MRI Identifies 'Hidden' Fat That Puts Adolescents at Risk for Disease
February 28, 2007 (EurekAlert) - According to a new study featured in the March issue of Radiology, single-slice magnetic resonance imaging (MRI) is a fast, non-invasive way to measure intra-abdominal fat, which when excessive, may put children and teenagers at risk for developing heart disease, diabetes and other illnesses.
Unlike the fat that lies just beneath the abdominal wall, forming skin folds or "love handles," internal fat located in and around the abdominal organs may actually be more damaging, predisposing children to adult diseases.
"Because metabolic abnormalities appear to be more closely associated with intra-abdominal fat tissue, it is critical to be able to reliably and accurately assess this fat tissue in order to identify children at risk," said the study's lead researcher Marilyn J. Siegel, M.D., professor of radiology and pediatrics at Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, Missouri.
Results from the 2003-2004 National Health and Nutrition Examination Survey found that an estimated 18.8 percent of children (age 6 to 11) and 17.4 percent of adolescents (age 12 to 19) in the United States are overweight.
Current methods used to estimate body fat include anthropometry, which involves physical measurements including waist circumference, abdominal height and body mass index, and dual energy absorptiometry (DEXA), a whole-body scan that distinguishes lean mass from fat tissue. However, anthropometry is imprecise and DEXA requires exposure to ionizing radiation.
In Dr. Siegel's study, 30 adolescents had fat tissue measurements taken using anthropometry, DEXA and single-slice and whole-abdominal, multi-slice MRI. The study's 20 boys and 10 girls were between the ages of 10 and 18 and included nine overweight but non-diabetic individuals, 10 Type-2 diabetic and overweight patients, and 11 normal weight, non-diabetic adolescents.
The single-slice and multi-slice MRI measurements were compared and tested for correlations with anthropometric and DEXA measurements.
"Single- and multi-slice MRI measurements for assessing body fat distribution strongly correlated with clinical and DEXA measures," Dr. Siegel said. "The single-slice MRI, which takes just a few seconds, characterized body fat as well as the multi-slice exam."
While all participants had similar fat distribution patterns with a predominance of fat in the tissue of the abdominal wall, the total amount of fat tissue varied. Overall fat volume was highest in the diabetic, overweight adolescents
According to Dr. Siegel, fat tissue estimation through single-slice MRI is simple, fast and could be useful in many clinical and research applications, including patient management, monitoring interventions, and implementing multi-center clinical trials or epidemiologic studies.
"Our ability to accurately measure abdominal fat may substantially advance strategies for achieving healthy weights in children," she said.
Posted by dlife at 09:36 AM | Comments (0)
Joslin Study Finds Increased Use of Insulin Pumps, New Insulin Types Give Teens More Tools to Better Manage Diabetes
Feb. 27, 2007 (Joslin) - It is widely recognized that the teenage years are often a challenging time for youth with diabetes to maintain good blood glucose control. Hormonal changes, peer pressure, food temptations, and resistance to following good health practices are among the factors that make it difficult for many youngsters. Unfortunately, poor diabetes control places youth at increased risk of developing complications from diabetes later in life.
The landmark Diabetes Control and Complications Trial, which ended in 1993, confirmed the long-held belief of Joslin's founder, Elliott P. Joslin, M.D., that good blood glucose control is necessary to help stave off diabetes-related complications, such as heart disease, blindness and nerve damage. Among the 1,441 people evaluated in the DCCT, about 200 were adolescents. It was not surprising that this small group generally had higher blood glucose levels than the adults.
Now a new study led by Lori Laffel, M.D., M.P.H., and her colleagues in Joslin Diabetes Center's Pediatric, Adolescent and Young Adult Section reveals some good news for youngsters with type 1 diabetes. The study found that adolescents are doing a better job controlling their blood glucose levels than they were previously, thanks in part to tools like insulin pumps and insulin analogs that have become available in recent years. The study appears in the March edition of the Journal of Pediatrics.
"The good news is that we have shown that teens are able to better control diabetes than they were in the DCCT study," said Dr. Laffel, Chief of Joslin Pediatrics, Investigator in the Genetics and Epidemiology Section and Associate Professor of Pediatrics at Harvard Medical School.
The researchers studied more than 400 youth with type 1 diabetes who were ages 8 to 16 years and divided into two groups. The first group of 299 youngsters began being studied in 1997; the second group of 152 began being followed by the researchers in 2002. Each group was followed for a two-year period. As five years separated the two study groups, the researchers were able to track the improvements in control from the first group to the second group.
