Transporters May Help Delay Diabetes-Related Retinal Damage

November 28, 2007 (EurekAlert) - Two transporters that deliver alternative energy sources to the eye may help delay retinal damage that can occur in diabetes, researchers say.

The transporters, SMCT1 and SMCT2, can circumvent the eye’s protective blood-retinal barrier, delivering energy sources lactate and ketone bodies to a healthy eye, says Dr. Pamela Martin, biochemist at the Medical College of Georgia.

In diabetes, characterized by plenty of glucose but the inability of cells to use it, the retina may turn to those alternate sources for survival.

“Glucose is your primary energy source,” says Dr. Martin. “But in diabetes, the retina undergoes a lot of stress, there is oxidative damage and a lot of other things going on. These transporters, we believe, may be instrumental in bringing in additional substrates which the cells can use for energy to try and prevent death.”

Diabetic retinopathy, the leading cause of blindness in working-age adults, results in death of retinal neurons, at least in part because glucose availability is compromised for this high-energy-consuming tissue, says Dr. Martin.

She suspects the two transporters work harder in diabetes to increase levels of lactate and ketones bodies, which may help explain why diabetes’ impact on the eye may go undiagnosed for years. “I think what fascinates me so much about the eye is you can have diabetes for more than 20 years before you or your doctor realize that you have diabetic retinopathy,” says Dr. Martin.

Understanding how these transporters work normally and in diabetes may enable early diagnosis of diabetic retinopathy and natural delivery mechanisms for drugs to stop it.

Dr. Martin was a postdoctoral fellow in the lab of Dr. Vadivel Ganapathy, chair of the MCG Department of Biochemistry and Molecular Biology who first cloned the SMCT1 and SMCT2 transporters, before she joined the faculty in 2005. She was first author on a paper published this year in Investigative Ophthalmology and Visual Science that showed the presence of the transporters in the retina.

Now she is one of four investigators nationally to receive a Pathway to Independence Award for new investigators from the National Eye Institute that will help her elucidate these transporters’ activity in healthy and diseased states.

Lactate and ketone bodies are substances called monocarboxylates and previously there was no evidence that transporters that typically haul these substances around are elevated in diabetes. But these monocarboxylate transporters, or MCTs, are more passive than the recently discovered, sodium-coupled SMCT1 and SMCT2 which are “driven,” able to go against the concentration gradient and change substrates, like lactate, from low to high concentrations inside the cells, says Dr. Martin.

“If you have these transporters, they can transport these substrates into your retina and hopefully prevent some of the neuronal cell damage that occurs,” Dr. Martin says.

An aggressive vehicle is necessary since, like the brain, the retina has a natural barrier to prevent many substances in the blood from reaching the eye.

The MCG researcher has shown SMCT1 is expressed in retinal neurons and in the retinal pigmented epithelium, one of the back layers of the multi-layer retina that is important in terms of transporting good things in and waste products out. SMCT2 is primarily expressed in supportive retinal Müller cells.

One of the many questions she wants to answer is whether they play different roles in these different cell types.

She’s using two diabetic mouse models, one that develops type 1 diabetes at about three weeks, which is comparable to children developing the disease in their first few years of life. The second is a mouse she makes diabetic, so she will know the precise moment it happens.

She’ll look at the expression, activity and function of these transporters in both models and is optimistic she’ll find them helpful to diabetics.

“The damage still occurs, people still go blind from diabetic retinopathy, but it may delay it,” says Dr. Martin. “But what if we could find some pharmacologic agents they could transport into the eye and save it."

Dr. Ganapathy, who is Dr. Martin’s mentor for the NIH grant, also is working on SMCT1 and its role in the colon where his experimental evidence indicates it has a tumor-suppressive role. In the colon, SMCT1 transports short-chain fatty acids such as butyrate, which is generated by bacterial fermentation of dietary fiber. The transporter is silenced in colon cancer but when colon cancer cells are forced to express it, they die in the presence of butyrate.

“The normal bacteria present in our colon are doing a lot of good things to benefit us,” Dr. Ganapathy says. “These findings may explain the age-old knowledge that dietary intake of fiber is protective against colon cancer.”

Posted by dlifenews at 11:12 AM | Comments (0)

UC Davis Researchers Discover Novel Pathway to Increased Inflammation in Diabetes Patients

November 27, 2007 (EurekAlert) - Researchers at UC Davis Health System have discovered a novel pathway that results in increased inflammation of blood vessels in patients with type 1 diabetes. Their findings suggest that, with good diabetes control, this inflammation may be reduced, possibly resulting in a reduction of cardiovascular disease as well.

In a study now available both in the online edition of the Journal of Clinical Endocrinology & Metabolism as well on the National Institutes of Health’s PubMed, the researchers provide the first-ever demonstration of increased expression and signaling in type 1 diabetics of two key receptors within the body’s innate immune system. Called TLR2 and TLR4, they are part of a family of pattern recognition receptors known as Toll-like receptors (TLRs), so-called because of their similarities to the well-defined Toll gene found in much-studied fruit flies.

Type 1 diabetes is a pro-inflammatory state associated with increased cardiovascular mortality.

Inflammation plays a pivotal role in all stages of atherosclerosis, the progressive narrowing and hardening of the arteries over time. The UC Davis study found that TLR2 and TLR4 expression and signaling are increased in type 1 diabetes patients and contribute to the pro-inflammatory state.

“It is not unreasonable to speculate that TLR2 and TLR4 promote atherogenesis by contributing to the pro-inflammatory state in type 1 diabetes,” said lead author Ishwarlal Jialal, director of the Laboratory for Atherosclerosis and Metabolic Research and professor of internal medicine at UC Davis. “Inflammation is central to heart disease, playing a pivotal role in plaque formation and stroke. We may well find that a serendipitous byproduct of controlling diabetes is the simultaneous control of this new pathway, leading to less inflammation and lower risk of heart problems.”

The study represents the first-ever demonstration of increased TLR2 and TLR4 activity in type 1 diabetes monocytes, which are part of the body’s immune system, protecting against blood-borne pathogens by moving quickly to sites of infection. The immune system comprises the cells and mechanisms that defend the host from infection by other organisms, accomplishing its defense with the help of such pattern-recognition receptors as TLRs for early detection of specific classes of pathogens.

“This finding provides us with a totally new insight into the causes of inflammation in diabetics,” adds Jialal, who holds the Robert E. Stowell Endowed Chair in Experimental Pathology at UC Davis. “It’s an exciting development in the emerging area of TLR research that has potentially wide-ranging implications.”

Further studies will use mice to examine the molecular mechanisms for increased TLR2 and TLR4 expression and determine their contribution to the pro-inflammatory state of diabetes.

Posted by dlifenews at 10:40 AM | Comments (0)

Binge Drinking by Adolescents and Young Adults has Long-term Health Consequences

November 27, 2007 (Newswise) — New research into lifelong alcohol consumption reveals that heavy binge drinking by adolescents and young adults is associated with increased long-term risk for heart disease, high blood pressure, type 2 diabetes, and other metabolic disorders. The risk is lower in people who start drinking alcohol later in life and maintain more moderate drinking patterns.

The study, accepted for publication in the Journal of Clinical Endocrinology & Metabolism (JCEM), also indicates that the increased health risks were independent of the total amount of alcohol consumed over a lifetime, or whether or not people stopped or curtailed drinking as they matured.

"To fully understand the effect of alcohol consumption on health, you need to consider lifetime drinking patterns," said Dr. Marcia Russell of the Pacific Institute for Research and Evaluation's Prevention Research Center in Berkeley, Calif., and senior author of the study. "Early initiation of alcohol drinking and heavy drinking in adolescence and early adulthood seem to be associated with a number of adverse health effects collectively known as the metabolic syndrome.”

The term metabolic syndrome describes a cluster of metabolic risk factors that increase the chances of developing heart disease, stroke, and type 2 diabetes. The exact cause of the metabolic syndrome is not known, but genetic factors, too much body fat (especially in the waist area), and lack of exercise increase the risk of developing the condition.

Russell and her colleagues based their research on data from the Western New York Health Study (WNYHS), conducted between 1996 and 2001. This study retrospectively collected lifestyle information on more than 2,800 people who reported that they were regular drinkers at one point in their lives. The study also collected data on the prevalence of the metabolic syndrome and its individual components, including obesity, high triglycerides, low HDL cholesterol, elevated blood pressure, and high fasting glucose.

The WNYHS study revealed two distinct lifetime drinking trajectories among people who were ever regular drinkers. Drinking trajectory refers to the variability in drinking behavior over the span of a person's lifetime.

Early peak lifetime trajectories were characterized by early and heavy drinking followed by a sharp reduction in alcohol intake. Stable trajectories were characterized by more moderate intakes over a longer period of life. Lifetime drinking patterns included total years of drinking, first and last age of regular drinking, total volume of alcohol consumed, and many other factors. Early peak drinkers were, on average, 10 years younger than stable drinkers. Despite this age difference, the early peak drinkers still had a modestly higher risk of developing metabolic syndrome.

“Drinking patterns associated with early peak and stable drinking trajectories were distinctly different,” said Russell. “Early peak drinkers generally began drinking earlier than stable drinkers. They drank fewer years, less frequently, and consumed less volume of alcohol over their lifetimes, but averaged more drinks per drinking day and had higher rates of episodic heavy drinking and intoxication.”

The researchers speculate that the reason for the increased risk for metabolic syndrome found in the study may be associated with the adverse health effects of early unhealthy drinking patterns, which were carried over to later life. Also, early peak drinkers may have adopted other lifestyle habits detrimental to cardio-metabolic health.

The lead author of the study is Dr. Amy Fan, also of the Prevention Research Center. Other study authors include Dr. Saverio Stranges of the University at Buffalo, N.Y., and the University of Warwick, U.K.; and Drs. Joan Dorn and Maurizio Trevisan of the University of Buffalo.

