Diabetes Increases Risk of Heart Disease Death for Women

January 31, 2008 (Newswise) — The word is out: women are at risk for heart disease, just like men. In fact, roughly twice as many women in this country will die of heart disease, stroke, and other cardiovascular diseases than from all forms of cancer combined, including breast cancer, according to the American Heart Association.

Risk factors for heart disease and stroke have long been identified. Several risk factors cannot be controlled by the individual, such as sex, increasing age and a family history of heart disease. Others can be modified and include:

• Smoking
• High blood pressure and cholesterol
• Diabetes
• Sedentary lifestyle
• Body weight

Diabetes continues to be a growing problem in the United States for both men and women. A study published in the December 2007 issue of the European Heart Journal reveals that diabetes is a stronger risk factor for heart disease death in women than in men.

“The reason for the higher relative risk of coronary heart disease in women with diabetes than in men with diabetes is still unclear,” explains Ane Cecilie Dale, M.D., the study’s lead researcher and head of the Department of Circulation and Medical Imaging at the Norwegian University of Science and Technology in Trondheim. “But research in this field continues to go on.”

According to the U.S. Food and Drug Administration, diabetes affects approximately 8.9 percent of American women. The occurrence of diabetes is significantly higher among African American, Hispanic/Latino, American Indian, and Asian/Pacific Islander women than in white women.

Women with diabetes have a two to four times higher risk of dying from heart disease and stroke compared to women without diabetes, according to data from the American Heart Association. Women with diabetes are often overweight and suffer from high blood pressure, also known as hypertension, and high cholesterol levels, which can add to the risk.

“Women with diabetes need to be aware of the associated risk of heart disease. The most important thing to do for all persons with diabetes to protect themselves from heart disease and other diabetes complications is to have a good glucometabolic control with a blood glucose as near normal as possible,” Dale said. “They also need to control other risk factors like hypertension and blood cholesterol levels. In addition it is important to quit smoking, have a healthy diet and practice regularly exercise.”

Considering how complex the management of diabetes and heart diseases risks are, women should talk to their health care providers to develop a plan of action. Without the support of health care professionals, patients can easily feel overwhelmed.

Posted by dlifenews at 10:21 AM | Comments (0)

Intensive insulin Therapy Protects Kidneys in Critically Ill Patients

Reductions in kidney injury and mortality risk question thinking on 'stress diabetes'

January 30, 2008 (EurekAlert) — For critically ill patients, intensive insulin therapy (IIT) to keep blood sugar (glucose) at normal levels reduces the risk of acute kidney injury, reports a study in the March Journal of the American Society of Nephrology.

The new research builds on previous randomized trials, including more than 2,700 patients, which reached the "startling" conclusion that IIT reduces the risk of death in critically ill patients, according to lead author Dr. Miet Schetz of University of Leuven, Belgium. In those studies, one group of patients received IIT, with insulin given continuously to maintain normal glucose levels. The other group received conventional insulin therapy, in which blood glucose levels are allowed to rise above normal.

Dr. Schetz and colleagues re-analyzed the trial data, focusing on differences in the rates of acute kidney injury (AKI) between the two treatment groups. Acute kidney injury is a common and serious complication among patients admitted to the intensive care unit (ICU). It occurs in five to 30 percent of patients, with death rates exceeding 40 percent.

The re-analysis showed that AKI developed in 4.5 percent of patients assigned to IIT, compared to 7.6 percent of those receiving conventional insulin therapy. The reduction in AKI was greatest when glucose levels remained within the normal range.

Intensive insulin therapy was more effective in protecting against AKI in patients admitted to the ICU after surgery (surgical ICU), compared to critically ill patients who did not undergo surgery (medical ICU). "This difference can be explained by the fact that IIT is a preventive strategy that cannot heal damage that is already present," explains Dr. Schetz. “The medical ICU patients were much sicker to begin with and may have already had kidney damage.”

For many years, the medical community has considered high blood sugar levels in critically ill patients—called "stress diabetes"—as a beneficial reaction of the body to ensure adequate energy supply to the organs during severe illness. The new research grew out of studies led by Dr. Greet Van den Berghe, exploring the hormonal changes induced by critical illness. Subsequent trials found that strict glucose control with IIT reduced the risk of death in both surgical and medical ICU patients. Rates of organ failure were also lower with IIT compared to conventional insulin therapy. (Dr. Van den Berghe is a co-author of the new study.)

The new analysis builds on these results by confirming that IIT reduces the risk of AKI in critically ill patients, especially after surgery. “This finding is especially important, because intensive insulin therapy is the first medical treatment that has been clearly shown to protect the kidney of critically ill patients," Dr. Schetz adds.

More research is needed to clarify how IIT acts to protect the kidneys—whether by preventing direct kidney damage caused by high blood sugar, or through indirect effects. Regardless of the mechanism, Dr. Schetz concludes, "Since AKI is associated with increased morbidity and mortality, the goal should be to prevent its development."

Posted by dlife at 04:43 PM | Comments (0)

Study Finds Increasing Rates of Diabetes Among Older Americans

January 30, 2008 (EurekAlert) - The annual number of Americans older than 65 newly diagnosed with diabetes increased by 23 percent between 1994 to 1995 and 2003 to 2004, according to a report in the January 28 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

“The prevalence of diabetes mellitus is increasing, in part because of population aging, but also in younger persons,” according to background information in the article. The high rate of existing diabetes also contributes to a high rate of diabetes-related complications and premature death. “Awareness of the importance of active monitoring and management of diabetes has become more widespread; however, adherence to recommended practices remains low.”

Frank A. Sloan, Ph.D., and colleagues at the Duke University Medical Center, Durham, North Carolina, and colleagues analyzed Medicare program data for patients first diagnosed with diabetes during 1994 (33,164 patients), 1999 (31,722 patients) and 2003 (40,058 patients). This data was compared with that of two control groups consisting of individuals without the disease who were of similar race and ethnicity to those with diabetes. Death and complications of diabetes such as cardiovascular, cerebrovascular (damage to blood cells in the brain), ophthalmic (eye), renal (kidney) and lower extremity events were recorded.

“The annual incidence of diabetes increased by 23 percent between 1994 to 1995 and 2003 to 2004, and prevalence increased by 62 percent,” the authors write. After diagnosis, the death rate in patients having diabetes decreased by 8.3 percent when compared with those who were not diagnosed with the disease.

Most patients with diabetes experienced at least one complication within the next six years; for example, almost half had congestive heart failure. “Complication rates among persons diagnosed as having diabetes generally increased or stayed the same compared with those in the control groups during 1994 to 2004 except for ophthalmic diseases associated with diabetes,” the authors note. “In some cases, most notably renal events, including the most serious complications, there were increases in prevalence in both the diabetes and control groups.”

“Overall, our findings emphasize the overwhelming burden of diabetes, including the near 90 percent prevalence of an adverse outcome and many serious and resource-consuming outcomes such as coronary heart failure, myocardial infarction [heart attack] and stroke,” the authors conclude. “The burden of financing and providing medical care for persons older than 65 in the United States having diagnosed diabetes is growing rapidly as a result of increased incidence and, especially, prevalence of diagnosed diabetes, decreased mortality and overall lack of improvement in rates of complications in persons having diagnosed diabetes.”

Posted by dlife at 04:41 PM | Comments (0)

Medtronic Announces FDA Approval of CGMS iPro™ Continuous Glucose Recorder

Simplified Evaluation Tool for Physicians to Personalize Diabetes Treatment Programs

January 29, 2008 (Press Release) — Medtronic, Inc. (NYSE: MDT) today announced the FDA approval of a new physician-use continuous glucose monitoring (CGM) system, the CGMS® iPro™ Recorder. Physicians send patients home with the CGMS iPro Recorder to uncover patterns and potential problems that often go undetected with today’s standard glucose measurements like finger stick meters and HbA1c tests.

The new iPro Recorder is smaller, lighter in weight and less time consuming to use than previous CGMS recorders. Physicians can now gain added clinical insights from the CGMS iPro Recorder in a matter of minutes, while improved ergonomics give patients added freedom when wearing the device. Physician services associated with CGMS iPro are reimbursed from Medicare in all 50 states and have broad private insurance reimbursement.

Patients wear the CGMS iPro Recorder for three days, after which physicians can review the data and use the results to uncover glucose patterns and optimize patient therapy. Based on the detailed glycemic profiles collected from the CGMS iPro Recorder, physicians can better tailor diabetes treatment programs for each patient. This may be particularly helpful for patients who experience inconsistent high and low glucose levels, who experience hypoglycemia unawareness and who generally desire better control, as well as for women with gestational diabetes and pregnant women with diabetes.

“Diabetes is a disease of individuals, and requires very specific and customized care for each patient,” said Thomas Blevins, M.D., Texas Diabetes and Endocrinology, Austin , Texas . “iPro will help me work with my patients to identify how everyday activities can affect their diabetes management. A tool like this has the ability to open a window into a patient’s diabetes in a way that A1c and fingerstick measurements cannot.”

The CGMS iPro Recorder is attached to a tiny glucose sensor inserted just under the skin. During the course of three days, the recorder automatically measures and stores glucose values during daily activities like work, sleep, eating, and exercise. After the recording period is completed, the patient returns to the physician’s office where the device is removed and downloaded. The physician can then generate and interpret detailed glucose reports to determine changes to the patient’s therapy.