"We found about 40 percent of the first group were checking their blood glucose at least four times per day, and in the second group, it was 72 percent," Dr. Laffel said. In regard to insulin delivery systems, no patients in the first group were on insulin pumps when they entered the study, compared to 23 percent of the youth in the second group.
The researchers also found fewer hospitalizations, emergency room visits and severe low blood glucose episodes (hypoglycemia) with the second group. Furthermore, they did not see evidence of increased weight gain with the second group, which can be associated with increased intensity of insulin usage.
The improved control paid off for the second group with lower A1C values, which reflect a patient's average blood glucose over several months. The average A1C at the start of the study was 8.7 percent for the first group, compared to 8.4 percent for the second group. Furthermore, only 30 percent of patients in the first group met a target A1C of 8 percent or below, while close to half of the patients in the second group met this goal. "Of course there's still room for improvement. We want to see 100 percent of patients achieving tight control," said Dr. Laffel. "Nonetheless, there was considerable improvement between the two groups," she added.
"While it took the general medical community some time to adopt intensive therapy and to provide patients and families with the skills necessary to carry out tight diabetes control, we at Joslin were quick to translate the DCCT findings to clinical care," Dr. Laffel said. "In Joslin's pediatrics program, about 80 percent of patients were put on insulin analogs early on," she said.
"It's not acceptable that only half the people in the second group reached the A1C target goal. Further technologic advances are still needed. For example, we are excited to be starting two new studies at Joslin evaluating the use of continuous glucose monitoring devices. We hope that this technology will be able to further help our patients achieve
Posted by dlife at 04:09 PM | Comments (3)
Growth Hormone to Boost Athletic Performance Risks Diabetes
February 26, 2007 (EurekAlert) - Use of growth hormone to boost athletic performance can lead to diabetes, reports a study published ahead of print in the British Journal of Sports Medicine.
The study reports the case of a 36 year old professional body-builder who required emergency care for chest pain.
He had lost 40 kg in 12 months, during which he had also experienced excessive urination, thirst, and appetite.
He admitted to using anabolic steroids for 15 years and artificial growth hormone for the past three. He had also taken insulin, a year after starting on the growth hormone.
This was done to counter the effects of high blood sugar, but he had stopped taking it after a couple of episodes of acute low blood sugar (hypoglycaemia) while at the gym.
Tests revealed that his liver was inflamed, his kidneys were enlarged and that he had very high blood sugar. He was also dehydrated, and diagnosed with diabetes.
He was given intravenous fluids and gradually increasing amounts of insulin over five days, after which he was discharged. His symptoms completely cleared up, and he was no longer diabetic.
The use of growth hormone has steadily risen among amateur athletes and bodybuilders all round the world, say the authors, because it is easy to buy online and difficult to detect in screening tests—unlike anabolic steroids.
The authors believe that this is the first reported case of diabetes associated with the use of high dose growth hormone, and urge anyone taking high doses to regularly check their blood sugar levels.
Posted by dlife at 02:01 PM | Comments (0)
Magic Beans -- Anti-Obesity Soya Could Help Prevent Diabetes
February 26, 2007 (EurekAlert) - A diet rich in black soya beans could help control weight, lower fat and cholesterol levels, and aid in the prevention of diabetes, reports Lisa Richards in Chemistry & Industry, the magazine of the SCI.
Yellow soya has already been hailed for its cholesterol lowering capabilities; this is one of the reasons why frozen food manufacturer Birds Eye has added the beans to its range. However, a team of Korean researchers has shown that black soya may be even more potent in rats, and also prevents weight gain (Journal of the Science of Food and Agriculture, February 2007 DOI: 10.1002/jsfa2808).
The researchers, led by Shin Joung Rho at Hanyang University, Seoul, allowed 32 rats to gorge on a fatty diet, supplemented with various levels of black soya. The results showed that, after two weeks, those getting 10% of their energy from black soya had gained half as much weight as those in the control group. Total blood cholesterol fell by 25% and LDL (so-called ‘bad’) cholesterol fell by 60% in the rats in the 10% group.
David Bender, sub-dean at the Royal Free and University College Medical School, London, thinks that the soya protein may be having an effect on fat metabolism in the liver and adipose tissue, reducing synthesis of new fatty acids and cholesterol. It is this metabolic effect that may explain the traditional Asian use of black soya in the treatment of diabetes. ‘The key problem in type II diabetes is impairment of insulin action, mainly as a result of excess abdominal adipose tissue - so loss of weight often improves glycaemic control,’ says Dr Bender.