Russell also was lead developer of the Cognitive Lifetime Drinking History, a computer-assisted personal interview designed to assess drinking patterns retrospectively over the lifetime in studies of chronic conditions related to alcohol use.

The paper “Association of Lifetime Alcohol Drinking Trajectories with Cardiometabolic Risk” will be published in the January 2008 issue of JCEM, a publication of The Endocrine Society.

For more information on the metabolic syndrome, visit: http://www.hormone.org/pdf/bilingual/bilingual_met_syndrome.pdf

Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of more than 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied and clinical interests in endocrinology.

Posted by dlifenews at 12:00 PM | Comments (0)

Treating Depression Prolongs Life for Older People with Diabetes

November 27, 2007 (Newswise) — Depressed, older adults with diabetes live longer when they are treated for depression, according to a study in the December issue of Diabetes Care, which publishes on November 27, 2007.

Also being published this month is an editorial by U.S. Food and Drug Administration (FDA) Medical Officer Dr. Robert Misbin, highlighting lessons learned from the recent Avandia controversy and suggesting a re-evaluation of the approval process for diabetes drugs.

The depression study, which followed primary care patients in the New York City, Philadelphia and Pittsburgh areas for five years, also showed that treating depression reduced mortality more for those who had diabetes than for those who did not.

“Depression is not only common in persons with diabetes but contributes to not taking medicines, not following prescribed diets, and overall reduced quality of life,” said lead researcher Dr. Hillary R. Bogner, Assistant Professor at the Department of Family Practice and Community Medicine at the University of Pennsylvania.

Depression and diabetes are two of the most commonly treated health problems treated in primary care settings. Previous studies have drawn a link between diabetes and depression, and between the combination of the two an increased risk of premature death. This is the first known study to examine the relationship between diabetes and mortality in a depression intervention trial.

The results led researchers to conclude that better models of care should be developed that integrate depression management into the treatment of people with diabetes.

Depressed people with diabetes who received more resources for depression treatment were half as likely to die over a 5-year period compared to depressed people with diabetes who did not receive more resources for depression treatment.

Lessons from the Avandia Controversy

“The time has come to reassess what should be expected of a new drug to treat diabetes,” concludes an editorial written by Dr. Robert Misbin, a Medical Officer for the U.S. Food and Drug Administration (FDA).

The editorial suggests that the FDA “reevaluate criteria for approval of drugs to treat type 2 diabetes,” in light of the recent controversy surrounding the diabetes drug rosiglitazone (Avandia).

Rosiglitazone, approved by the FDA in 1999, came under fire earlier this year when a meta-analysis in the New England Journal of Medicine reported that it may increase the risk of heart attacks. An FDA advisory committee concluded that the evidence against the drug’s safety was insufficient to have it withdrawn from the market. But the episode “undermined the confidence that patients have in the drugs they take and in the physicians who prescribe those drugs,” Misbin wrote. “It cast further doubt on FDA’s ability to protect patients from harm.”

Misbin concluded that it “is no longer enough” to show that a new drug is more effective than placebo in lowering glucose levels. “New drugs should be tested in comparison to other antidiabetic agents that are already in use,” he wrote. “A plan should be in place at the time of approval that will determine what benefits and harm can be expected from chronic use.”

Diabetes Care, published by the American Diabetes Association, is the leading peer-reviewed journal of clinical research into the nation’s fifth leading cause of death by disease. Diabetes also is a leading cause of heart disease and stroke, as well as the leading cause of adult blindness, kidney failure, and non-traumatic amputations. For more information about diabetes, visit the American Diabetes Association Web site http://www.diabetes.org or call 1-800-DIABETES (1-800-342-2383).

Posted by dlifenews at 11:56 AM | Comments (0)

High-Glycemic Index Carbohydrates Associated with Risk for Developing Type 2 Diabetes in Women

November 27, 2007 (Eurekalert) – Eating foods high on the glycemic index, which measures the effect of carbohydrates on blood glucose levels, may be associated with the risk for developing type 2 diabetes in Chinese women and in African-American women, according to two studies in the November 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. However, eating more cereal fiber may be associated with a reduced risk for type 2 diabetes in African-American women.

Researchers remain uncertain regarding exactly how diet, including carbohydrate intake, affects the development of type 2 diabetes, according to background information in the articles. Studies have revealed that the body absorbs carbohydrates from different foods at different rates. This leads to varying effects on levels of blood glucose and the hormone insulin, which converts glucose into energy. Foods high on the glycemic index, such as rice and other simple carbohydrates, cause a rapid spike and then a drop in blood glucose, whereas high-fiber foods tend to be lower on the glycemic index and have a more gradual effect. Some evidence has linked high–glycemic index foods with the risk of developing type 2 diabetes.

In one study, Supriya Krishnan, D.Sc., of Boston University School of Public Health, and colleagues examined data from 40,078 U.S. black women who filled out a food questionnaire in 1995. The glycemic index and glycemic load—a measure of the amount of carbohydrates from glucose—were calculated. Every two years through 2003, the women answered follow-up questionnaires about their weight, health and other factors.

During eight years of follow-up, 1,938 participants developed type 2 diabetes. Women who ate high–glycemic index foods or a diet with a high glycemic load had a higher risk for diabetes. However, women who ate more fiber from grains (cereal fiber) had a reduced risk; for women with a body mass index (BMI) of less than 25, women who ate about 1.5 grams of fiber per day were 59 percent less likely to develop diabetes than women who ate about 8.3 grams per day.

Because high–glycemic index foods increase blood glucose levels significantly, they increase the body’s demand for insulin, the authors note. This can contribute to problems with the pancreas (which produces insulin) that may eventually lead to diabetes. In addition, high–glycemic index foods can directly decrease the body’s response to insulin by increasing the production of fatty acids after meals.

“Our results indicate that black women can reduce their risk of diabetes by eating a diet that is high in cereal fiber,” the authors write. “Incorporating fiber sources into the diet is relatively easy: a simple change from white bread (two slices provides 1.2 grams of fiber) to whole wheat bread (two slices provides 3.8 grams of fiber) or substituting a cup of raisin bran (5 to 8 grams of fiber) or oatmeal (4 grams of fiber) for a cup of corn chex (0.5 grams of fiber) or rice chex (0.3 grams of fiber) will move a person from a low fiber intake category to a moderate intake category, with a corresponding 10 percent reduction in risk.”

In another study, Raquel Villegas, Ph.D., of Vanderbilt University Medical Center, Nashville, Tenn., and colleagues followed a group of 64,227 Chinese women for an average of five years. During in-person interviews conducted every two years between 2000 and 2004, the researchers collected data on dietary habits, physical activity and other health-related information.

During the study, 1,608 of the women developed diabetes. Women who consumed more carbohydrates overall were more likely to develop diabetes—when they were split into five groups based on carbohydrate intake, those in the group consuming the most (about 337.6 grams per day) had a 28 percent higher risk than those in the group consuming the least (about 263.5 grams per day). Women who ate diets with a higher glycemic index and who ate more staples such as bread, noodles and rice specifically also had an increased risk. Women who ate 300 grams or more of rice per day were 78 percent more likely to develop diabetes than those who ate less than 200 grams per day.

“Given that a large part of the world’s population consumes rice and carbohydrates as the mainstay of their diets, these prospective data linking intake of refined carbohydrates to increased risk of type 2 diabetes mellitus may have substantial implications for public health,” the authors conclude.

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

Insulin Regulates the Secretion of the Antiaging Hormome Klotho

November 27, 2007 (EurekAlert) - Dr. Carmela Abraham, a professor of biochemistry and medicine at Boston University School of Medicine (BUSM), reports this week in the Proceedings of the National Academy of Sciences new findings on Klotho, an anti-aging gene that is associated with life span extension in rodents and humans. Dr. Abraham’s interest in Klotho stems from her studies comparing the expression of genes in young and old brains.

Dr. Abraham and her colleagues observed that the levels of Klotho in the brain showed a striking decrease with aging. The association between Klotho and aging prompted Abraham’s group to investigate the regulation of Klotho further. These studies lead to the observation that secretion of Klotho is regulated by insulin.

The Klotho protein sits in the membrane of certain cells but is also found circulating in serum and cerebrospinal fluid, which indicates that it is secreted. The fact that Klotho is secreted suggested that enzymes that act like scissors must be involved in the liberation of Klotho from the cell membrane.
Dr. Ci-Di Chen, an assistant professor working in Dr. Abraham’s group, then sought to identify the enzymes responsible for Klotho release and also investigated other factors that may affect the release of active Klotho.

To their surprise, they found that insulin, a hormone usually associated with diabetes, increases significantly the levels of secreted Klotho. The reason this finding is important is because excess insulin has been previously implicated in a biochemical pathway that is associated with a decreased life span and elevated oxidative stress.

In addition, this observation provides a potentially pivotal link between Klotho and sugar metabolism, and raises an intriguing relationship between Klotho and type II diabetes, commonly known as late onset diabetes. The authors are proposing a novel mechanism of action for Klotho whereby insulin increases Klotho secretion, i.e., activity, and in turn, the secreted Klotho inhibits insulin’s actions in the cell, which are known to be detrimental when insulin is in excess.

Sonia Podvin, Earl Gillespie and Dr. Susan Leeman, all from Boston University School of Medicine, also participated in the study.

Following these findings, the Abraham laboratory is now studying various ways to increase the level of Klotho to those levels found in young individuals. “The findings reported here may lead to new research designed to regulate the aging process, in other words, compounds that would increase Klotho could become the next “fountain of youth,” said Abraham.