“CGMS iPro is the latest step in Medtronic’s CGM technology revolution,” said Chris O’Connell, president of the Diabetes business at Medtronic. “Medtronic has 10 years of CGM experience, and we continue to expand the application of our technologies into new and novel spaces. CGMS iPro represents a major breakthrough in making CGM a more central element of physician practice."

Posted by dlife at 01:59 PM | Comments (0)

Cutting Caffeine May Help Control Diabetes

January 29, 2008 (EurekAlert) - Daily consumption of caffeine in coffee, tea or soft drinks increases blood sugar levels for people with type 2 diabetes and may undermine efforts to control their disease, say scientists at Duke University Medical Center.

Researchers used new technology that measured participants’ glucose (sugar) levels on a constant basis throughout the day. Dr. James Lane, a psychologist at Duke and the lead author of the study, says it represents the first time researchers have been able to track the impact of caffeine consumption as patients go about their normal, everyday lives.

The findings, appearing in the February issue of Diabetes Care, add more weight to a growing body of research suggesting that eliminating caffeine from the diet might be a good way to manage blood sugar levels.

Lane studied 10 patients with established type 2 diabetes and who drank at least two cups of coffee every day and who were trying to manage their disease through diet, exercise and oral medications, but no extra insulin. Each had a tiny glucose monitor embedded under their abdominal skin that continuously monitored their glucose levels over a 72-hour period.

Participants took capsules containing caffeine equal to about four cups of coffee on one day and then identical capsules that contained a placebo on another day. Everyone had the same nutrition drink for breakfast, but were free to eat whatever they liked for lunch and dinner.

The researchers found that when the participants consumed caffeine, their average daily sugar levels went up 8 per cent. Caffeine also exaggerated the rise in glucose after meals: increasing by 9 percent after breakfast, 15 percent after lunch and 26 per cent after dinner.

“We’re not sure what it is about caffeine that drives glucose levels up, but we have a couple of theories,” says Lane, who is the lead author of the study. “It could be that caffeine interferes with the process that moves glucose from the blood and into muscle and other cells in the body where it is used for fuel. It may also be that caffeine triggers the release of adrenaline – the ‘fight or flight” hormone that we know can also boost sugar levels.”

Either way, he says, the higher sugar levels that result from caffeine are bad news for diabetic patients.

There are no current guidelines suggesting diabetics shouldn’t drink coffee, but Lane says that day may come, if further studies bear out their findings.

“Coffee is such a common drink in our society that we forget that it contains a very powerful drug – caffeine. Our study suggests that one way to lower blood sugar is to simply quit drinking coffee, or any other caffeinated beverages. It may not be easy, but it doesn’t cost a dime, and there are no side effects,” Lane says.

Posted by dlife at 01:56 PM | Comments (14)

Intensive Insulin Therapy Protects Kidneys in Critically Ill Patients

Reductions in kidney injury and mortality risk question thinking on 'stress diabetes'

January 29, 2008 (EurekAlert) — For critically ill patients, intensive insulin therapy (IIT) to keep blood sugar (glucose) at normal levels reduces the risk of acute kidney injury, reports a study in the March Journal of the American Society of Nephrology.

The new research builds on previous randomized trials, including more than 2,700 patients, which reached the "startling" conclusion that IIT reduces the risk of death in critically ill patients, according to lead author Dr. Miet Schetz of University of Leuven, Belgium. In those studies, one group of patients received IIT, with insulin given continuously to maintain normal glucose levels. The other group received conventional insulin therapy, in which blood glucose levels are allowed to rise above normal.

Dr. Schetz and colleagues re-analyzed the trial data, focusing on differences in the rates of acute kidney injury (AKI) between the two treatment groups. Acute kidney injury is a common and serious complication among patients admitted to the intensive care unit (ICU). It occurs in five to 30 percent of patients, with death rates exceeding 40 percent.

The re-analysis showed that AKI developed in 4.5 percent of patients assigned to IIT, compared to 7.6 percent of those receiving conventional insulin therapy. The reduction in AKI was greatest when glucose levels remained within the normal range.

Intensive insulin therapy was more effective in protecting against AKI in patients admitted to the ICU after surgery (surgical ICU), compared to critically ill patients who did not undergo surgery (medical ICU). "This difference can be explained by the fact that IIT is a preventive strategy that cannot heal damage that is already present," explains Dr. Schetz. “The medical ICU patients were much sicker to begin with and may have already had kidney damage.”

For many years, the medical community has considered high blood sugar levels in critically ill patients—called "stress diabetes"—as a beneficial reaction of the body to ensure adequate energy supply to the organs during severe illness. The new research grew out of studies led by Dr. Greet Van den Berghe, exploring the hormonal changes induced by critical illness. Subsequent trials found that strict glucose control with IIT reduced the risk of death in both surgical and medical ICU patients. Rates of organ failure were also lower with IIT compared to conventional insulin therapy. (Dr. Van den Berghe is a co-author of the new study.)

The new analysis builds on these results by confirming that IIT reduces the risk of AKI in critically ill patients, especially after surgery. “This finding is especially important, because intensive insulin therapy is the first medical treatment that has been clearly shown to protect the kidney of critically ill patients," Dr. Schetz adds.

More research is needed to clarify how IIT acts to protect the kidneys—whether by preventing direct kidney damage caused by high blood sugar, or through indirect effects. Regardless of the mechanism, Dr. Schetz concludes, "Since AKI is associated with increased morbidity and mortality, the goal should be to prevent its development."

Posted by dlifenews at 10:24 AM | Comments (0)

Environmental Pollution and Diabetes May be Linked

Scientists call for more research into neglected area

January 28, 2008 (EurekAlert) - Cambridge scientists are advocating additional research into the little understood links between environmental pollution and type 2 diabetes.

In the most recent edition of the Lancet, Drs. Oliver Jones and Julian Griffin highlight the need to research the possible link between persistent organic pollutants (POPs, a group which includes many pesticides) and insulin resistance, which can lead to adult onset diabetes.

In their commentary, Dr Jones and Dr. Griffin cite peer reviewed research including that of Dr D Lee, et al, which demonstrated a very strong relationship between the levels of POPs in blood, particularly organochlorine compounds, and the risk of type 2 diabetes.

“Of course correlation does not automatically imply causation,” says Dr. Jones. “But if there is indeed a link, the health implications could be tremendous. At present there is very limited information. Research into adult onset diabetes currently focuses on genetics and obesity; there has been almost no consideration for the possible influence of environmental factors such as pollution.”

Interestingly, in the Lee study an association between obesity and diabetes was absent in people with low concentrations of POPs in their blood. In other words, individuals were more at risk of diabetes if they were thin with high levels of POPs in their blood than if they were overweight but with low levels of POPs.

Dr Jones said: “I think research should be carried out to first test the hypothesis that POPs exposure can cause diabetes, perhaps using cell or tissue cultures, so we know for sure if this can occur. Assuming POPs can have this effect, the next step would be to try and develop a method of treatment for those people who might be affected.”

POPs came into prominence as effective pesticides with the introduction of DDT in the 1940s. However, many of these chemicals, including DDT, fell out of favour after they were blamed for the declining number of wild birds and other animals (brought to the public's attention in Rachel Carson's Silent Spring) and the possible negative human health effects. As the compounds biodegrade slowly, they continue to find their way into the food chain and ultimately into the blood streams of individuals even though many of these toxins were banned many years ago. Additionally, these compounds can persist in body fat for very long periods of time following exposure.

Posted by dlifenews at 03:25 PM | Comments (0)

Deficient Regulators in the Immune System Responsible for Type 1 Diabetes

January 25, 2008 (EurekAlert) - The main regulators of the immune system, called CD4+Treg cells, are thought to be highly involved in a large range of immune diseases. The gradual reduction in their regulating capacity seems to play a critical role in the onset of type 1 diabetes, as demonstrated in the latest study by Dr. Ciriaco Piccirillo, a researcher in the Department of Microbiology and Immunology at the Research Institute of the McGill University Health Centre and the principal investigator for this project. This study was published this month in the journal Diabetes.

The immune system needs to be regulated so that it attacks only the site of an inflammation and focuses its attack on pathogens rather than on the body tissues, causing an autoimmune disease.

In a healthy patient, CD4+Treg cells deactivate any T lymphocytes, a type of immune cell, that are misprogrammed and could attack the body. Dr Piccirillo’s research indicates that in type 1 diabetic patients this control mechanism may be deficient, thereby allowing the misprogrammed T lymphocytes to proliferate and gain the ability to destroy the insulin-producing cells of the pancreas. This leads to type 1 diabetes.

“We have been able to demonstrate this in mice with type 1 diabetes, and other genetic studies have shown that this same mechanism is applicable to humans,” explained Dr. Piccirillo. Dr Piccirillo is an assistant professor at the McGill University, and the Canada Research Chair in Regulatory Lymphocytes of the Immune System. “Furthermore, the predominant role of nTreg cells leads us to believe that they are also involved in other autoimmune pathologies. Finding this common denominator among diseases that were previously thought to be unrelated is a very promising avenue for future study”, he adds.

Although the mechanism of action of CD4+Treg cells has not yet been completely unravelled, the scientific community generally accepts that this mechanism is of crucial importance to the entire immune system. Major fundamental and applied research efforts are currently being directed down this path and aim to clarify the role of CD4+Treg cells in order to develop innovative cellular therapies that could restore immune stability in patients.

“The eventual hope is to treat the cause of type 1 diabetes and other autoimmune diseases and not just their symptoms, as we do today”, says Dr Piccirillo.