Lynne Garton, a registered dietician and nutritionist and consultant to the Soya Protein Association, said: "Soy fits in well to a healthy balanced diet which is important in preventing diabetes – low in fat, high in fibre and a good source of complex carbohydrates."
Posted by dlife at 01:44 PM | Comments (0)
Diabetes Risk Factors Develop Earlier in Women Than Men
February 20, 2007 (EurekAlert) - The “diabetes clock” may start ticking in women years in advance of a medical diagnosis of the disease, new research has shown.
Epidemiologists at the University at Buffalo have found that newly identified risk factors for diabetes found in the blood, such as markers of endothelial dysfunction, chronic sub-acute inflammation and blood clotting factors, are present early on in women who eventually progress from normal glucose status to the pre-diabetic condition.
Pre-diabetes is diagnosed when blood sugar levels are higher than normal (between 100-125 mg/deciliter of blood), but not high enough to indicate full-blown diabetes (over 125 mg/deciliter of blood). The markers weren’t associated with progression from normal to pre-diabetic status in men.
Results of the study appear in the February 2007 issue of Diabetes Care.
“This is one of the first reports to show that otherwise healthy women are more likely than men to show elevated levels of endothelial factors and other markers of progression to pre-diabetes,” said lead author Richard Donahue, Ph.D., professor of social and preventive medicine and associate dean for research in UB’s School of Public Health and Health Professions.
“Because these pre-diabetic markers are not routinely assessed, and because diabetes is strongly linked with coronary heart disease, the study may help explain why the decline in death rates for heart disease in diabetic women lags behind that of diabetic men,” he said.
“Previous research had shown that hypertension and cholesterol were elevated among women who later developed diabetes. However, current findings that these novel risk factors [markers of endothelial dysfunction, chronic sub-acute inflammation and blood clotting factors] are elevated among women even earlier than previously recognized does suggest that the ‘diabetes clock’ starts ticking sooner for women than for men.” The study involved 1,455 healthy participants originally enrolled in the Western New York Study, a case-control investigation of patterns of alcohol consumption and risk of cardiovascular disease conducted from 1996-2001. In the current study all participants were free of pre-diabetes, type 2 diabetes and known cardiovascular disease. They received a physical examination when they entered the study and again for this six-year follow-up.
Standard measures -- height, weight, waist girth, blood pressure -- were taken, plus blood samples to determine concentrations of fasting glucose and insulin, specific proinflammatory markers, C-reactive protein and markers of dysfunction in the endothelial tissue, the tissue lining blood vessels.
Results showed that 52 women and 39 men had progressed from normal blood glucose levels to pre-diabetic status during the previous six years.
Donahue said the question of what explains the sex difference remains to be determined, and he plans to study this in the future. Meanwhile, he suggested that women whose blood glucose increases over time, even if it doesn’t reach diabetic levels, should be screened more intensively for cardiovascular disease.
Posted by dlife at 09:50 AM | Comments (0)
US Health System Getting Worse, Says Expert
February 16, 2007 (EurekAlert) - The United States is the only major industrialised nation without universal health insurance, writes Karen Davis, President of the Commonwealth Fund. Coverage varies widely between states and has deteriorated in recent years. The number of uninsured people has increased from 40 million in 2000 to nearly 47 million in 2005.
Gaps in coverage lead to inequalities in access to care, poor quality care, lost economic productivity, and avoidable deaths.
The Institute of Medicine estimates that 18,000 lives are lost annually as a consequence of gaps in coverage. It calculates the annual cost of achieving full coverage at $34bn - $69bn, which is less than the loss in economic productivity from existing coverage ($65bn - $130bn annually).
Furthermore, expanding coverage would disproportionately help people on low incomes, who make up two thirds of the uninsured, thus increasing equity in access to health care and health outcomes, says Davis.
Several states have enacted plans to make cover affordable for all uninsured residents, using state programmes to subsidise care for the poor and creating an insurance pool for small businesses and the self employed.
Although these efforts are encouraging, most are taking place in states with relatively small uninsured populations, and there is little prospect that the federal government will legislate to make insurance affordable and mandatory for all.
What is clear is that the problem is getting worse, not diminishing, she warns. The fragmented, uncoordinated healthcare system is plagued by high administrative costs and missed opportunities to control chronic conditions and prevent life threatening conditions.
