who conduct clinical research, community outreach and provider education to improve health outcomes for Latinos living with diabetes and those at risk of developing the disease. Since its inception in 2002, there have been more than 4,433 patient visits to the bilingual Latino Clinic at Joslin in Boston, and the LDI staff has provided information that has been incorporated into Joslin’s continuing medical education programs, reaching thousands of providers throughout the country. For more information about the Joslin Latino Diabetes Initiative, call 617-264-2733 or visit www.joslin.org/latino.
Posted by dlife at 08:03 AM | Comments (0)
Risk Factors for Diabetes Following Liver Transplant
January 5, 2007 (EurekAlert) - A new study on risk factors of new-onset diabetes mellitus (NODM) following liver transplant found that a history of obesity, impaired fasting glucose and hepatitis C infection (HCV) paired with the use of a particular immunosuppressant are associated with an increased risk of NODM. Since all of these factors can be detected prior to undergoing a transplant, treatment should be tailored to the patient's risk.
The results of this study appear in the January 2007 issue of Liver Transplantation, the official journal of the American Association for the Study of Liver Diseases (AASLD) and the International Liver Transplantation Society (ILTS). The journal is published on behalf of the societies by John Wiley & Sons, Inc. and is available online via Wiley InterScience at http://www.interscience.wiley.com/journal/livertransplantation.
The development of NODM after a liver transplant is associated with increased cardiovascular disease and death, a higher incidence of rejection, more infections and reduced quality of life. It is therefore likely that the survival rate following liver transplant could be improved by reducing the incidence of NODM. However, the exact incidence of NODM is not clear because existing studies have used varying criteria. In addition, no definitive risk factors have been clearly established. Immunosuppressive drugs are known to contribute to diabetes, although this effect varies depending on the drug; calcineurine inhibitors are less likely to cause diabetes than steroids.
Led by Faouzi Saliba, M.D. of the Hôpital Paul Brousse in Villejuif, France, the study included 211 patients from 10 transplant centers in France who had undergone a liver transplant between October 2003 and June 2004. Patients' clinical records were reviewed and their fasting blood glucose levels were recorded 3, 6, 12 and 18 months after undergoing the transplant. For those with NODM, the date of diagnosis was noted, along with the immunosuppressive treatment and diabetes management they had received.
The results showed an incidence of NODM of 22.7 percent, with the majority of the cases diagnosed within three months of transplant. In addition, 12.4 percent of the patients with normal glucose levels pre-transplant developed impaired fasting glucose (IFG). The risk factors for developing NODM included HCV infection (especially when combined with the immunosuppressant tacrolimus), IFG prior to the transplant, and a history of clinical obesity. In addition, the presence of at least two cardiovascular risk factors and a history of either gestational diabetes or having given birth to a baby weighing over 4 kilograms also increased the risk of NODM. The authors note that since abnormal glucose regulation prior to transplantation has been implicated as a possible risk factor of NODM and IFG emerged as a strong predictor of the condition in the current study, pre-transplantation glucose screening may be important in helping to predict NODM.
"Our study suggests that it may eventually be possible to derive a composite risk factor equation for the development of NODM following liver transplantation with appropriate weighing for each variable, perhaps similar to the risk assessment instruments developed for the primary prevention of cardiovascular disease," the authors conclude.
In an accompanying editorial in the same issue, Paul J. Thuluvath, M.D., F.R.C.P, of the Johns Hopkins University School of Medicine in Baltimore notes that the study confirms that a significant number of patients develop NODM after liver transplantation, however almost all of them were on steroids and developed the disease within 3 months of transplant. A previous study showed that 24 of 88 patients were found to have diabetes mellitus at the end of the first year post-transplant, but by the end of the second year only 8 of them had the condition. "This may suggest that many patients in the cohort studied by Saliba et al. may not have diabetes with longer follow up especially when steroid is discontinued," the author states. He adds that the increased incidence of NODM in patients with HCV is noteworthy and confirms the trends seen in previous studies, although the mechanisms of how this happens remain unclear. "It is probable that NODM will have an impact on long-term survival, and therefore it is important to continue to study the impact of NODM and its intervention on long-term graft and patient survival in patients with and without HCV," the author concludes. "As we develop newer immunosuppressive drugs, we now have the ability to improve the diabetic control by tailoring and manipulating the medications in liver transplant recipients."