Posted by dlifenews at 10:44 AM | Comments (1)

Elusive Pancreatic Stem Cells Found in Adult Mice

January 25, 2008 (EurekAlert) - Just as many scientists had given up the search, researchers have discovered that the pancreas does indeed harbor stem cells with the capacity to generate new insulin-producing beta cells. If the finding made in adult mice holds for humans, the newfound progenitor cells will represent “an obvious target for therapeutic regeneration of beta cells in diabetes,” the researchers report in the Jan. 25 issue of Cell, a publication of Cell Press.

“One of the most interesting characteristics of these [adult] progenitor cells is that they are almost indistinguishable from embryonic progenitors,” said Harry Heimberg of the JDRF Center at Vrije Universiteit Brussel in Belgium and the Beta Cell Biology Consortium. “In terms of their structure and gene expression, there are no major differences. They look and behave just like embryonic beta cell progenitors."

Insulin is required for cells to take up blood sugar, the body’s primary energy source. In people with certain types of diabetes, blood sugar rises due to an inability of pancreatic beta cells to produce insulin in sufficient quantities.

Previous studies had failed to demonstrate the existence of bona fide beta cell progenitors in the pancreas after birth. The elusiveness of this cell type reached a summit when genetic lineage tracing provided evidence that pre-existing beta cells, rather than stem/progenitor cells, are the major source of new beta cells in adult mice, the researchers said. “Most people gave up looking because they are so few and so hard to activate,” Heimberg said.

In the new study, Heimberg’s team tied off a duct that drains digestive enzymes from the pancreas. That injury led to a doubling of beta cells in the pancreas within two weeks, they showed. The animals’ pancreases also began producing more insulin, evidence that the new beta cells were fully functional, Heimberg said. He suspects the regenerative process is sparked by an inflammatory response in the enzyme-flooded pancreas.

They further found that the production of new beta cells depends on a gene called Neurogenin 3 (Ngn3), which is known to play a role in the pancreas during embryonic development.

“The most important challenge now is to extrapolate our findings to patients with diabetes,” Heimberg said. Although he cautioned that any potential diabetes treatment remains far into the future, “our findings reveal the significance of investigating the feasibility of (1) isolating facultative beta cell progenitors and newly formed beta cells from human pancreas in order to expand and differentiate them in vitro and transplant them in diabetic patients and (2) composing a mix of factors able to activate beta cell progenitors to expand and differentiate in situ in patients with an absolute or relative deficiency in insulin,” the researchers wrote.

Posted by dlifenews at 10:41 AM | Comments (0)

Overweight Patients with Diabetes Appear More Likely to Achieve Remission with Weight-Loss Surgery

January 23, 2008 (EurekAlert) - Preliminary research indicates that obese patients with type 2 diabetes who had gastric banding surgery lost more weight and had a higher likelihood of diabetes remission compared to patients who used conventional methods for weight loss and diabetes control, according to a study in the January 23 issue of JAMA.

“Obesity and type 2 diabetes are likely to be the 2 greatest public health problems of the coming decades. The conditions are strongly linked, with the increased prevalence of diabetes correlating with the increased prevalence of obesity,” the authors write. Weight control is perhaps the most important aspect of type 2 diabetes management. Recent evidence indicates that improvement in blood glucose control is related to the degree of weight loss.

Currently available lifestyle and pharmacological strategies provide only small to modest levels of weight loss, a problem compounded by patients with diabetes experiencing greater difficulty in losing weight than those without diabetes. Significant sustained weight loss as a result of bariatric surgery has never been formally studied as a treatment for type 2 diabetes in obese participants, according to background information in the article.

John B. Dixon, M.B.B.S., Ph.D., of Monash University, Melbourne, Australia, and colleagues conducted a 2-year trial involving 60 obese participants (body mass index [BMI] greater than 30, less than 40) to compare surgically induced weight loss with conventional therapy for the management of type 2 diabetes. Patients were randomized to receive either conventional diabetes therapy with a focus on weight loss by lifestyle change or laparoscopic adjustable gastric banding with conventional diabetes care. Of the 60 patients enrolled, 55 (92 percent) completed the 2-year follow-up.

The researchers found that remission of type 2 diabetes was achieved by 26 study participants (43 percent) at two years, with 22/30 (73 percent) from the surgical program and 4/30 (13 percent) from the conventional-therapy program. This represented 76 percent and 15 percent remission rates for those in the surgery and conventional-therapy groups, respectively. Greater percentage of weight loss at two years and lower baseline HbA1c values (hemoglobin used primarily to identify the average plasma glucose concentration) were independently associated with remission, but percentage of weight loss alone explained most of the variance.

“After 2 years, the surgical group displayed a 5 times higher remission rate and 4 times greater reduction in HbA1C values than the conventional-therapy group,” the authors write.

The surgical group achieved an average 20.7 percent body weight loss at two years, compared with 1.7 percent among the conventional-therapy group, representing a loss of 62.5 percent of excess weight (using BMI of 25 as ideal weight) in the surgical group compared with 4.3 percent in the conventional-therapy group. There were no serious complications in either group.

“An important finding of this study is that degree of weight loss, not the method, appears to be the major driver of glycemic improvement and diabetes remission in obese participants. This has important implications, as it suggests that intensive weight-loss therapy may be a more effective first step in the management of diabetes than simple lifestyle change. This study shows that few participants achieved remission with a body weight loss of less than 10 percent, a level expected to produce important health benefits,” the researchers add.

“While caution is required in interpreting the longer-term benefits of surgery and weight loss, this study presents strong evidence to support the early consideration of surgically induced loss of weight in the treatment of obese patients with type 2 diabetes,” they conclude.

Posted by dlifenews at 10:15 AM | Comments (1)

Whole Grain Foods Might Reduce Diabetes Risk, But Evidence Weak

January 22, 2008 (HBNS) - Many have touted whole grain foods as a way to prevent type 2 diabetes, and a new review finds a reduction in risk for people who consume a diet high in unrefined grains. However, the authors caution that more research is necessary before scientists can confirm a causal relationship.

“At the moment, because there is only weak evidence, no definite conclusion can be drawn concerning the protective effect of whole grain foods for the development of type 2 diabetes,” said lead review author Marion Priebe.

Refined cereal food products remove the nutrient- and fiber-rich bran and germ of the grain, leaving only the starchy inner parts. A decrease in consumption of whole grain cereals over the last decade, occurring at the same time as an increase in type 2 diabetes, has lead to the theory that there is a connection between the two.

Priebe, a nutritionist and epidemiologist at the Center for Medical Biomics, University Medical Center Groningen in the Netherlands, and colleagues reviewed 12 studies that examined relationships between whole grain intake and type 2 diabetes. These studies consisted of a single randomized controlled clinical trial and 11 prospective studies.

The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

In the prospective studies, researchers followed groups of people without diabetes over long periods to see whether those who consumed more whole grain foods were less likely to get the disease than other participants were. These studies consistently showed a reduction of risk for the disease in those with a high intake of whole grain foods or cereal fiber.

Two of the studies that looked at the effect of whole grain consumption on weight, an important diabetes risk factor, found only a slight improvement.

Scientists consider evidence from prospective studies to be weaker than that from randomized controlled trials. Other factors, like an overall healthy lifestyle, can also influence the development of type 2 diabetes and it is not possible to completely correct for known and possibly unknown factors in this study design.

In randomized controlled trials, which are more difficult to perform, researchers can exclude — or control for — other influences on the development of the disease.

Priebe said she was surprised that only one randomized trial on this topic exists: “As type 2 diabetes mellitus is reaching epidemic proportions and diet is considered as a modifiable risk factor, it is important to have a sound knowledge of which kinds of food can contribute to the prevention of this disease and to identify gaps in this knowledge.”

Osama Hamdy, M.D., medical director of the Clinical Obesity Program at the Joslin Diabetes Center in Boston, said the kinds of data used within the review are troubling. He said that studies about diabetes prevention should be randomized controlled trials over long durations. Although the concept of a whole–grains-rich diet as a possible diabetes preventative is interesting, he said, none of the review studies would enable any kind of cause-and-effect conclusion.

“This is an additional piece of information that tells us diets rich in whole grains will probably do some good in the prevention of type 2 diabetes,” Hamdy said. “It is not a shortcut to tell you exactly what you need. It is just more support of a concept that has been around for a long time.”

“Whole grain foods are rich in dietary fiber and nutrients and they are recommended to be consumed together with plenty of fruit and vegetables for a healthy diet,” Priebe said. The findings of this review are in line with those recommendations.”

Posted by dlifenews at 10:12 AM | Comments (1)

Why High-Protein, Low-Fat, and Low-Carbohydrate Diets Suppress Hunger

January 21, 2008 (Newswise) — Many popular diet plans are based on changing the proportion of carbohydrates, proteins, and fats one ingests as a method to promote weight loss. There has been some controversy regarding the effectiveness of these diets, but a new study accepted for publication in the Journal of Clinical Endocrinology & Metabolism (JCEM) could shed light on potential mechanisms by which various diets promote weight loss.

This study examined the relative ability of different nutrient types to suppress ghrelin, which is secreted by the stomach and is the only known appetite-stimulating hormone. Circulating ghrelin levels increase shortly before meals and then decrease promptly after ingestion of food.

“We found that when fat is consumed, levels of ghrelin remain relatively high, which could in turn stimulate hunger,” said Dr. Karen Foster-Schubert of the University of Washington School of Medicine in Seattle, Washington. “Protein consumption resulted in the greatest suppression of ghrelin over a long period and, interestingly, consumption of carbohydrates resulted in a strong ghrelin suppression initially, although subsequent ghrelin levels rebounded well above baseline.”