If the US hopes to achieve a high performance health system that is value for money, it will have to tackle the perplexing problems of access, quality, and cost, and overcome considerable political and economic obstacles, as well as institutional resistance to change, she concludes.
Posted by dlife at 08:50 AM | Comments (0)
Xylitol Reduces Risk of Cavities
February 16, 2007 (EuerkAlert) - The sugar substitute xylitol affects the bacterial composition of the oral cavity even in low doses. On the other hand, a relatively high intake is needed to counteract the production of acid between the teeth, according to Pernilla Lif Holgerson in the dissertation she will defend at Umeå University in Sweden on February 23.
Xylitol is a sugar alcohol that is produced by reduction of the sugar xylose, or wood sugar. Xylitol occurs naturally in fruits and berries, such as pears and strawberries. It is used in sugarless sweets, above all in chewing gum and lozenges. The dissertation studies what effects the substance has on the ecology of the oral cavity and its role in preventing tooth decay (caries). In a series of studies on children and adolescents, samples of saliva and plaque were examined. Among other findings, it was determined that a daily intake of 3.4 grams of xylitol was sufficient to change the consistency of the bacteria, but this did not lead to a lower production of lactic acid in plaque. In another study it was shown that a single higher intake of xylitol for a limited time reduced the degree of acidity in plaque between teeth.
In a field study involving 128 children aged 7–12, the subjects were asked to chew gum three times a day, with a total daily dose of 6.0 grams of xylitol. The amount of plaque and the production of lactic acid declined dramatically during the trial period. After four weeks, the proportion of caries-producing bacteria was down by a third, but six months afterward the values had returned to the original levels. Despite the relatively high dose of xylitol used, no negative effects were reported, such as stomach troubles.
Products with xylitol as the sole sweetener are uncommon on the Swedish market today. In the most common sugarless products, xylitol accounts for roughly a third of the sweetening.
The studies nevertheless warrant the following recommendations:
• A daily intake of xylitol is recommended as a supplement for patients at high risk for tooth decay.
• Xylitol products that actively stimulate the secretion of saliva should be the first choice, such as chewing gum.
• About 6 g of xylitol per day is needed to counteract the production of acid and thereby reduce the risk of cavities.
• The daily intake should be distributed over at least three occasions.
• The products should contain as much xylitol as possible and not be mixed with other sweeteners.
Posted by dlife at 08:44 AM | Comments (0)
Study of Diabetes and Race Reveals the Imperfect Science of Defining Ethnic Groups
Biologists are swayed by social makeup and history
February 14, 2007 (EurekAlert) - While previous biomedical research studies have found that genetics and race increase risk for some diseases, a new look into how researchers study genetic triggers of type 2 diabetes suggests that defining race remains an inexact science, with social and historic facts mixing with biology throughout the research process.
The new study by a UC Irvine anthropologist calls into question not only how race-specific information is being gathered and interpreted by the medical community, but how it is presented to the public through media and pharmaceutical marketing.
Anthropologist Michael Montoya followed the trail of DNA samples from the moment they were donated by people living along the U.S.-Mexican border, to the eventual publication of findings in scientific journals. Examining the work of biomedical researchers across the U.S. and in England who used the data, Montoya found the scientists used social and historical explanations -- not biological differences -- to define race and ethnicity in the research. For example, he quotes scientists who cite differences in skin tone or historic events, such as an island's native population being wiped out, as part of their reasoning for labeling and comparing specific ethnic groups. Genetic studies have sparked international headlines suggesting that Mexicans are predisposed to type 2 diabetes.
"Although it's true that certain ethnic groups have higher rates of diabetes, our social understanding of race is grafted into the scientific research," said Montoya, assistant professor of anthropology and Chicano/Latino studies. "Therefore, research that presumes race is biological may confuse matters instead of improving our understanding of the causes of chronic diseases like diabetes."
The study appears in the February issue of the journal Cultural Anthropology.
"Montoya's detailed ethnographic research on Mexican American diabetes shows us just how problematical it is to link health inequalities in any way to genetic variation rather than structural inequalities," said Alan Goodman, president of the American Anthropological Association and professor at Hampshire College.