Posted by dlife at 09:25 AM | Comments (0)
Glucose Levels Trigger Compensation for Type 2 Diabetics
January 3, 2007 (EurekAlert) - Many individuals with type 2 diabetes are diabetic because the cells of their body no longer respond to the hormone insulin, which is crucial for lowering blood sugar levels (blood glucose levels). However, before individuals become clinically diabetic their body tries to compensate for the increasing resistance to the effects of insulin by increasing both the amount of insulin secreted and the mass of insulin-secreting cells (beta cells) in the pancreas. Several factors have been shown to induce an increase in beta-cell mass, but exactly what triggers this in individuals consuming a high-fat diet has not been clearly established.
In a study appearing in the January issue of the Journal of Clinical Investigation, Takashi Kadowaki and colleagues from the University of Tokyo, Japan, show that in mice with high-fat diet–induced insulin resistance, changes in glucose concentration are likely to be the main trigger of increased beta-cell mass. The beta-cell mass of mice expressing only one copy of the gene encoding the sensor of blood glucose levels, GCK (Gck-/- mice), showed little increase compared with wild-type mice fed a high-fat diet, and the mice developed diabetes. One important mediator of the beta-cell mass increase downstream of GCK sensing increased blood glucose levels, and was shown to be IRS2, as expression of IRS2 in Gck-/- mice partially prevented diabetes by increasing beta-cell mass. The authors therefore suggest that novel strategies to increase beta-cell mass to treat type 2 diabetes and overcome high-fat diet–induced insulin resistance might be developed if the mechanism linking GCK and IRS2 can be determined. However, in an accompanying commentary, Gordon Weir and Susan Bonner-Weir from the Joslin Diabetes Center remind us that before we develop new therapeutics "it is essential that glucose signals involved in beta-cell replication in both health and disease be carefully defined."
Posted by dlife at 09:17 AM | Comments (0)
Sugars in Liver Found to Clear Fats From the Bloodstream
January 3, 2007 (EurekAlert) - Maybe you ate a big, juicy steak for dinner last night, adding a large amount of fat – scientifically known as triglycerides – to your system. For one in ten of us, that could be a big problem.
Although we try to reduce fat in our diet, our bodies use it for energy. But patients with elevated levels of fat in their bloodstream – nearly 10 percent of Americans – are more likely to develop arthrosclerosis, or build-up of plaque in the arteries, which can lead to a heart attack or stroke.
In work with mice, researchers at the University of California, San Diego (UCSD) School of Medicine discovered a factor that could be responsible for many unexplained cases of elevated triglyceride levels.
In humans, this condition can be diabetes-related, diet-induced, or caused by drug interactions or chronic alcohol consumption. The problem can also run in families. But it turns out that another important factor is sugar – a complex one produced by all cells in the body called heparan sulfate, which is related to the anti-coagulant heparin.
The UCSD team found that heparan sulfate in the liver helps the body clear triglycerides from the blood. Their study, published in the January 1 issue of the Journal of Clinical Investigation, suggests that some patients with elevated triglyceride levels could have changes in heparan sulfate in the liver. The discovery could pave the way for new therapies for a major and growing medical problem.
"The work confirms that heparan sulfate in the liver plays a crucial role in clearing fat," said Jeffrey D. Esko, Professor of Cellular and Molecular Medicine at UCSD's School of Medicine. "These molecules clear triglycerides and cholesterol from the blood, working alongside the better known LDL receptors."
The UCSD researchers created a mouse model with a mutation of heparan sulfate, which resulted in elevated triglyceride levels, like those seen in many patients with diabetes. The researchers made mutations in only in the liver, because such mutations throughout all tissues would lead to the death of an embryo or death shortly after birth.
"By selectively mutating a single tissue in mice, in this case the liver, we avoided a lethal effect," said Esko. In the lab, the researchers combined the heparan sulfate mutation with a mutation in the LDL receptor, which has long known to be responsible for clearing cholesterol from the arteries. The UCSD team showed that heparan sulfate is involved in clearing not only triglycerides, but also cholesterol, from the blood.
"The finding, that the LDL receptor plus heparan sulfate work together to clear triglyceride and cholesterol-rich particles from the blood in a healthy person is very exciting," Esko said. The study suggests the possibility that mutations in one of 40 or so genes involved in production of heparan sulfate in the liver could result in high blood-fat levels and lead to complications such as arthrosclerosis, according to Esko.
In animal models with induced diabetes, changes in liver heparan sulfate – consistent with the UCSD researchers' findings – often appear. One of the team's next steps will be to induce diabetes in animals and examine the role of heparan sulfate in more detail.
"Such studies could lead to new drugs that change heparan sulfate in order to lower fat levels in patients," said Esko.
Posted by dlife at 09:11 AM | Comments (1)