In this study, subjects were given three beverages with widely varying compositions of macronutrients (carbohydrates, fats, and proteins). Blood samples were taken before the first beverage was ingested and every 20 minutes for six hours thereafter. Researchers then measured the ghrelin levels in each sample.

“These findings open the door to future research on the effectiveness of varying methods of dieting,” said Foster-Schubert. “Improving our understanding of the regulation of ghrelin by ingested macronutrients could facilitate rational design of weight-reducing diets.”

Other researchers involved in this study include Joost Overduin, Holly Callahan, and David Cummings of the University of Washington School of Medicine in Seattle, Washington; and Jianhua Liu, Bruce Gaylinn, Michael Thorner, and Catherine Prudom of the University of Virginia in Charlottesville, Virginia.

A rapid release version of this paper has been published on-line and will appear in the April 2008 issue of JCEM, a publication of The Endocrine Society.

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 over 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. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit our web site at www.endo-society.org.

Posted by dlifenews at 02:51 PM | Comments (0)

Welchol™ (colesevelam HCl) Receives FDA Approval to Reduce Blood Glucose in

First and only medication approved to reduce both A1C and LDL cholesterol

January 18, 2008 (Press Release) – Daiichi Sankyo, Inc., announced today that the United States Food and Drug Administration (FDA) has approved Welchol™ (colesevelam HCl) to improve glycemic control (measured as hemoglobin A1C) in adults with type 2 diabetes mellitus in combination with metformin, sulfonylureas, or insulin, either alone or in combination with other anti-diabetic agents. Welchol is now the first and only medication approved to reduce both glucose levels and low density lipoprotein cholesterol levels (LDL-C). The ADA estimates that 20.8 million people in the United States have diabetes with more than 90 percent of these people having type 2 diabetes.1 Forty percent of patients with type 2 diabetes also have high LDL-cholesterol2. Welchol is a new option that addresses both these chronic health conditions and provides physicians with a unique therapeutic approach for treating patients with type 2 diabetes.

Pivotal data presented at the American Diabetes Association’s (ADA) 67th Annual Scientific Sessions in Chicago in June, 2007 demonstrated that Welchol can lower both A1C and LDL-C levels in patients with type 2 diabetes who were uncontrolled on a metformin-based regimen. Patients in the study were randomly assigned to two groups. The addition of Welchol was compared to the addition of placebo in patients on a metformin-based regimen. The addition of Welchol (n=79) to pre-existing metformin monotherapy achieved a significant mean reduction in A1C levels of 0.47 percent relative to placebo (p<0.0024). Further, the total Welchol treatment group, when treated with either metformin monotherapy or metformin-combination therapy, achieved significantly greater reductions in A1C levels compared to placebo (mean reduction of 0.54%; p<0.001). The study further demonstrated that the total Welchol treatment group achieved significantly lower LDL-C levels compared to the placebo group (mean reduction of 15.9%; p<0.001).

In addition, two other pivotal studies showed similar results in A1C reductions when Welchol was added to either sulfonylurea-based therapy or insulin-based therapy. In patients with type 2 diabetes who were inadequately controlled on sulfonylurea-based therapy the addition of Welchol was shown to have significant reductions in A1C (mean reduction of 0.54%; p<0.001) vs. placebo at week 26. In patients inadequately controlled with insulin, alone or in combination with other anti-diabetic agents, the addition of 2 Welchol was shown to have a significant mean reduction in A1C (mean reduction of 0.50%; p<0.0001) vs. placebo.

"Welchol now offers physicians a treatment option that addresses two major cardiovascular risk factors; elevated LDL cholesterol and blood glucose in patients with type 2 diabetes," said Ronald B. Goldberg, MD, an investigator in the insulin and metformin pivotal studies and Professor of Medicine at the Division of Diabetes and Metabolism and Associate Director of the Diabetes Research Institute at the University of Miami, Miller School of Medicine in Florida. “Cardiovascular risk factors are of great concern because patients with type 2 diabetes have a significantly increased risk of developing cardiovascular disease. Once clinical cardiovascular disease develops, these patients have a poorer prognosis than normoglycemic patients.”

Since 2000, Welchol, a bile acid sequestrant, has been indicated, alone or in combination with a statin, for the reduction of elevated LDL-C in patients with primary hypercholesterolemia. It is different from most other cholesterol-lowering drugs on the market because it is non-systemic, meaning that the body does not absorb it and it is eliminated without traveling to the liver or kidneys. Therefore, Welchol is not expected to have drug interactions via the cytochrome P450 pathway. Systemic medications, which include statins, fibrates and cholesterol absorption inhibitors, are those that are absorbed from the intestine into the bloodstream and travel throughout the body, specifically to the liver and/or kidneys.

Additionally, Welchol has demonstrated beneficial effects on other lipid parameters such as HDL- C and APO-B. Welchol has also been studied in combination with fenofibrate in patients with mixed dyslipidemia (Fredrickson Type IIb), and provided additional LDL-C reductions in these patients when added to a stable fenofibrate regimen. Welchol is not indicated for use in combination with fenofibrate or in the treatment of mixed dyslipidemia or lipid parameters other than LDL-C.

"We are excited by the opportunity to help more patients with chronic conditions reach their recommended health goals,” said Joseph P. Pieroni, President and CEO of Daiichi Sankyo, Inc. “This approval represents an important milestone for our growing U.S. organization and underscores our continued commitment to combating cardiovascular and metabolic diseases.”

People with diabetes face significantly higher risk of developing cardiovascular disease. The ADA recommends that patients with type 2 diabetes target an A1C level of < 7%.4 A1C is a common test for persistent hyperglycemia (“too much glucose in the blood”). Additionally, the National Cholesterol Education Program (NCEP) recommends that patients with type 2 diabetes keep their cholesterol levels in check and target an LDL-C goal of < 100 mg/dL.5 Despite this recommendation, nearly 40 percent of
patients with type 2 diabetes have LDL cholesterol levels greater than 130 mg/dL.

It is estimated that half of all Americans have elevated blood cholesterol levels that can negatively impact their health and quality of life.7 According to the National Healthcare Quality Report, nearly 40 percent of adults with high cholesterol also have type 2 diabetes.

Posted by dlifenews at 02:37 PM | Comments (0)

How Does Insulin Influence Resistin?

January 17, 2008 (EurekAlert) - Obesity is a worldwide health problem directly linked to several diseases such as hypertension and type 2 diabetes. Resistin is a cysteine-rich hormone mainly secreted by adipose tissues and may form a biochemical link between obesity and type 2 diabetes.

It has been reported insulin inhibits resistin mRNA level in 3T3-L1, which does not support a role for resistin in insulin resistance. Does resistin play a role in insulin resistance? Is insulin the major regulator of resistin?

A research article to be published on January 7, 2008 in the World Journal of Gastroenterology (volume 14, issue 1) addresses these questions. The research team led by Dr. Guo Xi-Rong studied the resistin action in vitro and resistin secretion. In addition to this, diet-induced obese rats were used to study the relationship between insulin, resistin and insulin resistance.

One result reported by the investigators was resistin expression and secretion was enhanced during 3T3-L1 pre-adipocytes differentiation, insulin inhibits resistin expression and secretion. Insulin does not support a role for resistin in insulin resistance.

The result showed resistin induces cellular insulin resistance in H4IIE hepatocytes and L6 rat myoblasts. Serum resistin negatively correlates to insulin sensitivity, not to serum insulin in diet-induced obesity rats.

The results of this study suggest insulin inhibits resistin secretion and resistin induces insulin sensitivity. In vivo study shows serum resistin correlated to rat insulin sensitivity, so insulin is not the major regulator of resistin. Resistin induced hepatocytes insulin resistance takes part in diet induced insulin resistance.

Posted by dlifenews at 09:40 AM | Comments (0)

Type 1 Diabetes Triggered By 'Lazy' Regulatory T-cells

January 17, 2008 (Science Daily) - A research team led by Dr. Ciriaco A. Piccirillo of McGill University's Department of Microbiology and Immunology has discovered that in some individuals, the specialized immunoregulatory T-cells that regulate the body's autoimmune reactions may lose their effectiveness and become "lazy" over time, leading to the onset of type 1 diabetes.

The study -- conducted on non-obese diabetic (NOD) mice, which were genetically engineered to model human diabetes -- was published in the January 2008 edition of the journal Diabetes.

In diabetes mellitus, or type 1 diabetes, insulin-producing beta islet cells in the pancreas are attacked and destroyed by the body's own immune system. Patients must inject insulin on a regular basis or risk diabetic shock and death, and are also at increased risk for numerous secondary health problems, including blindness, heart attack and stroke.

"The genetic and cellular mechanisms by which the immune system goes out of control and destroys the islets has been an enigma and an area of great interest over the last few decades," said Dr. Piccirillo, Canada Research Chair in Regulatory Lymphocytes of the Immune System, and a leading figure in this research area. "For the last several years, it's been postulated that non-functional regulatory T-cells are the critical mechanism, and this study proves it."

Regulatory CD4+ T-cells, whose development and function is dictated by the Foxp3 gene in mice and humans, "have the primary function of pouring a cold shower on inflammatory responses," explained Dr. Piccirillo. "They suppress and regulate the function of various immune responses to microbes, tumors, allergens and transplants." While the diabetes-susceptible NOD mice actually generate normal numbers of Foxp3 T-cells over their lifetimes, Dr. Piccirillo and his colleagues discovered that the T-cells' functional potency declined with age, leaving potential autoimmune responses in the pancreas unchecked.