Posted by dlifenews at 10:44 AM | Comments (0)

UW-Madison Scientists Guide Human Skin Cells to Embryonic State

November 26, 2007 (Eurekalert) - In a paper to be published Nov. 22 in the online edition of the journal Science, a team of University of Wisconsin-Madison researchers reports the genetic reprogramming of human skin cells to create cells indistinguishable from embryonic stem cells.

The finding is not only a critical scientific accomplishment, but potentially remakes the tumultuous political and ethical landscape of stem cell biology as human embryos may no longer be needed to obtain the blank slate stem cells capable of becoming any of the 220 types of cells in the human body. Perfected, the new technique would bring stem cells within easy reach of many more scientists as they could be easily made in labs of moderate sophistication, and without the ethical and legal constraints that now hamper their use by scientists.

The new study was conducted in the laboratory of UW-Madison biologist James Thomson, the scientist who first coaxed stem cells from human embryos in 1998. It was led by Junying Yu of the Genome Center of Wisconsin and the Wisconsin National Primate Research Center.

"The induced cells do all the things embryonic stem cells do," explains Thomson, a professor of anatomy in the University of Wisconsin School of Medicine and Public Health. "It's going to completely change the field."

In addition to exorcising the ethical and political dimensions of the stem cell debate, the advantage of using reprogrammed skin cells is that any cells developed for therapeutic purposes can be customized to the patient.

"They are probably more clinically relevant than embryonic stem cells," Thomson explains. "Immune rejection should not be a problem using these cells."

An important caveat, Thomson notes, is that more study of the newly-made cells is required to ensure that the "cells do not differ from embryonic stem cells in a clinically significant or unexpected way, so it is hardly time to discontinue embryonic stem cell research."

The successful isolation and culturing of human embryonic stem cells in 1998 sparked a huge amount of scientific and public interest, as stem cells are capable of becoming any of the cells or tissues that make up the human body.

The potential for transplant medicine was immediately recognized, as was their promise as a window to the earliest stages of human development, and for novel drug discovery schemes. The capacity to generate cells that could be used to treat diseases such as Parkinson's, diabetes and spinal cord injuries, among others, garnered much interest by patients and patient advocacy groups.

But embryonic stem cells also sparked significant controversy as embryos were destroyed in the process of obtaining them, and they became a potent national political issue beginning with the 2000 presidential campaign. Since 2001, a national policy has permitted only limited use of some embryonic stem cell lines by scientists receiving public funding.

In the new study, to induce the skin cells to what scientists call a pluripotent state, a condition that is essentially the same as that of embryonic stem cells, Yu, Thomson and their colleagues introduced a set of four genes into human fibroblasts, skin cells that are easy to obtain and grow in culture.

Finding a combination of genes capable of transforming differentiated skin cells to undifferentiated stem cells helps resolve a critical question posed by Dolly, the famous sheep cloned in 1996. Dolly was the result of the nucleus of an adult cell transferred to an oocyte, an unfertilized egg. An unknown combination of factors in the egg caused the adult cell nucleus to be reprogrammed and, when implanted in a surrogate mother, develop into a fully formed animal.

The new study by Yu and Thomson reveal some of those genetic factors. The ability to reprogram human cells through well defined factors would permit the generation of patient-specific stem cell lines without use of the cloning techniques employed by the creators of Dolly.

"These are embryonic stem cell-specific genes which we identified through a combinatorial screen," Thomson says. "Getting rid of the oocyte means that any lab with standard molecular biology can do reprogramming without difficulty to obtain oocytes."

Although Thomson is encouraged that the new cells will speed new cell-based therapies to treat disease, more work is required, he says, to refine the techniques through which the cells were generated to prevent the incorporation of the introduced genes into the genome of the cells. In addition, to ensure their safety for therapy, methods to remove the vectors, the viruses used to ferry the genes into the skin cells, need to be developed.

Using the new reprogramming techniques, the Wisconsin group has developed eight new stem cell lines. As of the writing of the new Science paper, which will appear in the Dec. 21, 2007 print edition of the journal Science, some of the new cell lines have been growing continuously in culture for as long as 22 weeks.

Posted by dlifenews at 03:33 PM | Comments (0)

Study Suggests Link Between Obesity, Poor Bone Health

November 26, 2007 (EurekAlert) - Being overweight is a known risk factor for heart disease, diabetes and a host of other health conditions. Now, a University of Georgia study published in the November issue of the American Journal of Clinical Nutrition finds that obesity may also be bad for bone health.

Researchers conducted advanced three-dimensional bone scans on 115 women ages 18 and 19 with normal (less than 32 percent) and high (greater than 32 percent) body fat. After adjusting for differences in muscle mass surrounding the bone, the researchers found that the bones of participants with high body fat were 8 to 9 percent weaker than those of normal body fat participants.

“Obesity is an epidemic in this country, and I think this study is critical because it highlights another potential negative health effect that people haven’t considered,” said study co-author Richard D. Lewis, professor of foods and nutrition at the UGA College of Family and Consumer Sciences.

Previous studies on bone health and obesity used a two-dimensional bone densitometer that is commonly used in osteoporosis screenings. Lewis explained that a notable shortcoming of the bone densitometer is that it does not take into account bone shape and geometry, which have a substantial influence on bone strength. The new study used a three-dimensional imaging technique that measures both the amount of mineral in the bone and its shape and geometry. The study found that, surprisingly, normal- and high body-fat young adult females have comparable bone strength in a direct comparison that does not account for muscle mass.

“The fact that the two groups had similar bone strength measures is remarkable in itself, because you would expect it to be higher in the heavier person,” Lewis said.

Doctoral candidate Norman Pollock, lead author of the study, explained that muscle exerts force on bones, which stimulates bone growth. Overweight people tend to have more muscle surrounding their bones than their leaner counterparts, leading most researchers to assume that being overweight is good for bone health.

“When we corrected for the amount of muscle, we found that the obese person is not making as much bone as they should be for the amount of muscle that they have,” Pollock said. “People haven’t observed that in the past because they weren’t using the three-dimensional scan.”

Lewis said the exact mechanisms by which excess fat hinders bone strength are unclear, but studies of obese rats show that they produce more fat cells in the bone marrow and fewer bone cells. Since fat and bone cells originate from the same precursor, it may be that fat cell production is favored over bone cell production in obese people.

The women the researchers studied were 18 and 19, an age at which the bones have stopped growing but before age-related degeneration begins. Lewis said future studies using three-dimensional bone imaging should follow children with normal and high levels of body fat through time to see how their skeletons grow. Other researchers have documented increased fractures in overweight children, suggesting that childhood obesity may be particularly detrimental to bone health.

“When you’re young you have the capacity to change the shape of your bones, but when you get older you don’t have that capacity.” Lewis said. “And because of that, childhood obesity could have a significant, long lasting negative impact on the skeleton.”

Posted by dlifenews at 10:35 AM | Comments (0)

Doubled Calorie Intake From Beverages Likely Contributes to Adult Obesity

November 19, 2007 (EurekAlert) - It’s not just sugary sodas that are adding to the obesity crisis – it’s fruit drinks, alcohol and a combination of other high-calorie beverages, say University of North Carolina at Chapel Hill School of Public Health researchers. And during the holidays, when eggnog, cocktails and spiced cider are abundant, the problem can be even more apparent.

Over the past 37 years, the number of calories adults get through beverages has nearly doubled, according to a UNC study published in the November issue of Obesity Research by Kiyah J. Duffey, a doctoral candidate in the department of nutrition, and Barry M. Popkin, Ph.D., professor of nutrition and a fellow at the Carolina Population Center.

The study used nationally representative data to quantify both trends and patterns in beverage consumption among 46,576 American adults aged 19 and older. Patterns and trends of all beverages adults consumed were examined between 1965 and 2002. Researchers found that, over these 37 years, total daily intake of calories from beverages increased by 94 percent, providing an average 21 percent of daily energy intake among U.S. adults. That amounts to an additional 222 calories from all beverages daily.

Water intake was measured from 1989 to 2002, and during that time, the amount of water consumed stayed roughly the same, but the average adult consumed an additional 21 ounces per day of other beverages, Popkin said.

“This has considerable implications for numerous health outcomes, including obesity and diabetes as this is just adding several hundred calories daily to our overall caloric intake,” Popkin said.
Most researchers agree that beverages do not fill you up, Popkin said. “Regardless of beverage type – water, sodas, milk, orange juice or beer – those extra calories are not compensated for by a reduction in food intake.”

Data analyzed for this study came from the federally funded Nationwide Food Consumption Surveys of 1965 and 1977-1978 and the National Health and Nutrition Examination Surveys of 1989-1994 and 1999-2002.

“For each exam year, we calculated total energy intake, percent consuming and calories per consumer for 16 different beverages, and determined total beverage intake (fluid ounces) for each beverage,” Duffey said. “Then, using a method that finds patterns within data, we generated 5 different groups of individuals who had similar patterns of beverage consumption and compared the beverages that comprised these groups in 1977 and 2002 to determine if the combinations of beverages were different.”

As it turns out, they were different.

“The biggest difference we observed was that the 2002 beverage patterns were more complex than they were in 1977,” she said. “For example, just five beverages dominated the patterns in 1977, but in 2002 there were eight beverages consumed in significant quantities – and new beverages appeared in these 2002 patterns. Fruit and vegetable juices and diet beverages were not important in 1977 patterns, but were in 2002.”

Equally important, Popkin noted, are the overall trends in total calories from beverages. In 1965, beverages accounted for just 12 percent of daily energy intake. That number jumped to 21 percent by 2002.

As noted in previous studies, 23 percent more adults reported drinking soda between 1965 and 2002 (accounting for an additional 108 calories per day) while calories from whole-fat milk declined nearly 45 percent (from 119 calories per day in 1965 to 69 calories per day in 2002). Alcohol (up 73 calories per day) and fruit juice (up 20 calories per day) had considerable increases in their contribution to daily energy intake as well.