Montoya found that some genetic scientists are concerned about how race is politicized in their research. He recounts the story of two genetic researchers in conflict with editors at a major scientific journal who insisted that the title of their article about diabetes and genetics specify that the findings were in "Mexican Americans." Later, when the findings were replicated in white groups, the researchers were allowed to omit the ethnic label from the title. The implication, notes Montoya, is that to ethnically label the scientific discovery promotes the idea that the finding is not about universal human biology, but only about Mexican American biology, which he calls "scientific nonsense."
"Unfortunately, looking for genetic factors that influence diabetes in ethnic groups ignores the social factors like poverty and access to health care that have a much stronger correlation to the rates of diabetes among certain groups. And if we don't understand that those groups are not biological, we will look for biological explanations for their disease rates when we should be looking for social ones."
Posted by dlife at 04:06 PM | Comments (0)
MUHC led Research Identifies Risk Factor Genes for Type 2 Diabetes
February 11, 2007 (MUHC News) - A new study led by researchers at the McGill University Health Centre (MUHC) has identified four genes that increase the risk of developing type 2 diabetes. This form of diabetes is the most common worldwide and affects nearly 2 million Canadians. In recent years, the prevalence of Type 2 diabetes has increased rapidly. This genetic discovery may help stem this rise.
This genetic study, published today in the journal Nature, was led by MUHC endocrinologist Dr. Rob Sladek at the McGill University and Genome Quebec Innovation Centre together with Dr. Constantin Polychronakos at the MUHC and Dr. Philippe Froguel at the Pasteur Institute (Lille, France). The study also involved scientists at the University of Montreal, Imperial College (London, UK) and the Montreal Diabetes Research Centre.
Sladek and his colleagues systematically searched the entire human genome to identify genes that predispose individuals to developing diabetes. By comparing hundreds of thousands of DNA fragments from patients with diabetes to those from non-diabetic individuals, they discovered that patients who developed diabetes shared common gene variants on chromosomes 8, 10 and 11.
“Of the four genes we have identified, two are involved in the development or function of insulin-secreting cells and one plays a role in the transport of zinc, an important mineral required for the production of insulin,” says Sladek.
“We used a totally new concept and technology to look for the genes,” says Polychronakos. “It worked very successfully and our findings are proof of principle that these approaches can be used to dissect the genetic component of other complex diseases and, eventually, other complex human traits.”
Type 2 diabetes is the most common form of diabetes in adults and is becoming increasingly common in children. It is caused by the decreased production or effect of insulin, a hormone that is secreted by the pancreas and which regulates the amount of glucose in the blood. It has been known for some time that for Type 2 diabetes is caused by a combination of genetic and lifestyle factors. The group’s new finding helps identify the population at the highest risk of developing this disease.
The research was funded by a grant from Genome Canada and Genome Quebec headed by Dr. Barry I. Posner, professor of Medicine at McGill University and the MUHC; and by a grant from the Canadian Foundation for Innovation to the Montreal Diabetes Research Centre, headed by Dr. Marc Prentki, professor of Medicine at the University of Montreal.
"In the last few years, advances in technology pioneered in Quebec, have made complex genetic analyses, such as those used in this study, possible," stated Genome Quebec President Paul L’Archevêque. "Without these advances an the collaboration between institutes, this research would not have been possible. The experimental approach used in this study, may help lead to the unraveling of other complex genetic diseases."
The Research Institute of the McGill University Health Centre (RI MUHC) is a world-renowned biomedical and health-care hospital research centre. Located in Montreal, Quebec, the institute is the research arm of the MUHC, a university health center affiliated with the Faculty of Medicine at McGill University. The institute supports over 500 researchers, nearly 1000 graduate and post-doctoral students and operates more than 300 laboratories devoted to a broad spectrum of fundamental and clinical research. The Research Institute operates at the forefront of knowledge, innovation and technology and is inextricably linked to the clinical programs of the MUHC, ensuring that patients benefit directly from the latest research-based knowledge. For further details visit: www.muhc.ca/research.
Posted by dlife at 11:45 AM | Comments (0)
Interfering with Vagal Nerve Activity in Mice Prevents Diabetes and Hypertension
February 6, 2007 (EurekAlert) - Interrupting nerve signals to the liver can prevent diabetes and hypertension in mice, according to scientists at Washington University School of Medicine in St. Louis. The finding is reported in the February issue of the journal Cell Metabolism.
The research team surgically removed the vagus nerve in mice and found the procedure prevented or reversed the development of insulin resistance and high blood pressure in mice primed to develop these disorders through treatment with glucocorticoids.