It is likely, the researchers say, that certain genetic predispositions, coupled with the possible contribution of external environmental factors or infections, could potentially alter regulatory T-cell function in susceptible individuals and trigger a full-scale diabetic autoimmune reaction in the pancreas.

"Once they start, these immune responses are like a fire that goes unchecked by firemen, or a car going downhill without brakes," said Dr. Piccirillo. Moreover, he said, this discovery not only elucidates the mechanism by which type 1 diabetes is triggered, but it also points the way to the development of new immune system-based therapies for a whole range of diseases.

"We believe that these regulatory cells may represent a kind of master switch, and by understanding how they are made, how they function and how they survive, we may be able to stop disease from occurring."

Posted by dlifenews at 09:36 AM | Comments (0)

Scientists Study the Link Between Children's Nutrition and Adult Diseases

January 16, 2008 (EurekAlert) - Researchers from the Department of Pediatrics of the University of Granada, in collaboration with another 38 universities and companies from 16 European countries, will study the effects of children’s nutrition on the onset of cardiovascular problems, diabetes, obesity, allergies, weak bones, neuromotor functioning and children’s behavioural aspects. The EARNEST project (The Early Nutrition Programming Project) aims to help in the development of policies, information campaigns, documents, guides and recommendations on the nutritional components of children’s food, for the improvement of children’s formulas. It also collaborates in the design of plans preventing and avoiding nutrition effects on the metabolism.

Thanks to this project, the University of Granada becomes the only Spanish investigation centre taking part in this ambitious initiative, the first of its kind in Europe. Cristina Campoy Folgoso, the professor heading this initiative in Granada, emphasizes that the “early nutrition programming” is quite a recent subject in the health and science field today. “Different studies show how food can have long-term consequences in children’s growth and health during pregnancy, the breastfeeding period and childhood. Moreover, food can also have influence over the later onset of diseases”, states the researcher.

Study of diseases

This project aims to answer the question about the extent of nutrition effects of prenatal, postnatal, and infant diets of someone among the current European population in critical periods of development as well as the efficiency of actions preventing and avoiding long, medium and short-term metabolic effects on health.

The project will tackle randomly assigned clinical tests and nutritional interventions during pregnancy and childhood, pilot studies, tests on animals, cells and genomita, as well as social and economic studies connected with nutrition in the first stages of life and their significance in the development of later diseases. The researchers hope to find the genetic mechanism of diseases such as diabetes and obesity with this project. “Obesity, a growing global epidemic, begins, partly, during child development –explains professor Campoy Folgoso-. It is known that breastfed children’s growth kinetics differ from those fed with commercial foods. These children easily gain weight and height. Considering these consequences, linked with eating habits, the purpose of this project is to study whether breastfeeding can prevent a later risk of obesity.

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

Researchers Report Breakthrough in Lowering Cholesterol, Fatty Acids

January 14, 2008 (Newswise) — Researchers at the University of Alberta, in Edmonton, Canada, have found a way to reduce the amount of bad cholesterol and fatty acids that end up in the blood from food the body metabolizes, a key discovery that could lead to new drugs to treat and reverse the effects of Type 2 diabetes and heart disease related to obesity.

In a series of recently published articles,* Dr. Richard Lehner and his colleagues report they successfully decreased the level of LDL (low-density lipids) – the so-called bad cholesterol – and triglycerides in the blood of mice and hamsters by manipulating a particular enzyme.

It’s well-known that eating too much fat and sugar and too little exercise will make you fat, and that obesity often leads to diabetes and heart disease. Lehner’s group studied the mechanisms behind this.

“We established the proof of principle of how these metabolic pathways work,” he says. “We discovered the activity of an enzyme that releases fatty acids from fat cells and the liver into the blood and how to inhibit this from happening.”

Drugs called statins are used to lower LDL levels in patients, but do not treat obesity. What makes the U of A researchers’ findings noteworthy is their discovery of how to inhibit LDL and triglycerides, which are another form of fat in the blood and a leading risk in obesity-related Type 2 diabetes as well as heart disease.

Lehner is director of the Group on Molecular and Cell Biology of Lipids in the U of A’s Faculty of Medicine and Dentistry. The research is being supported by the Canadian Institutes of Health Research and the Heart and Stroke Foundation.

Lehner is also a senior scholar for the Alberta Heritage Foundation for Medical Research.

“There is a substantial pharmacological interest in the enzymes that control TG (triglycerides – fatty acids) and cholesterol metabolism in tissues,” he says.

This unique discovery is an important scientific breakthrough, but one that requires further testing, he notes.

He also notes that a pill would not be “a magic bullet.” People still need to make the right lifestyle choices by exercising and eating properly, he says.

*Journal of Lipid Research (December 2007); Journal of Biological Chemistry (November 2007, March 2007)

Posted by dlifenews at 10:18 AM | Comments (0)

Novo Nordisk Refocuses Its Activities Within Inhaled Insulin and Discontinues the Development of AERx®

January 14, 2008 (Press Release) - Based on a detailed analysis of the future prospects for inhaled insulin and a review of the medical and commercial potential of the AERx® iDMS inhaled insulin system (AERx®), Novo Nordisk has decided to refocus its inhaled insulin activities and discontinue all further development of AERx®. The decision to discontinue the development of AERx® is not due to safety concerns. The decision impacts the company's 2007 operating profit with a non-recurring cost of around DKK 1.3 billion.

"The AERx® system has been developed for delivering fast-acting insulin in connection with meals, and we have concluded that fast-acting inhaled insulin in the form it is known today is unlikely to offer significant clinical or convenience benefits over injections of modern insulin with pen devices such as Novo Nordisk's FlexPen®," says Lars Rebien Sørensen, president & CEO of Novo Nordisk. He continues: "In general, people with type 2 diabetes start insulin therapy with long-acting or premixed insulin, and experience shows that they want very simple, very convenient devices for administering their insulin. This requires a completely new approach to inhalation of insulin."

Against this background, Novo Nordisk will increase research and development activities targeted at inhalation systems for long-acting formulations of insulin and GLP-1. The activities will take place at two centres of excellence in Hayward, California, and Hillerød, Denmark.

The people with diabetes who are currently participating in phase 3 clinical trials with AERx® will be switched to the treatment alternative recommended by their doctors. Subject to local regulations, Novo Nordisk will fund medication and medical supervision for the planned duration of the trials.

"We regret the inconvenience caused by the termination of the trials and will do our utmost to support doctors and medical staff in ensuring as smooth a transition as possible for the affected patients," says Lars Rebien Sørensen.

Activities related to clinical development and manufacturing of AERx® devices and insulin strips will be discontinued. As a consequence of this decision, a significant number of employees at Novo Nordisk's site in Hayward, California, are expected to become redundant.

Financial implications
For 2007, a non-recurring cost of discontinuing all clinical development and manufacturing activities related to the AERx® system is expected to amount to around DKK 1.3 billion which will negatively impact operating profit in 2007. Around DKK 900 million relates to write-down and impairment of tangible and intangible assets, around DKK 300 million relates to the discontinuation of clinical trials and, finally, around DKK 100 million relates to other exit costs such as leasing and investment commitments. For 2007, the discontinuation will not impact the reported cash flow.

Novo Nordisk will provide financial results for 2007 and detailed financial guidance for 2008 in connection with the release of the full-year 2007 financial results on 31 January 2008.

However, at the current point in time, Novo Nordisk can reconfirm the sales growth guidance given in connection with the release of the financial results for the first nine months of 2007 on 31 October 2007. For 2007, sales growth measured in local currencies is now expected to be realised in the middle of the 11-14% range indicated as part of the release of the financial results for the first nine months of 2007. Furthermore, as the discontinuation primarily impacts R&D costs in 2007, Novo Nordisk now expects the R&D to sales ratio for 2007 to be slightly more than 20%.

For 2008, the discontinuation of further development of AERx® is expected to result in an R&D to sales ratio of around 17% including a non-recurring cost of around DKK 300 million related to severance payments and other costs.

Posted by dlifenews at 09:33 AM | Comments (0)

Researcher Uncovers Possible Explanation for Ties Between Diabetes, Heart Disease

January 11, 2008 (Newswise) — A researcher at the University of Virginia Health System is demonstrating why so many people with diabetes may have heart disease. Assistant Professor of Internal Medicine Dr. Zhenqi Liu has shown that in healthy humans, insulin greatly increases blood flow in heart muscle. His work was recently published in the American Journal of Physiology – Endocrinology and Metabolism.

The study involved 13 healthy volunteers who had fasted overnight experienced a 41 percent increase in microvascular (smallest blood vessels) blood volume in heart tissue after an insulin infusion.

Now, Dr. Liu is conducting trials focused on insulin resistance, a cardinal feature of type 2 diabetes. He is testing the theory that insulin resistance limits circulation in heart muscle in patients with type 2 diabetes and is the major contributor to the development of heart disease in diabetic patients.

"I hope findings from this project will eventually lead to the development of new ways to diagnose and treat diabetes-related cardiac complications," Dr. Liu says.

Posted by dlifenews at 04:43 PM | Comments (0)

Good News! Heart Health Improved with Vitamin E for 40% of Type 2 Diabetics

January 11, 2008 (Newswise) — Vitamin E supplements can significantly reduce the risk of heart attacks and related deaths for type 2 diabetics who carry a particular version of a gene, according to researchers at the Technion-Israel Institute of Technology and Clalit Health Services in Israel.