“One of the strengths of this study,” Popkin said, “is that we examined the full range of beverages consumed, providing a broad understanding of the role of beverages, and patterns of beverages, to overall dietary intake.”

Because data are not collected on the same individuals over time, conclusions cannot be made about the influence of the observed trends or patterns on changes in individual health outcomes over time, but they can provide a starting point for future analyses to examine this issue.

Posted by dlifenews at 12:12 PM | Comments (0)

Pedometers Motivate People with Diabetes to Walk More

Program that counts every step, not just steps taken during long walks, is more satisfying

November 19, 2007 (EurekAlert) — The use of a pedometer and a Web site that tracked physical activity levels proved to be powerful motivators for people with diabetes who participated in a recent walking study conducted by researchers from the University of Michigan Health System and VA Ann Arbor Healthcare System. The study also suggests that certain types of goal-setting may be more effective than others.

All participants in the study wore pedometers and received automated weekly goals that were based on their previous week’s walking activity. For half of the participants these goals were “lifestyle goals,” meaning that any step taken during the day counted. The other half received “structured goals,” in which only steps taken during long walks that lasted at least 10 minutes counted. These participants had a smaller target number of steps to take in a day than the lifestyle group.

Study participants in both groups increased their walking significantly during the program and there was no difference between the groups in terms of increased walking. However, the type of goals that participants were given in the six-week study strongly influenced their satisfaction with the program.

Those who received lifestyle goals were more satisfied with the walking program, and wore the pedometer more days during the study period and for more hours during each day than those who received structured goals.

The finding sheds light on a debate among exercise experts about the ways in which people should increase their levels of activity. Some have contended that the only effective walking programs are those in which long periods of activity (known as “bout steps” in this study) are counted. Others have said that counting every step is a better motivator and is just as effective as bout-step programs.

“Walkers in the group where every step counted experienced the same benefit as those who just had their bout steps recorded,” says lead author Caroline R. Richardson, M.D., assistant professor in the Department of Family Medicine at the U-M Medical School and research scientist at the Veterans Affairs Health Services Research and Development at the VA Ann Arbor Healthcare System. The study appears in the International Journal of Behavioral Nutrition and Physical Activity.

“The fact that they were also more satisfied with their program suggests that this approach may be more successful for many people than a program that only recognizes long periods of activity,” Richardson adds.

Study participants were 35 individuals with type 2 diabetes who were both sedentary and overweight, and who were interested in starting a walking program. All participants were given a pedometer that tracked walking and had a built in USB port so that the walking data could be automatically uploaded to the study Web site. Each participant could view his or her step count records and new goals, along with tailored motivational messages and tips about walking, on a personalized study home page.

The focus was on people with type 2 diabetes because exercise is thought to be essential to prevent a worsening of the condition and the development of complications such as nerve damage. That’s why a program that inspires adherence is so important, Richardson notes.

Among the 30 participants who completed the study, steps taken during longer walks lasting 10 minutes or more increased by about 1,900 to 2,700 steps a day, and the increases were roughly the same in both the lifestyle and structured groups. Even though the lifestyle-goals group had every step counted, they, like their counterparts in the other group, chose to increase their walking by taking longer walks rather than by accumulating more steps during many short walks.

In other words, a lifestyle group participant would have her steps counted whether she went for a half-hour walk or just walked outside to get the mail, while the structured group would only have the half-hour walk counted. But in both groups, the increase in the daily totals came from activities like half-hour walks, not by taking more short trips to the mailbox, to and from the car, or visiting a co-worker down the hall.

That means that the increases in both groups stemmed from longer walks – the type of walking that is most beneficial to one’s health. Yet the group that had every step counted was more inclined to enjoy the overall program and was more likely to stick with it.

Richardson’s team also is conducting further studies about the effectiveness of pedometers as tools for motivating people to increase their levels of physical activity. Richardson is a national leader in this area of research.

Posted by dlifenews at 12:08 PM | Comments (0)

GlaxoSmithKline Revises US Labeling for Avandia®

November 14, 2007 (Press Release) - GlaxoSmithKline announced today that it is implementing changes to the US product label for Avandia® (rosiglitazone maleate), based on an extensive and thorough review by the FDA of myocardial ischemia data on Avandia, the most widely studied oral anti-diabetic medicine available.

The existing boxed warning has been revised to add the FDA’s conclusion that, while an FDA meta-analysis of short-term studies – mostly against placebo - showed an association between Avandia and an increase in myocardial ischemic events, that risk was not confirmed or excluded in three long-term clinical trials comparing Avandia against both placebo and other oral anti-diabetes medicines. The box will state that the available data on the risk of myocardial ischemia are inconclusive.

The FDA has also concluded there is insufficient information available to determine whether any oral anti-diabetic medicine reduces cardiovascular risk. The FDA has directed that the sentence - “There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction with Avandia or any other oral antidiabetic drugs” - will be added as a warning on the labels of all oral anti-diabetic medicines.

The Avandia label also has been updated to add that Avandia is not recommended - though not contraindicated - for use with patients who are taking insulin or nitrates. The label summarizes the data on myocardial ischemia to help doctors continue to evaluate which patients could benefit from taking Avandia, and those for whom alternative treatment should be considered.

The changes are now included in labeling for Avandia, and will be incorporated into future revised labeling for all approved rosiglitazone-containing products, including Avandamet (rosiglitazone maleate and metformin hydrochloride), and Avandaryl (rosiglitazone maleate and glimepiride). GSK is also preparing a Medication Guide to help educate patients about potential benefits and risks and to provide other information on Avandia.

“Avandia remains a valuable medicine for most patients with type 2 diabetes, and when used according to the labeling, has a well described and appropriate safety and effectiveness profile,” said Dr. Ronald Krall, GSK Chief Medical Officer. “Given the severity of this disease and the importance of Avandia in helping patients manage their diabetes, we will continue to work with the FDA to conduct more studies about the safety and benefits of our medicine.”

As previously stated by GSK, two long-term trials in diabetic patients comparing Avandia to other oral anti-diabetic medicines show no increased risk for cardiovascular events compared to other commonly used medications, other than the well-known risk of congestive heart failure with TZDs. One trial – ADOPT - shows no increased myocardial ischemic risk compared to metformin or sulfonylurea. The interim results of a second long-term trial – RECORD - also show no increased risk of major cardiovascular events (death, heart attack and stroke) between Avandia and other medications; however, firm conclusions cannot be drawn because the trial has not yet been completed. The updated label includes data from ADOPT and RECORD plus a third long-term trial in pre-diabetic patients (DREAM). The combined analysis of these three studies show there was no increased risk of Avandia over comparatorswith regard to myocardial infarction, mortality, or other non-heart failure cardiovascular events.

GSK believes data from ongoing and future clinical trials will provide additional scientific support for both the benefit and safety of Avandia. GSK has agreed to work with the FDA to plan and carry out a clinical trial to further investigate the cardiovascular effects of Avandia.

Avandiahas been prescribed to more than seven million people over the last seven years to help them control their blood sugar levels. Importantly, Avandia has been shown to control blood sugar for longer than the most commonly used oral anti-diabetic medicines – up to five years. Long-term glycemic control is important to help prevent the serious complications of diabetes, especially microvascular complications leading to blindness, amputation and kidney failure. Avandia is an important treatment option for physicians, since two-thirds of diabetic patients suffer with uncontrolled disease and many require two or three medicines to maintain their blood sugar.

GlaxoSmithKline — one of the world’s leading research-based pharmaceutical and healthcare companies — is committed to improving the quality of human life by enabling people to do more, feel better and live longer. For company information, visit GlaxoSmithKline on the World Wide Web at www.gsk.com.

Posted by dlifenews at 03:26 PM | Comments (0)

First United Nations World Diabetes Day Unites Global Diabetes Community to Fight the Epidemic

November 14, 2007 (PRNewswire) - On the first United Nations World Diabetes Day, the International Diabetes Federation (IDF) calls on governments to develop national policies for the prevention, care and treatment of diabetes and calls on donors worldwide to consider the need for a diabetes global fund to tackle the growing diabetes epidemic.

Speaking at the World Diabetes Day press conference, Dr Martin Silink, President of the International Diabetes Federation, explained that policy change and increased funding will be required to curb the growth of diabetes. "Diabetes is now seen as a serious threat to global health. It is one of the most devastating epidemics the world has seen," said Dr Silink, "yet diabetes funding is dismally insufficient in comparison to other diseases."

November 14 marks the first observance of the existing World Diabetes Day by the United Nations. At the end of last year, the UN General Assembly passed Resolution 61/225. The resolution establishes November 14 as an officially observed UN world day from this year, making diabetes only the second disease after HIV/AIDS to have an official UN day.

The World Diabetes Day resolution describes diabetes as "a threat to families, member states and the entire world." For the first time a non-infectious disease is seen as posing as serious a threat to global health as the infectious diseases like HIV/AIDS, tuberculosis and malaria. IDF and WHO figures indicate that over 246 million people now have diabetes worldwide. This number is set to reach 380 million by 2025 if significant action is not taken.(i)

Speaking at today's press conference held in New York City to mark the first United Nations World Diabetes Day, IDF President-Elect Jean-Claude Mbanya explained why widespread apathy in the face of the growing diabetes threat has contributed to the diabetes epidemic: "Diabetes was long dismissed as 'nothing serious' a 'touch of sugar', or a 'disease of the elderly and the rich'. For years the growing threat of diabetes went largely ignored. Successive generations failed to act decisively. Diabetes slipped in under the radar unnoticed to become a global health catastrophe." According to Dr Mbanya, the time is right to take action to address the diabetes threat: "The political momentum generated by the World Diabetes Day Resolution, the coordinated advocacy of a strong diabetes community and the availability of cheap medication have created the opportunity for governments to implement policies to prevent diabetes and its complications."