"So at least in mice, we've shown we can prevent the development of diabetes and hypertension by interrupting vagal nerve signaling," says senior investigator Clay F. Semenkovich, M.D., professor of medicine and of cell biology and physiology. "We don't know whether the same will hold true for humans, but we think somehow altering vagal nerve activity could provide a novel approach for treating these common metabolic disorders."
Previously, the research team had shown that a nuclear receptor called PPAR-alpha (Ppara) was necessary for the induction of both diabetes and hypertension when mice were treated with glucocorticoids, also known as steroids.
"Mice that can't make Ppara don't develop diabetes or hypertension in response to glucocorticoids," says Semenkovich, who also is chief of the Division of Endocrinology, Metabolism and Lipid Research. "The use of steroids is very common in medicine. People with asthma, arthritis, organ transplants and others rely on those steroid drugs, and many of them go on to develop insulin resistance that can advance to diabetes and hypertension."
But in these most recent experiments, the researchers showed that both Ppara and the vagus nerve seem to play important roles in the development of these disorders.
"If the vagus nerve has been surgically removed, the mice won't develop diabetes or hypertension in response to glucocorticoids, even if they have Ppara," says first author Carlos Bernal-Mizrachi, M.D., an assistant professor of medicine in the Division of Endocrinology, Metabolism and Lipid Research. "The process seems to be mediated by communication between the liver cells, the liver branch of the vagus nerve and its signals to the brain."
Actually, the vagus nerve communicates with just about everything. Its name is taken from the Latin word meaning "wanderer." Early neuroanatomists chose the name because it seemed whenever they looked at an organ in the body, they also found fibers from the vagus. It extends from the base of the brain, through the chest where it innervates part of the heart. It also sends nerve signals to other internal organs, including the liver, and eventually connects to the intestine. In these studies, however, the researchers were interested mainly in the connection between the vagus nerve coming from the liver and its communication with the brain.
When mice are treated with glucocorticoids, Ppara in the liver communicates with the vagus nerve, which signals the brain. Then the brain uses the vagal pathway to feed back instructions to the liver and kidneys. The brain instructs the liver to increase glucose production and the kidney to alter fluid metabolism, elevating blood pressure.
The same sort of process can occur in people who are obese. Semenkovich says a modest elevation of glucocorticoids is associated with obesity. Those elevated levels can initiate Ppara activity in the liver, which then will communicate with the vagus nerve to signal the brain and, in turn the brain will signal the liver and kidneys, contributing to diabetes and hypertension.
"We think obesity is probably initiating a similar process to the one we've interrupted in the mice," says Semenkovich. "An environmental influence — such as treatment with glucocorticoids or excess caloric intake that causes obesity — engenders a signal started by Ppara, which then is transmitted from the liver, along the vagus nerve."
That cascade of communication along the vagal nerve pathway has made the investigators think that they may be able to help people with diabetes and hypertension by interrupting normal vagal signaling. And there may be a ready-made population to study because many people already have surgically implanted devices that alter the signaling of the vagus nerve.
Some people with seizure disorders and treatment-resistant depression already have implanted electrodes that stimulate the vagus nerve to help alleviate their symptoms. Semenkovich believes the new mouse study suggests a similar approach might help people with insulin resistance or hypertension. They plan to follow patients who already have stimulators to see if signals from the stimulators affect susceptibility to diabetes, insulin resistance or hypertension.
"We used surgery to interrupt all signaling from the vagal nerve pathway," Bernal-Mizrachi says. "But it might actually be possible to change very specific signaling patterns to provide benefit to people who are at risk for hypertension or diabetes."
Some available drugs might be able to attack the problem in other ways. A class of medications called fibrate drugs can modulate the activity of Ppara. Those drugs are used to lower triglycerides and to elevate levels of HDL (good) cholesterol. Some studies have indicated the drugs provide a modest benefit, but other studies have suggested that such drugs might be harmful. So for now, the researchers are focusing more on the potential of the vagus nerve.
"I would argue that you can clearly produce a major impact by stimulating this nerve because it carries signals to so many organs," Semenkovich says. "We know the vagal pathway can influence seizures, depression and other disorders. This study suggests it affects diabetes and hypertension, too."
Posted by dlife at 01:58 PM | Comments (0)
People with Diabetes Fail to Get Enough Physical Activity
February 6, 2007 (ADA) - According to a study by researchers at the University of Colorado at Denver and Health Sciences Center, just 39 percent of adults with diabetes are physically active, compared to 58 percent of adults who don’t have diabetes. As the number of risk factors for type 2 diabetes (such as obesity and hypertension) increase, the amount of physical activity decreases, the study found.