After 18 months of treatment, people with the haptoglobin (Hp) 2-2 gene who took 400 International Units (IU) of vitamin E daily had more than 50 percent fewer heart attacks, strokes, and related deaths than Hp 2-2 patients who took a placebo pill. 40% of individuals with diabetes carry the Hp 2-2 gene.
The findings were published in the November 21 online edition of the journal Arteriosclerosis, Thrombosis, and Vascular Biology.

Most of the difference came from the reduced number of heart attacks among those taking vitamin E. In the group of 1,434 Hp 2-2 individuals taking part in the study, seven people had a heart attack, compared to 17 who did not take the vitamin. Dr. Andrew Levy, of the Technion Faculty of Medicine, said there were no side effects observed in patients who took vitamin E.

The study suggests that genetic testing for the Hp 2-2 gene “may be useful to identify a large group of diabetes individuals who could potentially derive cardiovascular benefit from a very inexpensive treatment,” Levy said.

The finding is a new answer to an old question: can antioxidant vitamins such as vitamin E help prevent heart disease? Previously, cardiologists routinely prescribed vitamin E for their patients, but the practice has dwindled as several major studies in the past decade showed no heart-protective effects and potential harm from vitamin E mega-doses.

However, Levy and colleagues suspected that there might be one group of patients who could benefit from vitamin E: diabetic individuals with a particular variant of the haptoglobin gene. Haptoglobin is a powerful antioxidant protein that stabilizes the iron-rich red blood cell molecule called hemoglobin, preventing inflammation in the walls of arteries.

There are several versions of the haptoglobin gene. In previous studies, Levy and colleagues showed that Hp 2-2 is an inferior antioxidant compared to its genetic siblings, and that this difference is exaggerated in patients with diabetes. The researchers also discovered that diabetic patients with Hp 2-2 are two-to-three times more likely than other diabetics to suffer a cardiovascular event such as a heart attack.

“This version of the gene does not determine whether or not an individual will develop diabetes but rather whether an individual with diabetes is susceptible to developing the devastating complications associated with diabetes such as heart disease, kidney disease or visual loss,” Levy noted.

A genetic test for Hp 2-2 is commercially available, said Levy, who is also a consultant for Synvista Therapeutics, which owns a patent on the use of Hp testing to predict diabetic complications.

By making a kit, the group hopes to considerably lower the price of testing. According to Levy, the test would cost about $30 and only have to be done once.

Posted by dlifenews at 04:40 PM | Comments (0)

Type 2 Diabetics Require Special Heart Care

January 11, 2008 (Newswise) — The worldwide obesity epidemic is of top concern to Dr. George A. Beller, Professor of Cardiology at the University of Virginia Health System. As he explains it, patients who are obese often have type 2 diabetes, a condition that requires special heart care.

Type 2 diabetes is the most common form of diabetes mellitus. People who have this condition are resistant to their insulin and often develop inflammation in their coronary arteries. Although type 2 diabetes commonly occurs in adults, an increasing number of overweight children and adolescents are also developing it.

Six years ago, Dr. Beller established one of the nation’s first combined Diabetes-Cardiovascular Disease clinics at UVA to care for diabetic patients with suspected or known heart disease. At the clinic, a cardiologist and an endocrinologist who specializes in diabetes use a team-based approach to treat patients.

“About 70 percent of diabetics die from cardiovascular disease,” notes Dr. Beller. “That’s why our clinic acts as if the diabetics we treat already have some degree of heart disease, even if they have never exhibited any signs of it.”

Treatment goals for diabetic patients without heart disease symptoms include reducing their LDL (bad cholesterol) to under 100, which often requires use of cholesterol lowering drugs like statins. “An LDL below 100 is the same level we aim for when treating someone who has had a heart attack,” says Dr. Beller. “We also focus on getting the patient’s systolic blood pressure below 135 and place them on aspirin.”

When treating a diabetic patient with heart disease, cardiologists have to get “extremely aggressive,” Dr. Beller says. “These people have a much greater risk of having a heart attack or dying of heart disease than someone who isn’t diabetic.”

Diagnostic testing is the first step in assessing diabetic patients whose symptoms suggest they may have heart disease. “Many obese type 2 diabetics who have heart disease may experience shortness of breath with exertion rather than chest pain. Such patients need to have stress testing with cardiac nuclear imaging or echocardiography to detect if they have severe blockages in their coronary arteries,” notes Dr. Beller.

When heart disease is detected, cholesterol goals become even more stringent. Treatment plans focus on getting a patient’s LDL under 70 and their HDL (good cholesterol) above 40.

As Dr. Beller notes, a crucial element of treatment is encouraging diabetics to make lifestyle changes that include weight loss and exercise. “Obesity is driving the epidemic of type 2 diabetes, and drugs alone will not solve the problem,” he says. “Obese people who lose just ten percent of their body weight can reverse inflammation of the arteries and reverse many other cardiometabolic abnormalities.”

Posted by dlifenews at 04:37 PM | Comments (0)

Insulin First Used Successfully 86 Years Ago Today

January 11, 2008 (DiabetesUK) - Eighty-six years ago today Canadian Frederick Banting administered the first insulin injection.

In 1922 Banting's work came to a head as he injected a man called Leonard Thompson with insulin. Thompson lived for another 13 years.

Banting thought of his "great idea" to find the active secretion of the Islets of Langerhans whilst working at a medical school in Ontario. He persuaded Professor JJR Macleod of Toronto to help him along with Charles Herbert Best and James Bertram Collip.

They conducted research on depancreatised dogs which was central to the discovery of insulin.

Nobel Prize

Banting and Macleod were awarded the Nobel Prize for Medicine in 1923.

Although Banting's contribution to diabetes and other medical research was cut short when he died in an air crash in 1941, the discovery of insulin has saved the lives of many people with diabetes and transformed the quality of life for countless more.

Posted by dlifenews at 10:14 AM | Comments (0)

Warning Over Severe Weight Loss Caused by Chewing Gum

January 11, 2008 (Newswise) — In this week’s BMJ, doctors warn of excess sorbitol intake, a widely used sweetener in “sugar-free” products such as chewing gum and sweets.

Sorbitol has laxative properties and is poorly absorbed by the small intestine.

Their advice follows the cases of two patients with chronic diarrhoea, abdominal pain and severe weight loss. Although extensive investigations were carried out, final diagnosis was only established after detailed analysis of eating habits.

On questioning, both patients admitted consuming substantial amounts of sugar-free gum and sweets.

The first patient (a 21 year old woman) chewed large amounts of sugar-free gum, accounting for a total daily dose of 18-20g sorbitol (one stick of chewing gum contains about 1.25g sorbitol). The second patient (a 46 year old man) reported chewing 20 sticks of sugar-free gum and eating up to 200g of sweets each day, which together contained around 30g sorbitol.

After both patients started a sorbitol free diet, diarrhoea subsided, normal bowel movements resumed and weight gain was achieved.

As possible side effects are usually found only within the small print on foods containing sorbitol, consumers may be unaware of its laxative effects and fail to recognise a link with their gastrointestinal problems, write the authors.

In conclusion, they say, our cases demonstrate that sorbitol consumption can cause not only chronic diarrhoea and functional bowel complaints but also considerable unintended weight loss (about 20% of usual body weight). Thus, the investigation of unexplained weight loss should include detailed dietary history with regard to foods containing sorbitol.

Click here to view paper: http://press.psprings.co.uk/bmj/january/prac96.pdf

Posted by dlifenews at 09:53 AM | Comments (0)

Carrot Cake Study on Sugar in Type 2 Diabetes

New study adds to new thinking on sugar in the diabetes diet

January 9, 2008 (EurekAlert) - Patients with type 2 diabetes are often advised to cut out sucrose (table sugar) all together. However, in recent years this traditional advice has been questioned by some researchers who suggest that moderate amounts of sugar can be safely consumed as part of the diet of patients with diabetes. Now a new study has been published that is consistent with this revised approach. It showed that patients who increased their daily sugar intake (in the form of carrot cake) but maintained a stable body weight, showed no adverse changes in their blood glucose.

The study was conducted by the Department of Nutrition and Dietetics at London’s Hammersmith Hospital. Three slices of carrot cake were added to the daily diets of nine, overweight type 2 diabetes patients over 24 days (bringing their daily total to 88g or 18 teaspoons of sugar). Consumption of the carrot cake slices was evenly distributed across the day. Several measurements were recorded at the beginning and end of the study, including the patients’ weight, blood sugar (glucose) levels, cholesterol levels, and insulin sensitivity (which is a measure of how well the body responds to the hormone insulin).

Professor Gary Frost, who led the study, explained ‘In this study, the energy intake of these patients was balanced to their body weight, and their sucrose intake was spread evenly over a day. Correspondingly, they did not gain weight or show an increase in blood glucose levels at the end of the study; in addition, their cholesterol levels and insulin sensitivity did not change.’ He added ‘the results of this small, short-term study support other scientific studies, which suggest that there could be more flexibility with sucrose in the diets of patients with type 2 diabetes. There is evidence from other studies (reviewed by Kirk et al 2000) that inclusion of sucrose may help people to lower their fat intake, which in turn may be beneficial to overall health’.

Professor Frost continued ‘This research is in line with the dietary guidelines set by the American Diabetes Association (2007), which state that sucrose does not cause a greater increase in blood glucose levels than an equivalent amount of starch. Therefore sucrose or sucrose-containing foods should be treated similarly to other carbohydrate containing foods by people with diabetes; either substituted for other carbohydrates in the total daily intake, or managed with appropriate diabetes medication.