Diabetes affects 6% of the global adult population. It is a leading cause of blindness, heart disease, stroke, kidney failure and amputation. Every year, over 3.8 million deaths are due to diabetes, making diabetes a more significant global killer than HIV/AIDS and malaria combined. Every 10 seconds a person dies from diabetes-related causes. In that same 10 seconds, two people develop the disease.
Diabetes is an expensive condition, with wide-ranging costs for individuals, for families and for healthcare systems. It threatens to undermine economic growth, particularly in developing countries, which currently shoulder most of the diabetes burden.

Current spending to treat and prevent diabetes is estimated at more than US$232 billion each year. This will balloon to more than US$302 billion each year within 20 years. More than 80% of this investment is made in the world's most developed countries. The majority of all people with diabetes (70% of the total), however, are found in the developing countries.

Despite the size and seriousness of the diabetes epidemic, it has not attracted significant funding from donors. Overseas Development Aid to the health sector, for example, reached US$2.9 billion in 2002. Most of that US$2.9 billion went to support infectious diseases, particularly HIV/AIDS. Of the global total, only 0.1% was available to fund all non-communicable chronic diseases including diabetes.

While the passage of the Resolution has created great political momentum, significant financial resources will be required to address the diabetes epidemic meaningfully. Recognizing this need, the International Diabetes Federation is exploring the possibility of establishing a global financing facility for diabetes, based on an analysis of existing global health financing mechanisms and consultations with a diverse group of stakeholders.

Wrapping up the press conference, Dr Silink emphasized that: "A fully implemented national plan to treat and prevent diabetes should be a right for everyone. It is time," continued the IDF President "to make a significant difference for the 246 million people living with diabetes and to introduce effective strategies for the prevention of diabetes itself."

The International Diabetes Federation (IDF) is an umbrella organization of over 200 member associations in more than 160 countries, representing almost 250 million people with diabetes, their families, and their healthcare providers. The mission of the IDF is to promote diabetes care, prevention and a cure worldwide. Its main activities include education for people with diabetes and healthcare professionals, public awareness campaigns and the promotion and exchange of information. IDF is a non-governmental organization in official relations with WHO and associated to the United Nations' Department of Public Information. For more information, please visit http://www.idf.org.

Introduced by IDF and the World Health Organization in 1991, World Diabetes Day has been celebrated by diabetes representative organizations worldwide ever since. The date of 14 November was chosen because it marks the birthday of Frederick Banting, who, along with Charles Best, is credited with the discovery of insulin. UN Resolution 61/225 establishes November 14 as a United Nations observed day from 2007.

Visit http://www.worlddiabetesday.org for further information about the campaign and for a full list of landmarks that will light up.

Posted by dlifenews at 10:42 AM | Comments (0)

Discovery Health Travels the World to Present the Groundbreaking Documentary - Diabetes: A Global Epidemic

November 13, 2007 (PRNewswire) -- Nearly every society on earth is affected by diabetes -- one of the most pressing health crises facing humanity today. Currently, more than 246 million people worldwide are living with the disease, a number that is expected to explode to 380 million within 20 years. Despite recent advancements -- including new medications, monitoring devices and measurements -- the fight against diabetes continues to be an uphill battle. In an effort to raise awareness and uncover new clues for combating the disease, Discovery Health, with support from an unrestricted educational grant from Novo Nordisk, presents DIABETES: A GLOBAL EPIDEMIC -- the definitive look at how diabetes affects the global community.

Featuring narration from five-time Oscar nominee Glenn Close, DIABETES: A GLOBAL EPIDEMIC takes viewers across six continents to gain greater knowledge of the disease and how it affects different communities. In a television first, Discovery Health travels around the world to investigate diabetes' escalating human and economic toll across differing cultures and health care systems. The documentary's premiere comes on the heels of a historic milestone -- the first United Nations World Diabetes Day, which will be observed on November 14, 2007. With generous support from Novo Nordisk, the one-hour documentary will be presented commercial-free in the United States.

"This groundbreaking documentary shows diabetes for what it is: the silent epidemic of the 21st century, which doesn't discriminate between culture, continent or civilization," says Lise Kingo, executive vice president at Novo Nordisk. "The film also captures the care, professionalism and determination of all those who live with, treat and seek new treatments for diabetes around the world and who are working toward consigning diabetes to medical history."

DIABETES: A GLOBAL EPIDEMIC follows Francine Kaufman, MD, former American Diabetes Association president and head of the Center for Endocrinology, Diabetes and Metabolism at Children's Hospital Los Angeles, as she tours the world. Over a six-month period, Dr. Kaufman journeys from Los Angeles to Cape Town, South Africa; Chennai, India; Sao Paulo, Brazil; Melbourne and Perth, Australia; and Helsinki, Finland, in her quest to increase focus on the prevention, treatment and care of diabetes. In her travels, Dr. Kaufman meets with physicians and diabetes thought leaders to discuss the challenges of combating the disease, as well as their success stories of treatment and prevention. In addition, she spends time with diabetes patients of all ages who share their personal stories and offer a unique insight into the realities of living with the disease.

"During my travels, I realized that while diabetes is a worldwide issue, it often affects different cultures in different ways," said Kaufman. "It became clear to me that in order to effectively address the disease globally, we need to apply culturally sensitive solutions locally."

DIABETES: A GLOBAL EPIDEMIC gives audiences an in-depth understanding of the impact the westernization of the world has had on the incidence and prevalence of diabetes, and how differing cultures add unique dynamics to the problem at local levels.

We learn how South Africans don't want to be thin because of the stigma of AIDS. In India, when people become financially secure their eating increases- to be large in size symbolizes wealth and success. Australians talk about their country becoming a nation of sports watchers instead of sports players. All these factors are prompting leading experts to urgently join forces in the common goal of defeating this enemy, which can lead to blindness, heart disease and renal failure.

Medical professionals are eligible to receive CME credits for viewing DIABETES: A GLOBAL EPIDEMIC. More information is available at DiscoveryHealthCME.com.

About Novo Nordisk
Novo Nordisk is a healthcare company with an 84-year history of innovation and achievement in diabetes care. The company has the broadest diabetes product portfolio in the industry, including the most advanced products within the area of insulin delivery systems. In addition to diabetes care, Novo Nordisk has a leading position within areas such as hemostasis management, growth hormone therapy, and hormone therapy for women. Novo Nordisk's business is driven by the Triple Bottom Line: a commitment to economic success, environmental soundness, and social responsibility to employees and customers. With headquarters in Denmark, Novo Nordisk employs more than 25,000 employees in 79 countries, and markets its products in 179 countries. Novo Nordisk's B shares are listed on the stock exchanges in Copenhagen and London. Its ADRs are listed on the New York Stock Exchange under the symbol 'NVO'. For global information, visit novonordisk.com; for United States information, visit novonordisk-us.com.

About Discovery Health Media Enterprises
Discovery Health Media Enterprises includes the Discovery Health and FitTV television networks and online assets including http://www.discoveryhealth.com, as well as its Continuing Medical Education (CME) business and Discovery's first stand-alone VOD service, Discovery Health On-Call. Discovery Health Media Enterprises is part of Discovery Communications, the number-one nonfiction media company reaching more than 1.5 billion cumulative subscribers in over 170 countries. Discovery's 100-plus worldwide networks are led by Discovery Channel, TLC, Animal Planet, The Science Channel, Discovery Health and HD Theater, with digital media properties including HowStuffWorks.com. Discovery Communications is owned by Discovery Holding Co. , Advance/Newhouse Communications and John S. Hendricks, Discovery's founder and chairman. For more information please visit http://www.discoverycommunications.com/.

Posted by dlifenews at 10:35 AM | Comments (0)

Diabetes Rates Are Increasing Among Youth

NDEP Introduces New Resources to Help Teens Manage the Disease

November 13, 2007 (NIH News) - While most children and young adults with diabetes have type 1, soaring obesity rates are making type 2 diabetes, a disease that used to be seen primarily in adults over age 45, more common among young people. To help young people diagnosed with diabetes and their parents, the National Diabetes Education Program (NDEP) is introducing a new series of tip sheets and an online quiz specially created for teens to help them manage their disease and reduce their risk for complications. NDEP is jointly sponsored by the National Institutes of Health and the Centers for Disease Control and Prevention.

About 154,000 youth under age 20 have diabetes in the United States. According to data reported by the Centers for Disease Control and Prevention in 2006, one in 523 people younger than age 20 has diabetes. Among this group, 79 percent are aged 10 to 19 years.

NDEP's new "Tips for Teens with Diabetes" series, which encourages youth to take steps to manage their disease for a long, healthy life, includes topics such as "What is Diabetes?, Be Active, Make Healthy Food Choices, Stay at a Healthy Weight, and Dealing with the Ups and Downs of Diabetes". NDEP also has a tip sheet addressing teens at risk for type 2 diabetes, called "Lower Your Risk for Type 2 Diabetes". In addition, NDEP has developed an interactive online quiz for teens with diabetes based on information found in the tip sheets, using a question-and-answer format, with direct links to the new series of tip sheets. All of the tip sheets are available at no charge from the NDEP.

The release of NDEP's new educational materials for teens and their parents coincides with National Diabetes Awareness Month in November. The new tools also support the 2007 World Diabetes Day campaign theme "Diabetes in Children and Adolescents," which raises awareness of the rising prevalence of type 1 and type 2 diabetes among youth around the world. World Diabetes Day, November 14, is sponsored by the International Diabetes Federation.

NDEP's new resources support youth with diabetes and their families to ensure their health and well-being now and into adulthood. For more information about NDEP's free resources for children and teens, visit www.YourDiabetesInfo.org or call 1-888-693-NDEP (6337).