The results reinforce the need for Americans to become more physically active in general, but also suggest a need to better tailor exercise programs for people who may have physical limitations as a result of their disease, said lead researcher Dr. Elaine Morrato.
“Everyone can benefit from regular, daily physical activity,” she said. “But people who have diabetes, or who are at greatest risk for it, have even greater incentive to get out there and exercise. We know for a fact that increased physical activity can greatly reduce the risk for type 2 diabetes and its numerous complications. We need to do a better job reaching, motivating and helping these people to stay active.”
The study looked at activity levels for adults with both type 1 and type 2 diabetes. While increased physical activity can’t prevent type 1 diabetes (the least common form of diabetes), it can help to prevent complications in both type 1 and type 2 diabetes. Numerous studies have shown that regular physical activity does help to prevent type 2 diabetes, the most common form of this disease.
Studies show that exercising for 30 minutes a day, at least five days per week, along with moderate weight loss, can reduce the risk of developing type 2 diabetes by nearly 60 percent. Dr. Morrato said people who have diabetes may have a harder time exercising because of complications from the disease, such as painful peripheral neuropathy. The challenge is to encourage people to work exercise into their routine before diabetes and its complications develop, or to find ways to help them stay active if complications have already set in.
To reach Dr. Morrato, email: Elaine.Morrato@uchsc.edu or phone: 303-724-1535.
Posted by dlife at 12:00 PM | Comments (2)
Managing Glucose in the Hospital: The Need for Consistency
February 6, 2007 (ADA) - Studies show that when people with diabetes are admitted into the hospital for serious illnesses, they are more likely to survive if their glucose levels are kept under tight control.
But maintaining proper glucose targets isn’t that simple, according to a paper by the research team led by Dr. Kathleen Dungan at the University of North Carolina at Chapel Hill. Numerous variables can make it difficult to determine if the patient is actually meeting optimal glucose targets. For example, where blood is taken from and the instrument used to measure glucose levels can produce substantially different results. Medications can also obscure proper blood glucose readings, along with the patient’s physiology.
“Nowhere else is there greater potential for multiple confounding factors to be present at once than in the hospital setting,” wrote the authors, in the paper’s conclusions. Because of this, the researchers advise that glucose targets be individualized for each health care setting, taking into account how measurements will be taken and the needs of specific patient populations.
Posted by dlife at 11:38 AM | Comments (3)
In India, Diabetes Takes One-Third of Family Income from Poor
February 6, 2007 (ADA) - The economic burden of diabetes in developing countries has risen substantially over the past decade, as the prevalence of this potentially fatal and often debilitating disease has also grown worldwide.
In India, which lacks a comprehensive health care system, the direct cost of diabetes has doubled since 1998, as it has in the United States. However, the economic burden upon low-incomes families is much higher in developing countries such as India, where reimbursement for care is low to nonexistent.
In India, poor urban families spend as much as 34 percent of their total income treating diabetes and its complications; the rural poor don’t fare much better, spending up to 27 percent of their income on health-related costs due to diabetes.
Not surprisingly, the economic burden for families grew along with the duration of their diabetes and the number of complications they developed.
To reach lead researcher Dr. Ambady Ramachandran, Ph.D., MD, Director, Diabetes Research Center, M.V. Hospital for Diabetes & WHO Collaborating Centre for Research, Education & Training in Diabetes, email: ramachandran@vsnl.com.
Posted by dlife at 11:35 AM | Comments (0)
18 Million Men in the United States Affected by Erectile Dysfunction
February 5, 2007 (Newswise) — More than 18 million men in the United States over age 20 are affected by erectile dysfunction, according to a study by researchers from the Johns Hopkins Bloomberg School of Public Health. The prevalence of erectile dysfunction was strongly linked with age, cardiovascular disease, diabetes and a lack of physical activity. The findings also indicate that lifestyle changes, such as increased physical activity and measures to prevent cardiovascular disease and diabetes, may also prevent decreased erectile function. The study is published in the February 1, 2007, issue of the American Journal of Medicine.
“Physicians should be aggressive in screening and managing middle-aged and older patients for erectile dysfunction, especially among patients with diabetes or hypertension,” said Elizabeth Selvin, PhD, MPH, lead author of the study and a faculty member in the Bloomberg School of Public Health’s Department of Epidemiology. “The associations of erectile dysfunction with diabetes and cardiovascular risk factors may serve as powerful motivators for men who need to make changes in their diet and lifestyle.”