Posted by dlifenews at 04:35 PM | Comments (8)

Protein Power: Researchers Trigger Insulin Production in Diabetic Mice

January 9, 2008 (EurekAlert) - If the human body were a stage, then proteins would rank among the lead actors in the play we call “Life.”

These large biological molecules hold many starring roles, and their lines are dictated by information encoded in our genes. They are production powerhouses, regulating the basic processes of living and controlling countless functions. Many are enzymes that produce or use energy. Others regulate genes.
Researchers are increasingly studying proteins as potential therapies for a variety of dread diseases because they can influence cell behavior by fueling or dampening certain molecular signals.

Now University of Florida researchers have coaxed liver and pancreatic cells within diabetic mice into churning out insulin by injecting the animals with a naturally occurring protein called Pdx1, opening up a new research avenue that someday could lead to safer treatments for type 1 diabetes. Pdx1 activates the genes controlling the development of the pancreas cells that make and release insulin to maintain safe levels of glucose in the body. The UF research team’s novel approach is described online in the journal Diabetes.

“Pdx1 is so special because it possesses a unique amino acid sequence that acts as a sort of molecular passport, allowing it to pass freely into cells, enter the nucleus and activate insulin production and release,” said lead scientist Dr. Li-Jun Yang, an associate professor of pathology, immunology and laboratory medicine at UF’s College of Medicine.

Earlier research has shown that inserting the Pdx1 gene into liver or pancreas cells can induce insulin production, but most gene therapy methods use viruses to introduce a piece of genetically engineered DNA into cells. The disadvantage of such approaches is that researchers can never be certain the viruses are entirely harmless, Yang said.

The idea with protein therapy is that eventually a person’s own cells could be reprogrammed to naturally produce the hormone, restoring the body’s ability to properly regulate blood sugar levels without having to use a potentially hazardous virus to slip corrective genes into the body or having to transplant pancreatic cells from someone else. That could eliminate the adverse effects sometimes associated with gene therapy and eliminate the need for lifelong suppression of the immune system so transplanted cells are not rejected, Yang said.
“We sought to see what happens if we inject highly pure Pdx1 protein into (the abdomens of) diabetic animals,” said Yang, who is also a founder and head of the scientific advisory board for Transgeneron Therapeutics Inc., which seeks to develop Pdx1 as a treatment for diabetes. UF holds a provisional patent on Pdx1 protein therapy. “Amazingly, the treated mice did all the rest. Upon daily injection of this protein for 10 days into diabetic animals, their blood glucose levels became normalized within two weeks following the first injection. We repeated the experiment six times, and we got the reproducible result every time. What is remarkable is that the protein also promotes regeneration of insulin-producing cells in the pancreas, allowing the diabetic mice to become normal.”
Yang said there is now reason to believe normal blood sugar levels can be maintained for long periods, suggesting that an infrequent Pdx1 injection might someday replace daily insulin injections. Even more importantly, the reprogrammed and regenerated cells should make and release insulin, automatically maintaining safe blood sugar levels, she said.
“Right now, promoting beta cell regeneration has become such a hot topic,” she added. “The trick is to figure out how to trigger glucose-regulated insulin-producing cells to regenerate.”
Still, the approach will have to be tested in studies that assess its safety before scientists could conduct patient trials to determine whether it works in people, studies that are still years away.
“What’s so innovative about UF’s approach is the ability to normalize blood glucose levels in diabetic mice simply by delivering Pdx1 protein in the target cells, thus effectively eliminating the side effects associated with gene therapy,” Yang said.

Dr. Joel Habener, a professor of medicine at Harvard Medical School whose research team was one of three groups that discovered Pdx1 and identified it as an important regulator of pancreas development, said using viruses as vectors for gene therapy in humans can pose problems because of the body’s immune reaction to them. He heralded the UF findings and said the idea of using a protein to correct a condition like diabetes is appealing because it is naturally occurring, “not a chemical compound that’s been synthesized from the mind of a chemist that’s a foreign substance.”

“What these findings teach is there is promise for a therapeutic approach to the treatment of diabetes,” he said. “I think one of the really major breakthroughs here is the demonstration of principle that the naked protein in and of itself can get into cells and cause changes that are remarkable in a mouse model of type 1 diabetes, the regeneration of the insulin-producing cells in the pancreas.”

Posted by dlifenews at 04:27 PM | Comments (2)

Legumes Linked to Lower Diabetes Risk

January 8, 2008 (Nutra) - An increased intake of legumes like peanuts and soybeans could reduce the risk of developing type-2 diabetes by over 40 per cent, suggests a new study.

The dietary habits of over 64,000 women were assessed and correlated with the development of type-2 diabetes over about five years, and a high intake of all legumes was associated with a 38 per cent reduction in risk of developing the disease, report researchers in this month's American Journal of Clinical Nutrition.

An estimated 19 million people are affected by diabetes in the EU 25, equal to four per cent of the total population. This figure is projected to increase to 26 million by 2030.

In the US, there are over 20 million people with diabetes, equal to seven per cent of the population. The total costs are thought to be as much as $132 bn, with $92 bn being direct costs from medication, according to 2002 American Diabetes Association figures.

According to background information in the study, it has been suggested previously that a high intake of these foods can have benefits against the development of type-2 diabetes, although data is limited for this link.

Researchers from Vanderbilt University Medical Center and the Shanghai Cancer Institute set about filling in these gaps, and recruited 64,227 middle-aged Chinese women with no previous history of diabetes, cardiovascular disease or cancer, and followed then for an average of 4.6 years.

The authors, led by Raquel Villegas, used food-frequency questionnaires to assess the dietary intakes of the subjects, and reported an inverse association between the intake of legumes and the incidence of type-2 diabetes.

Indeed, for a high intake of all legumes, the researchers reported a 38 per cent reduction in risk, while a high intake of soybeans was associated with a 47 per cent reduction in risk.

Interestingly, no relationship was observed for the consumption of soy products and soy protein with diabetes risk.

The study does have several limitations, including the use of food frequency questionnaires to measure dietary intakes, which are subject to recall errors, and being focused on Chinese women, which prevents generalization of the results to other populations.

Late last year, researchers from the University of Massachusetts Amherst reported that soy yoghurts could play an important role in the management of type-2 diabetes and high blood pressure.

The Massachusetts researchers reported that phenol-rich soy yogurts could inhibit about 92 per cent of the activity of the angiotensin-I converting enzyme (ACE-I), which plays a role in the constriction of blood vessels.

Posted by dlifenews at 10:18 AM | Comments (0)

SYMLIN Pen-injector Devices Now Available

SymlinPen Offers SYMLIN Administration for Enhanced Glucose Control with Potential Weight Loss

January 7, 2008 (Press Release) – Amylin Pharmaceuticals, Inc. (Nasdaq: AMLN) announced today the availability of the SymlinPen™ 120 and the SymlinPen™ 60 pen-injector devices for administering SYMLIN® (pramlintide acetate) injection. These new pre-filled pen-injector devices feature simple, fixed dosing to improve mealtime glucose control.

“SYMLIN offers enhanced blood glucose control with potential weight loss for patients with diabetes using mealtime insulin, enabling them to do more to manage their diabetes,” said Daniel M. Bradbury, President and CEO, Amylin Pharmaceuticals. “The convenience of the new SymlinPen™ with simple, fixed dosing will make it easier for these patients using multiple daily injections to start and stay with SYMLIN.”

SymlinPen™ 120 features fixed dosing to deliver 60 or 120 micrograms of SYMLIN per dose. SymlinPen™ 60 features fixed dosing to deliver 15, 30, 45, or 60 micrograms of SYMLIN per dose. Both pen-injector devices can be conveniently stored at room temperature not to exceed 86 degrees F (30 degrees C) after first use.

Posted by dlifenews at 04:44 PM | Comments (0)

Hormone Blocker Found to Help Prevent Obesity & Diabetes

January 3, 2008 (Newswise) — A new study finds that a chemical found in the body is capable of promoting weight loss, improving insulin resistance and reversing diabetes in an animal model. The hormone is gastric inhibitory polypeptide (GIP) receptor blockade.

Background

GIP is a peptide hormone that is secreted in response to food. It inhibits the secretion of acids stimulates the releases insulin as part of the digestive process in response to food. It is found in a variety of tissues, including the intestine, heart, stomach, brain and in adipose (fat).

While the significance of its action is largely unknown, its potent and prolonged stimulation after a high-fat diet has led researchers to speculate it may play a key role in metabolizing fat. Research has shown that high fat feeding results in elevated circulating GIP concentrations, traits often found in patients who are obese with diabetes. GIP also effects the growth of fat cells. Other studies have shown that mice injected with the GIP receptor antagonist – (Pro3)GIP – can reverse or prevent many of the metabolic abnormalities associated with obesity.

The Study

A new study examined whether prolonged GIP receptor antagonism using daily injections of (Pro3) GIP was able to reverse well established diet-induced obesity and related metabolic abnormalities.

The new study is entitled, “GIP Receptor Antagonism Reverses Obesity, Insulin Resistance, and Associated Metabolic Disturbances Induced in Mice by Prolonged Consumption of High-Fat Diet.” It was conducted by Paula L. McClean, Nigel Irwin, Roslyn S. Cassidy, Victor A. Gault and Peter R. Flatt, all of the School of Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland, UK; and Jens J. Holst, Department of Medical Physiology, The Panum Institute, University of Copenhagen, Copenhagen, Denmark. It is entitled The findings appear in the American Journal of Physiology – Endocrinology and Metabolism (doi:10.1152/ajpendo.00460.2007), a publication of the American Physiological Society (APS; http://www.the-aps.org/).