NDEP chair-elect Francine Kaufman, M.D., head of the Center for Diabetes, Endocrinology and Metabolism for the Childrens Hospital of Los Angeles, is chair of the Youth Section for World Diabetes Day. Listen to an NIH Radio interview with Dr. Kaufman about diabetes in youth and World Diabetes Day at http://www.nih.gov/news/radio/nihpodcast.htm.

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 - is comprised of 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 investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Posted by dlifenews at 10:30 AM | Comments (0)

Too Much Sugar Turns Off Gene That Controls the Effects of Sex Steroids

New research supports advice to eat complex carbs and avoid sugar

November 8, 2007 (EurekAlert) – Eating too much fructose and glucose can turn off the gene that regulates the levels of active testosterone and estrogen in the body, shows a new study in mice and human cell cultures that’s published this month in the Journal of Clinical Investigation. This discovery reinforces public health advice to eat complex carbohydrates and avoid sugar. Table sugar is made of glucose and fructose, while fructose is also commonly used in sweetened beverages, syrups, and low-fat food products. Estimates suggest North Americans consume 33 kg of refined sugar and an additional 20 kg of high fructose corn syrup per person per year.

Glucose and fructose are metabolized in the liver. When there’s too much sugar in the diet, the liver converts it to lipid. Using a mouse model and human liver cell cultures, the scientists discovered that the increased production of lipid shut down a gene called SHBG (sex hormone binding globulin), reducing the amount of SHBG protein in the blood. SHBG protein plays a key role in controlling the amount of testosterone and estrogen that’s available throughout the body. If there’s less SHBG protein, then more testosterone and estrogen will be released throughout the body, which is associated with an increased risk of acne, infertility, polycystic ovaries, and uterine cancer in overweight women. Abnormal amounts of SHBG also disturb the delicate balance between estrogen and testosterone, which is associated with the development of cardiovascular disease, especially in women.

“We discovered that low levels of SHBG in a person’s blood means the liver’s metabolic state is out of wack – because of inappropriate diet or something that’s inherently wrong with the liver – long before there are any disease symptoms,” says Dr. Geoffrey Hammond, the study’s principal investigator, scientific director of the Child & Family Research Institute in Vancouver, Canada, and professor in the Department of Obstetrics & Gynecology at the University of British Columbia.

“With this new understanding, we can now use SHBG as a biomarker for monitoring liver function well before symptoms arise,” says Dr Hammond, who is a Tier 1 Canada Research Chair in Reproductive Health. “We can also use it for determining the effectiveness of dietary interventions and drugs aimed at improving the liver’s metabolic state.”

Physicians have traditionally measured SHBG in the blood to determine a patient’s amount of free testosterone, which is key information for diagnosing hormonal disorders. In addition, SHBG levels are used to indicate an individual’s risk for developing type 2 diabetes and cardiovascular disease.

The discovery dispels the earlier assumption that too much insulin reduces SHBG, a view which arose from the observation that overweight, pre-diabetic individuals have high levels of insulin and low levels of SHBG. This new study proves that insulin is not to blame and that it’s actually the liver’s metabolism of sugar that counts.

Posted by dlifenews at 10:39 AM | Comments (0)

Fat Cells Send Message that Aids Insulin Secretion

November 7, 2007 (EurekAlert) - The body's fat cells help the pancreas do its job of secreting insulin, according to research at Washington University School of Medicine in St. Louis. This previously unrecognized process ultimately could lead to new methods to improve glucose metabolism in type 2 diabetic or insulin-resistant people.

In a study using laboratory mice, published in the November 7, 2007 issue of Cell Metabolism, scientists at the School of Medicine report that fat cells release a protein that aids insulin secretion from pancreatic beta cells, which are the sole source of insulin. The protein is an enzyme that the pancreatic cells themselves produce in only minimal amounts. The enzyme works to enhance glucose-stimulated insulin secretion from pancreatic beta cells.

Insulin helps the body process blood sugar (glucose), and those with type 2 diabetes have a deficiency of insulin or a resistance to its effects. More than 7 million people in the U.S. are living with a diagnosis of type 2 diabetes and many more are undiagnosed.

The researchers assert that the enzyme secreted by fat cells, called Nampt, is an important component of the insulin-secretion pathway. "We think this secretion process allows fat cells to communicate with the pancreas and aid its function," says senior author Shin-ichiro Imai, M.D., Ph.D., assistant professor of medicine and of molecular biology and pharmacology. "I suspect this process could be critical for compensating pancreatic beta cell function in the face of increasing insulin resistance."

The association of type 2 diabetes and insulin resistance with obesity suggests there may be limits to the ability of the process to enhance pancreatic function, according to Imai. "It may be that in some obese individuals a threshold has been reached so that this mechanism no longer provides adequate compensation," he says. "But there may be ways to overcome this threshold."

Interestingly, in 2004 Nampt provoked excitement in the scientific community because it was reported to be a newly discovered fat-derived hormone that worked very much like insulin. That study named the enzyme visfatin. The scientists who made this assertion have since retracted their claim.

In the new study, the Washington University researchers contend that Nampt is not an insulin-like hormone. Instead, their investigation shows it's an enzyme that modulates pancreatic function.
"Our work marks a conceptual breakthrough," Imai says. "Nampt synthesizes a compound in the bloodstream, and when that compound reaches the pancreas it stimulates insulin secretion. This is a surprising mechanism by which a circulating metabolite modulates pancreatic function."

Imai says he believes it's possible that the compound produced by Nampt, called NMN for short, could be used to raise insulin secretion from pancreatic cells and thus help improve the way the body handles sugar. Imai and his group are collaborating with clinical researchers at the University to find out how much NMN is in the blood of normal and diabetic or obese patients. They also hope to initiate clinical trials to test NMN as a therapeutic agent in patients with type 2 diabetes or insulin resistance.

Nampt is actually a widespread enzyme and catalyzes such a fundamental process that most cells of the body have an internal form of it. But, studying mice, the researchers saw that Nampt could be secreted from cells — but only from fat cells. And because Nampt levels are low in pancreatic cells, the pancreas depends on the enzyme secreted from fat and its product, NMN, in the blood.

When pancreatic beta cells absorb enough NMN, it stimulates them to secrete insulin. In the bloodstreams of laboratory mice, NMN was measured at a concentration shown to be sufficient to enhance insulin secretion from pancreatic beta cells. No one had previously known that NMN circulated in the bloodstream.

Mice engineered to have just one instead of two copies of the Nampt gene had a mildly impaired ability to metabolize glucose and had a defect in insulin secretion. The researchers showed that NMN restored normal insulin secretion in these mice.

In conjunction with the Office of Technology Management at the University, Imai has patented the use of Nampt and NMN for the prevention and treatment of metabolic complications, such as type 2 diabetes.
Next, the researchers will try to identify the factors that cause secretion of Nampt from fat cells and the mechanisms by which NMN enhances insulin secretion in the pancreas.

Posted by dlifenews at 04:14 PM | Comments (0)

Chronic Kidney Disease in the US Appears to be Increasing

November 7, 2007 (EurekAlert) - The estimated prevalence of chronic kidney disease among adults in the U.S. has increased to 13 percent, in part because of the increase in diabetes and hypertension, according to a study in the November 7 issue ofJAMA.

Chronic kidney disease (CKD) is now recognized as a common condition that elevates the risk of cardiovascular disease as well as kidney failure and other complications. The number of patients with kidney failure treated by dialysis and transplantation (the end-stage of CKD) has increased dramatically in the United States, as has the incidence of end-stage renal disease, according to background information in the article. “Estimation of the prevalence of earlier stages of CKD in the U.S. population and ascertainment of trends over time is central to disease management and prevention planning, particularly given the increase in the prevalence of obesity, diabetes, and hypertension, the leading risk factors for CKD,” the authors write. Whether there have been changes in the prevalence of earlier stages of CKD is uncertain.

Josef Coresh, M.D., Ph.D., of Johns Hopkins University, Baltimore, and colleagues compared the prevalence, stages and severity of CKD in National Health and Nutrition Examination Surveys (NHANES 1988-1994 [n = 15,488] and NHANES 1999-2004 [n = 13,233]), a nationally representative sample of adults age 20 years or older. Chronic kidney disease prevalence was determined based on persistent albuminuria (the presence of excessive protein in the urine) and decreased estimated glomerular filtration rate (GFR; a measurement of fluid filtered by the kidney).

The researchers found that the prevalence of both albuminuria and decreased GFR increased from 1988-1994 to 1999-2004. The prevalence of CKD stages 1 to 4 increased from 10.0 percent in 1988-1994 to 13.1 percent in 1999-2004. A higher prevalence of diagnosed diabetes and hypertension and higher body mass index explained the entire increase in prevalence of albuminuria but only part of the increase in the prevalence of decreased GFR. Change in average serum creatinine (a product of protein metabolism) accounted for some of the increased prevalence of CKD.

“In conclusion, survey data suggest that the prevalence of CKD in the United States is high and has increased between 1988-1994 and 1999-2004, from 10 percent to 13 percent, while awareness of kidney disease among the general public remains very low. The increasing prevalence of diagnosed diabetes and hypertension has contributed to this increase, which may propagate to higher rates of complications and kidney failure requiring dialysis or transplantation. Earlier stages accounted for most of the individuals with CKD. Because individuals with early stages of CKD have a higher risk of cardiovascular disease morbidity and mortality than their risk of progression to kidney failure, cardiovascular risk factor management in this group is critical. The high prevalence of CKD overall, and particularly among older individuals and persons with hypertension and diabetes, suggests that CKD needs to be a central part of future public health planning,” the authors write.

Posted by dlifenews at 04:12 PM | Comments (0)

'Tweens' Double Use of Diabetes Drugs

More children taking chronic medications for blood pressure, cholesterol, asthma, depression and diabetes

November 7, 2007 (EurekAlert) – America’s tweens more than doubled their use of type-2 diabetes medications between 2002 and 2005, with girls between 10 and 14 years of age showing a 166 percent increase. The likely cause: Obesity, which is closely associated with Type 2 diabetes.