For the study, the research team analyzed data from 2,126 men who participated in the National Health and Nutrition Examination Survey (NHANES). Men who reported being “sometimes able” or “never able” to get and keep an erection were categorized as having erectile dysfunction, while men who reported being “always or almost always able” or “usually able” were not.
The overall prevalence of erectile dysfunction among men in the United States was 18 percent. Men aged 70 and older were much more likely to report having erectile dysfunction compared to only 5 percent in men between the ages of 20 and 40. Nearly half of all men in the study with diabetes also had erectile dysfunction. And, almost 90 percent of all men with erectile dysfunction had at least one risk factor for cardiovascular disease, including diabetes, hypertension, having poor cholesterol levels or being a current smoker. Men with erectile dysfunction were also less likely to have engaged in vigorous physical activity within the month prior to participation in the study.
“Prevalence and Risk Factors for Erectile Dysfunction in the U.S.” was written by Elizabeth Selvin, PhD, MPH, Arthur L. Burnett, MD, and Elizabeth A. Platz, ScD, MPH. Selvin and Platz are with the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. Platz and Burnett are with the James Buchanan Brady Urological Institute at Johns Hopkins Hospital.
The researchers were supported by grants from the National Institutes of Health’s National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK.)
Posted by dlife at 09:48 AM | Comments (0)
Sedentary Teens More Likely to Have Higher Blood Pressure
February 5, 2007 (Newswise) — Teenagers who spend a lot of time planted in front of the TV are more likely to have higher blood pressure, regardless of whether they are overweight. “This is the first research to show a direct and independent connection between TV watching and higher blood pressure among adolescents,” said study leader Nicolas Stettler, M.D., M.S.C.E., a pediatric nutrition specialist at The Children’s Hospital of Philadelphia.
The team reported on their study of 4,500 American adolescents in the February issue of the Journal of Adolescent Health. They found that sedentary activities and higher body mass index (BMI) were associated with higher systolic blood pressure. Systolic blood pressure is the pressure found when the heart pumps, in contrast to diastolic blood pressure, the pressure between heart beats.
“It was already known that physical activity lowers blood pressure in both adults and children, but sedentary activity is not just the opposite of physical activity,” said Dr. Stettler. “For example, other studies have found that decreasing sedentary activity in young people helps prevent or treat obesity better than interventions to increase physical activity.”
If further studies confirm these results, encouraging adolescents to reduce their sedentary activity may improve their blood pressure and lower their later risk of cardiovascular disease and stroke.
The researchers studied nationally representative data from 4,500 U.S. adolescents, aged 12 to 19, who participated in the 1999-2002 National Health and Nutrition Examination Survey. Interviewers assessed the adolescents’ nutritional intake and activities. Measurements of blood pressure and BMI were adjusted for gender and age.
Within the 12- to 15-year-old age group, the study team found higher blood pressure to be especially associated with higher levels of watching television and video. “Although the association between sedentary activity and systolic blood pressure was rather small, most adolescents spend several hours per day in sedentary activities,” said Yasuki Kobayashi, M.D., Ph.D., of the University of Tokyo Department of Public Health, a co-author on this study. “Interventions to decrease sedentary activities may have an important public health impact.”
“Elevated blood pressure is one of the most important risk factors for cardiovascular diseases and stroke,” said Mr. Takehiro Sugiyama, a medical student at the University of Tokyo and first author on this study. “High blood pressure in adolescents is predictive of hypertension in adulthood, and in addition, adolescent obesity is a predictor or obesity and cardiovascular risk factors in young adulthood and beyond.”
The researchers also found that higher BMI is associated with lower diastolic blood pressure, contrary to associations found previously in studies of adults. The implications of this finding are unclear, but shows that adolescents are not just “small adults” and may have determinants of blood pressure that are different from adults said the authors.
Dr. Stettler’s co-authors were Takehiro Sugiyama, of the University of Tokyo, Japan; Dawei Xie, of the University of Pennsylvania; Rose C. Graham-Maar, M.D., M.S.C.E. now of St. Christopher’s Hospital for Children; and Kazuo Inoue, M.D., Ph.D., and Yasuki Kobayashi, M.D., Ph.D., Department of Public Health, University of Tokyo.
Posted by dlife at 09:44 AM | Comments (0)