Methodology

The researchers used a model for diet-induced obesity that has been used extensively alongside genetic models and has close parallels with obesity, increasingly found in humans who consume a high-fat, energy-rich diet. In this model, young (8-week old) male, age matched mice were age-divided into groups and housed individually in an air-conditioned room at 22±2°C with a 12 hour light: 12 hour dark cycle. Experimental animals had free access to drinking water and a high fat diet (45 percent fat, 20 percent protein and 35 percent carbohydrate; percent of total energy of 26.15kj/g). Age-matched control mice from the same colony had free access to a standard rodent maintenance diet (10 percent fat; 30 percent protein; 60 percent carbohydrate; percent of total energy of 12.99kj/g.). The two were used for comparison purposes.

Prior to the study, mice were maintained on a high fat diet for 160 days. In addition, a separate set of mice were maintained on a high fat diet for 112 days prior to measuring circulating GIP and GLP-1 levels. On both occasions, obesity and diabetes were clearly evident.

The mice which had previously been fed a high fat diet for 160 days received only daily injections of either saline or (Pro3)GIP over a 50-day period. Food intake and body weight were recorded daily while plasma glucose and insulin concentrations were monitored at 5-7 day intervals.

Blood was taken on day 50 to measure cholesterol, triglycerides, glucagon (the hormone involved in metabolizing carbohydrate), corticosterone (involved with carbohydrates in the liver) and circulating adipokines (which play a key role in obesity-related diseases). Glucose tolerance and insulin sensitivity tests were performed at the end of the study period. The metabolic response of both groups of mice was also analyzed.

Key Findings

Highlights of the research findings include the following:

* Compared with the standard rodent diet (control), the mice that were fed the high-fat diet for the previous 160 days exhibited increased body weight, energy intake, and circulating glucose concentrations. The levels remained elevated throughout the study. The cholesterol and triglycerides levels increased at day 50.

* consumption of the high fat diet resulted in progressive weight gain and elevations of plasma glucose and gyrated hemoglobin, leading to impaired insulin sensitivity and glucose intolerance by 10 days. Fat (adipose) tissue deposits were increased as were circulating cholesterol and triglyceride concentration levels.

* (Pro3)GIP was able to counter many of the detrimental effects of high fat diet on body weight and indices of glucose and lipid metabolism.

Conclusion

This study showed that blocking GIP activity using (Pro3)GIP in mice with established, high fat diet-induced obesity and diabetes results in significant weight loss, improvement of insulin resistance and amelioration of diabetes. These findings represent an interesting new approach to the treatment of obesity and metabolic disturbances.

According to the research team’s Nigel Irwin, Ph.D., “Interestingly, possible parallels exist with the benefits of Roux-en-Y surgery (gastric bypass surgery) in treating gross obesity and associated diabetes in people. In this procedure, nutrients surgically bypass the area of the small intestine, resulting in a deficiency of circulating GIP. We are looking to better understand how and why.”

Posted by dlifenews at 01:54 PM | Comments (0)

Lack of Deep Sleep May Increase Risk of Type 2 Diabetes

January 2, 2008 (EurekAlert) - Suppression of slow-wave sleep in healthy young adults significantly decreases their ability to regulate blood-sugar levels and increases the risk of type 2 diabetes, report researchers at the University of Chicago Medical Center in the “Early Edition” of the Proceedings of the National Academy of Science, available online as soon as Dec. 31, 2007.

Deep sleep, also called “slow-wave sleep,” is thought to be the most restorative sleep stage, but its significance for physical well-being has not been demonstrated. This study found that after only three nights of selective slow-wave sleep suppression, young healthy subjects became less sensitive to insulin. Although they needed more insulin to dispose of the same amount of glucose, their insulin secretion did not increase to compensate for the reduced sensitivity, resulting in reduced tolerance to glucose and increased risk for type 2 diabetes. The decrease in insulin sensitivity was comparable to that caused by gaining 20 to 30 pounds.

Previous studies have demonstrated that reduced sleep quantity can impair glucose metabolism and appetite regulation resulting in increased risk of obesity and diabetes. This current study provides the first evidence linking poor sleep quality to increased diabetes risk.

"These findings demonstrate a clear role for slow-wave sleep in maintaining normal glucose control," said the study's lead author, Esra Tasali, MD, assistant professor of medicine at the University of Chicago Medical Center. "A profound decrease in slow-wave sleep had an immediate and significant adverse effect on insulin sensitivity and glucose tolerance."

“Since reduced amounts of deep sleep are typical of aging and of common obesity-related sleep disorders, such as obstructive sleep apnea these results suggest that strategies to improve sleep quality, as well as quantity, may help to prevent or delay the onset of type 2 diabetes in populations at risk,” said Eve Van Cauter, PhD, professor of medicine at the University of Chicago and senior author of the study.

The researchers studied nine lean, healthy volunteers, five men and four women between the ages of 20 and 31. The subjects spent two consecutive nights in the sleep laboratory, where they went to bed at 11 P.M., slept undisturbed but carefully monitored, and got out of bed 8.5 hours later, at 7:30 A.M.

The same subjects were also studied for three consecutive nights during which they followed identical nighttime routines. During this session, however, when their brain waves indicated that they were drifting into slow-wave sleep they were subtly disturbed by sounds administered through speakers beside the bed.

These sounds were loud enough to disrupt deep sleep but not so loud as to cause a full awakening. This technique enabled the researchers to decrease slow-wave sleep by about 90 percent, shifting the subjects from the onset of deep sleep (stage 3 or 4) to a lighter sleep (stage 2) without altering total sleep time.

"Our system proved quite effective," Tasali said. When asked about the sounds the next morning, study subjects vaguely recalled hearing a noise "three or four times," during the night. Some recalled as many as 10 to 15. On average, however, subjects required about 250-300 interventions each night, fewer the first night but more on subsequent nights as "slow-wave pressure," the body's need for deep sleep, accumulated night after night.

"This decrease in slow-wave sleep resembles the changes in sleep patterns caused by 40 years of aging," Tasali said. Young adults spend 80 to 100 minutes per night in slow-wave sleep, while people over age 60 generally have less than 20 minutes. "In this experiment," she said, "we gave people in their 20s the sleep of those in their 60s."

At the end of each study, the researchers gave intravenous glucose (a sugar solution) to each subject, then took blood samples every few minutes to measure the levels of glucose and insulin, the hormone that controls glucose uptake.

They found that when slow-wave sleep was suppressed for only three nights, young healthy subjects became about 25 percent less sensitive to insulin. As insulin sensitivity decreased, subjects needed more insulin to dispose of the same amount of glucose. But for eight of the nine subjects, insulin secretion did not go up to compensate for reduced effects. The result was a 23 percent increase in blood-glucose levels, comparable to older adults with impaired glucose tolerance.

Those with low baseline levels of slow-wave sleep had the lowest levels after having their sleep patterns disrupted and the greatest decrease in insulin sensitivity.

The alarming rise in the prevalence of type 2 diabetes is generally attributed to the epidemic of obesity combined with the aging of the population. "Previous studies from our lab have demonstrated many connections between chronic, partial, sleep deprivation, changes in appetite, metabolic abnormalities, obesity, and diabetes risk," said Van Cauter. "These results solidify those links and add a new wrinkle, the role of poor sleep quality, which is also associated with aging."

"Chronic shallow non-REM sleep, decreased insulin sensitivity and elevated diabetes risk are typical of aging," the authors conclude. "Our findings raise the question of whether age-related changes in sleep quality contribute to the development of these metabolic alterations."

Posted by dlifenews at 10:28 AM | Comments (0)

Restless Legs Syndrome Doubles Risk of Stroke and Heart Disease

January 2, 2008 (EurekAlert) - People with restless legs syndrome (RLS) are twice as likely to have a stroke or heart disease compared to people without RLS, and the risk is greatest in those with the most frequent and severe symptoms, according to research published in the January 1, 2008, issue of Neurology®, the medical journal of the American Academy of Neurology.

The study, the largest of its kind enrolling both men and women, involved 3,433 people with an average age of 68 who were enrolled in the Sleep Heart Health Study. Participants were diagnosed with RLS by detailed questionnaire and asked if they had been diagnosed with a variety of systemic diseases including cardiovascular disease and cerebrovascular disease. Of the participants, nearly seven percent of women and three percent of men had RLS.

The study found people with RLS were more than twice as likely to have cardiovascular disease or cerebrovascular disease. The results remained the same after adjusting for age, sex, race, body mass index, diabetes, high blood pressure, high blood pressure medication, HDL/LDL cholesterol levels, and smoking.

"The association of RLS with heart disease and stroke was strongest in those people who had RLS symptoms at least 16 times per month," said study author John W. Winkelman, MD, PhD, with Harvard Medical School in Boston. "There was also an increased risk among people who said their RLS symptoms were severe compared to those with less bothersome symptoms."

Winkelman says although this study does not show that RLS causes cardiovascular and cerebrovascular disease, a number of potential mechanics for such a process exist. “In particular, most people with RLS have as many as 200 to 300 periodic leg movements per night of sleep and these leg movements are associated with substantial acute increases in both blood pressure and heart rate, which may, over the long term, produce cardiovascular or cerebrovascular disease.

Winkelman says there are limitations to the study, including that the diagnosis of RLS was self-reported by questionnaire rather than by clinical interview.

Posted by dlifenews at 10:25 AM | Comments (0)