The finding is included in a study of chronic medication use in children 5 to 19 reported Wednesday, Nov. 7 at the annual meeting of the American Public Health Association by researchers from the Saint Louis University School of Medicine and School of Public Health and pharmacy benefit manager Express Scripts. In addition to diabetes, utilization patterns for blood pressure, cholesterol, asthma and depression medications were also examined.

“Across every chronic medication class we examined over this four year period of time, children’s use increased, with varying patterns of growth across males and females and age groups,” said Emily R. Cox, Ph.D., RPh, senior director of research at Express Scripts.

For example, the number of males between 15 and 19 using a blood pressure drug increased by 15.4 percent even as the number of females in the age group taking the drugs, called antihypertensives, declined by 1.6 percent.

On the other hand, the number of females between 15 and 19 taking an anti-depressant increased by 6.8 percent while, for males in the same age group, utilization declined slightly.

This increase in anti-depressant use among 15 to 19 year old girls was a striking exception to decreases for boys and girls 5 to 9 and boys 10 to 19. It also occurred despite a Public Health Advisory released by the Food and Drug Administration in October 2003, regarding anti-depressant use by children. Among all children, the prevalence of antidepressant use had been increasing prior to the advisory after which it decreased.

With asthma, children age 5 to 9 accounted for the largest increase in the use of controller medication among the three age groups at 67.3 percent as compared to 38.8 percent for the 10 to 14 age group and 34.7 percent for the 15 to 19 age group.

“This may be explained by concerns over long-term side effects of these medications in children and/or greater physician office visits, and therefore greater likelihood of prescribing,” explained Donna R. Halloran, M.D., MSPH, assistant professor of pediatrics at Saint Louis University School of Medicine.

“Overall, these patterns could reflect changing prescribing behaviors by physicians (anti-hypertensives), increases in the risk factors for chronic diseases (type-2 antidiabetics, antihyperlipidemics), increased office visit rates and therefore screening rates – particularly for females – or trends toward greater use of drug therapy as the preferred mode of treating children with chronic conditions,” observed Sharon M. Homan, Ph.D., professor of community health at Saint Louis University School of Public Health.

Posted by dlifenews at 02:24 PM | Comments (0)

Team Uncovers Gene’s Role in Type 1 Diabetes

November 7, 2007 (Newswise) — Researchers at the University of Virginia Health System have identified an enzyme thought to be an important instigator of the inner-body conflict that causes Type 1 diabetes. A chronic condition that affects nearly three million American children and adults, Type 1 diabetes is more severe than Type 2. Type 1 diabetes, also called autoimmune diabetes, arises when the body’s infection-fighting white blood cells start destroying the beta-cells that produce insulin in the pancreas.

To shed light on how this conflict begins, UVa researchers focused on a single gene, 12/15-lipoxygenase (12/15-LO). This gene leads to the production of the enzyme, which appears to have an important role in the activation of white blood cells in the pancreas.

Researchers developed non-obese diabetic female mice to serve as a model of Type 1 diabetes. After turning off the 12/15-LO gene in study mice, they discovered that these mice without the enzyme were 97 percent less likely to develop diabetes than mice that had normal levels of it, according to the study, published online in the journal Diabetes (to be published in print in February 2008).

“This research is exciting because it advances our knowledge of a new gene that is involved in causing Type 1 diabetes and could pave the way for new treatments to prevent or reverse this increasingly prevalent disease,” said Dr. Jerry L. Nadler, who is chief of the UVa Division of Endocrinology and Metabolism.

UVa researchers also discovered that study mice that did not have the 12/15-LO gene and remained non-diabetic demonstrated better glucose tolerance than non-diabetic NOD mice that were matched for age. (Worse glucose tolerance is an indication of having a pre-diabetes condition). The same group of study mice also had improved beta cell mass and less severe insulitis than their non-diabetic NOD counterparts.

Insulitis is a change in the islet cells that includes a high-fluid volume and too many white blood cells. While white blood cells normally help to fight off infections, they can cause damage over time when they infiltrate the islet cells of the pancreas.

“Our findings have two practical implications,” said co-author Marcia McDuffie, professor of Microbiology at UVa. “First, they help us to understand the complicated process that produces self-destructive white blood cells. This knowledge may be useful in predicting which children may be at risk for developing Type 1 diabetes before significant damage has occurred in the islets. Second, we may be able to design drugs targeting this enzyme that may help to prevent Type 1 diabetes in people at risk for the disease and also to prevent recurrence of disease in transplanted islets.”

Type 1 diabetes requires insulin injections, because the body cannot produce insulin on its own.

Posted by dlifenews at 02:22 PM | Comments (0)

UCSD Researchers Discover Inflammation, Not Obesity, Cause of Insulin Resistance

Findings may have important potential for new drug discoveries in fight against Type 2 diabetes

November 6, 2007 (UCSD News) - Researchers at the University of California, San Diego (UCSD) School of Medicine have discovered that inflammation provoked by immune cells called macrophages leads to insulin resistance and Type 2 diabetes. Their discovery may pave the way to novel drug development to fight the epidemic of Type 2 diabetes associated with obesity, the most prevalent metabolic disease worldwide.

In recent years, it has been theorized that chronic, low-grade tissue inflammation related to obesity contributes to insulin resistance, the major cause of Type 2 diabetes. In research done in mouse models, the UCSD scientists proved that, by disabling the macrophage inflammatory pathway, insulin resistance and the resultant Type 2 diabetes can be prevented.

The findings of the research team, led by principle investigators Michael Karin, Ph.D., Professor of Pharmacology in UCSD’s Laboratory of Gene Regulation and Signal Transduction, and Jerrold Olefsky, Distinguished Professor of Medicine and Associate Dean for Scientific Affairs, will be published as the feature article of the November 7 issue of Cell Metabolism. Co-first authors of the paper are Giovanni Solinas, UCSD Department of Pharmacology and Cristian Vilcu, UCSD Division of Endocrinology and Metabolism.

“Our research shows that insulin resistance can be disassociated from the increase in body fat associated with obesity,” said Olefsky.

Macrophages, found in white blood cells in the bone marrow, are key players in the immune response. When these immune cells get into tissues, such as adipose (fat) or liver tissue, they release cytokines, which are chemical messenger molecules used by immune and nerve cells to communicate. These cytokines cause the neighboring liver, muscle or fat cells to become insulin resistant, which in turn can lead to Type 2 diabetes.

The UCSD research team showed that the macrophage is the cause of this cascade of events by knocking out a key component of the inflammatory pathway in the macrophage, JNK1, in a mouse model. This was done through a procedure called adoptive bone marrow transfer, which resulted in the knockout of JNK1 in cells derived from the bone marrow, including macrophages.

With this procedure, bone marrow was transplanted from a global JNK1 knockout mouse (lacking JNK1 in all cell types) into a normal mouse that had been irradiated to kill off its endogenous bone marrow. This resulted in a chimeric mouse in which all tissues were normal except the bone marrow, which is where macrophages originate. As a control, the scientists used normal, wild-type mice as well as mice lacking JNK1 in all cell types. These control mice were also subjected to irradiation and bone marrow transfer.

The mice were all fed a high-fat diet. In regular, wild-type mice, this diet would normally result in obesity, leading to inflammation, insulin resistance and mild Type 2 diabetes. The chimeric mice, lacking JNK1 in bone marrow-derived cells, did become obese; however, they showed a striking absence of insulin resistance – a pre-condition that can lead to development of Type 2 diabetes.

“If we can block or disarm this macrophage inflammatory pathway in humans, we could interrupt the cascade that leads to insulin resistance and diabetes,” said Olefsky. “A small molecule compound to block JNK1 could prove a potent insulin-sensitizing, anti-diabetic agent.”

The research also proved that obesity without inflammation does not result in insulin resistance. Olefsky explained that when an animal or a human being becomes obese, they develop steatosis, or increased fat in the liver. The steatosis leads to liver inflammation and hepatic insulin resistance.

The chimeric mice did develop fatty livers, but not inflammation. “Their livers remained normal in terms of insulin sensitivity,” said Olefsky, adding that this shows that insulin resistance can also be disassociated from fatty liver.

“We aren’t suggesting that obesity is healthy, but indications are promising that, by blocking the macrophage pathway, scientists may find a way to prevent the Type 2 diabetes now linked to obesity and fatty livers,” Olefsky said.

Additional contributors include Jun-Li Luo, Willscott Naugler and Sergei Grivennikov, UCSD Department of Pharmacology; Jaap G. Neels, and Gautam K. Bandyopadhyay, UCSD Division of Endocrinology and Metabolism; Anthony Wynshaw-Boris, UCSD Departments of Pediatrics and Medicine; and Miriam Scadeng, UCSD Department of Radiology.

This research was supported by National Institutes of Health grants ES004151, ES006376, DK033651 and DK074868. Additional funding was provided by a fellowship from the Swiss National Science Foundation, a University of California Discovery Grant and Mentor-Based Postdoctoral Fellowships from the American Diabetes Association. Michael Karin is an American Cancer Society Research Professor.

Posted by dlifenews at 02:28 PM | Comments (0)

Low Dose of Serotonin-Acting Chemical Improves Blood Sugar Tolerance

November 6, 2007 (EurekAlert) - An appetite-suppressing chemical also improves glucose tolerance and lowers insulin levels in obese and diabetic mice, researchers report in the November issue of Cell Metabolism, a publication of Cell Press. Importantly, the researchers found, those effects of the drug occurred at a low dose that had no influence on feeding behavior, body weight, activity level, or energy expenditure.

The decades-old drug compound, known as m-chlorophenylpiperazine (mCPP), triggers serotonin receptors in the brain. The findings suggest a new strategy for treating the rising tide of people with type 2 diabetes via targeting the so-called serotonin 2C (5-HT2C) receptors.

“Though just a first step, this work provides a new direction in the search for novel pathways and molecules in the brain to target for the treatment of type 2 diabetes,” said Lora Heisler of the University of Cambridge. “The challenge now is to come up with drugs that selectively target 5-HT2C receptors safely and effectively.”

mCPP has primarily been used in scientific studies of the serotonin pathway and may not itself be appropriate for type 2 diabetes treatment due to its other known effects, Heisler added. Heisler’s collaborators included Joel Elmquist of the University of Texas Southwestern Medical Center and Andrew Butler of Louisiana State University System.

Serotonin is a chemical nerve messenger with effects on physiology and behavior, including mood, sleep, and appetite, that are mediated by multiple serotonin receptors clustered into seven distinct families that are widely expressed in the central and/or peripheral nervous systems, the researchers explained.

Earlier studies had explored serotonin-acting drugs in treating obesity, but the possibility of a direct role for serotonin in the development and treatment of type 2 diabetes has received little attention, they said.

Earlier studies revealed that mice lacking the 5-HT2C receptor develop insulin resistance and type 2 diabetes and later overeat and become obese. In the current study, the researchers examined whether a drug that acts on 5-HT2C receptors could improve glucose tolerance. They show in mouse models of obesity and insulin resistance that the drug does improve blood sugar levels. Moreover, it does so even at concentrations that do not lead to reductions in food intake or body weight.

The researchers further report evidence that the serotonin-acting drug may work by stimulating “a-melanocyte-stimulating hormone” (a-MSH) in the brain’s arcuate nucleus, a portion of the hypothalamus important for appetite control. They show that the primary effect of the drug on glucose balance requires activation of one type of a-MSH receptor, called melanocortin-4 receptors (MC4R).

“Our findings add to emerging evidence that the brain may have important influences on glucose metabolism and insulin action,” Heisler added.

While the findings do link serotonin pathways to improved blood sugar tolerance, serotonin supplements would not produce this effect, Heisler noted. That’s because serotonin taken in through the diet cannot cross the blood-brain barrier to reach the critical receptors.

“The identification of new classes of antidiabetic agents is a clinical imperative,” the researchers concluded. “The findings presented here identify a novel therapeutic application for a class of pharmacological compounds developed more than two decades ago. We demonstrate that 5-HT2C receptor agonists significantly improve glucose tolerance and [lower insulin levels in mouse] models of obesity and type 2 diabetes via an MC4R-dependent mechanism. These findings not only delineate specific neuronal pathways of relevance to a highly prevalent metabolic disease but also suggest that 5-HT2C receptor agonists may prove an effective and mechanistically novel treatment for type 2 diabetes.”

Posted by dlifenews at 02:18 PM | Comments (0)

Diabetes Increasing along U.S.-Mexico Border

November 5, 2007 (PAHO)—Diabetes has become the leading cause of death in Mexico and the third-leading cause of death among those living along the U.S. side of the border, health officials from the United States and Mexico said today in presenting the results of a new study coordinated by the Pan American Health Organization (PAHO).

Analyzing data from both sides of the U.S.-Mexico border, the study finds that type 2 diabetes is increasing throughout border area, along with risk factors for the disease. Some 1.1 million border residents 18 and older suffer from type 2 diabetes, and 836,000 are pre-diabetic. Nearly 22 percent of those with type 2 diabetes are unaware they have the disease.

"It is a serious problem when nearly a quarter of border residents who have diabetes do not know their health status. It means they cannot take the basic steps to prevent the progression of the disease and its complications," said Dr. María Teresa Cerqueira, Chief of PAHO's U.S.-Mexico Border Office.

The findings of the study were presented today at a Community Forum in El Paso, Texas, by representatives of PAHO's U.S.-Mexico Border Office, the Centers for Disease Control and Prevention (CDC), the Secretariat of Health (SSA) of Mexico, and more than 130 local and state governmental and nongovernmental organizations concerned about the growing public health burden of type 2 diabetes.

The study is based on data collected between 2000 and 2002 in 16 U.S. counties and 28 Mexican municipalities.

According to survey data in the study, only four in 10 residents with type 2 diabetes monitored their blood sugar levels during the 12 months prior to the study.

"Poor disease management and control produce higher rates of complications from diabetes, leading to lowered quality of life, physical disability and earlier mortality," said Dr. Agustin Lara, Director of the Elderly Health Program of Mexico's Secretariat of Health.

Dr. Rosalba Ruiz, coordinator of the PAHO Diabetes Project, noted that in 2002, health care for people with diabetes cost some $13,243 per capita per year. "Considering that diabetes alone represents 11 percent of U.S. health care expenditures, there is a very serious concern that in a short period of time the health systems in both countries will be overwhelmed by the needs of those who suffer from this disease."

Among other findings, the study shows that 90 percent of border residents suffering from diabetes are overweight or obese: 3 out of 10 are overweight, and 6 out of 10 are obese.

"Obesity and overweight are among the most important risk factors of type 2 diabetes, which is a preventable condition," said Dr. Cerqueira.

The study also finds that 1.8 million border residents overall suffer from hypertension, and among people with diabetes, 36 percent suffer from hypertension.

About 61 percent of diabetes sufferers in the border region have at least one other family member with the disease, according to the study. Family history of diabetes is an important risk factor, noted Dr. Cerqueira, and people with such a history should self-monitor their health status and seek advice during routine health checkups to detect subclinical stages of the disease.

PAHO and the World Health Organization recommend primary disease prevention, good nutrition, and physical activity as part of a healthy lifestyle that can prevent or delay the development of diabetes and reduce the need for health care services to treat its complications.

The border diabetes research project is the first to analyze the U.S.-Mexico border region as a single epidemiological unit. Researchers selected a representative sample from the entire population 18 years and older on both sides of the border. The study included a survey with 65 questions and clinical measures for weight, height, waist circumference, blood pressure, and blood glucose levels.

For additional information on the results of the study and recommendations on diabetes management and prevention, visit www.fep.paho.org.

Posted by dlifenews at 02:29 PM | Comments (0)

“dLife Holiday Helpline” Launches First-of-its-Kind Resource to Make Thanksgiving Dinner Healthy and Diabetes-Friendly

--Throughout November, www.dlife.com/holidayhelpline will be staffed with Registered Dietitians and Certified Diabetes Educators --

November 5, 2007, Westport, CT – Most Americans look forward to sitting down to a delicious Thanksgiving dinner. But for the 21 million Americans with diabetes and their families, friends, and hosts, Thanksgiving often means challenges and anxiety over what to eat and how to eat healthy. But not this year, thanks to the “dLife Holiday Helpline,” the first-ever resource to help people prepare a diabetes-friendly Thanksgiving meal, provided by dLife, the #1 destination for diabetes information, inspiration, and connection.

The dLife Holiday Helpline will be staffed with knowledgeable Registered Dietitians and Certified Diabetes Educators who will answer questions via an online forum, and provide tips on how to make standard Thanksgiving fare healthier for people with diabetes. This free service can be accessed through the dLife Holiday Helpline web portal, www.dlife.com/holidayhelpline, which also features over 8,000 recipes, more than 30 streaming step-by-step cooking videos and a comprehensive list of holiday-related tips. The dLife Holiday Helpline is free, and available 24/7, including last-minute advice on Thanksgiving Day.

Eating right is the biggest challenge for people with diabetes and those who cook for them. According to a recent dLife survey, 63 percent of participants indicated “food-related” challenges as the biggest obstacle in managing their diabetes. The holidays – with carbohydrate heavy traditional favorites, rich foods, desserts, and cocktails – present even greater problems. Nearly half (44 percent) of people with diabetes said avoiding food temptations is the hardest part about the holidays.

“As a chef, I find it a great professional challenge to makeover a notoriously unhealthy meal like Thanksgiving dinner, so that it can become healthy fare enjoyed by all around the table,” said celebrity chef Michel Nischan, who regularly appears on dLifeTV. “Having two sons with diabetes, I appreciate that the dLife Holiday Helpline will be staffed with trained professionals who can work with the household chef as they prepare to make their Thanksgiving enjoyable, tasty, and healthy for everyone invited to their table.”

November also marks National Diabetes Awareness Month, a condition that affects 7 percent of Americans. More than 41 million others have a condition called “pre-diabetes,” and are at greater risk for developing diabetes.

“Changing habits is one of the hardest things to do when you’re diagnosed with diabetes, and good eating habits present one of the biggest obstacles,” said Donna Rice, President of the American Association of Diabetes Educators. “The dLife Holiday Helpline helps those with diabetes overcome that very obstacle, making it an innovative resource for patients and their families.”

After nearly 40 years of living with diabetes, dLife founder Howard Steinberg knows firsthand the difficulty of managing temptations of holiday meals. “I know how hard the holidays can be for people with diabetes. The anxiety of sitting at a table where there are little choices that don’t raise your blood sugar can take all the fun out of the festivities. As the top destination for those living with diabetes, dLife always strives to become the best possible resource to support these challenges people with diabetes face each day. We’re hopeful the dLife Holiday Helpline will make Thanksgiving worry-free and diabetes-friendly.”

About dLife – For Your Diabetes Life
dLife is the only multimedia network serving the diabetes community. Its award winning media outlets include, dLifeTV — a weekly lifestyle series, and dLife.com — the #1 online destination for diabetes information, inspiration, and connection. The dLife.com Viewing Room offers original streaming video content — unique and entertaining information for people who have diabetes, prediabetes, or have a family member with diabetes. With over 8,000 recipes and 10,000 pages of superior content, dLife.com is the first of its kind. dLife also includes the dLife Diabetes Minute o