Understanding Red Wine’s Potential Benefit for Diabetes

April 30, 2008 (Newswise) — New research suggests that resveratrol, a chemical commonly found in red wine, has the ability to lower blood sugar levels, but might have certain untoward side effects. This research will be presented at the American Association of Clinical Endocrinologists (AACE) 17th Annual Meeting & Clinical Congress by Kimberly Martin, MD, and mentor, Dr. F. Ismail-Beigi, on Friday, May 16th, at the Walt Disney World Dolphin Resort in Orlando.

Resveratrol is a naturally occurring chemical found in grapes that has been reported to have cardioprotective, anti-inflammatory, anti-viral, and glucose-lowering properties. The effect of resveratrol on lowering blood glucose in diabetic rats has been reported by several investigators in the past.

Their results have shown that resveratrol improves glycemia by stimulating glucose transport in certain tissues including the skeletal muscle that expresses the insulin-sensitive Glut4 isoform of glucose transporters. However, the research by Drs. Martin and Ismail-Beigi shows that in cells expressing the Glut1 isoform, resveratrol blocks glucose transport by binding and inhibiting the Glut1 transporter. This may be of importance because certain cells and tissues, including brain, retina, placenta, and red blood cells express large amounts of this transporter. Hence, the presumed inhibition of the Glut1 transporter in these tissues in-vivo may have undesired and negative effects on their normal function.

“It’s exciting to see resveratrol’s glucose-lowering effect in diabetic experimental animals,” Dr. Martin said. “However, studies are currently underway in our laboratory to determine whether the agent inhibits glucose transport in the brain of normal and diabetic animals.”

At the 2008 AACE Annual Meeting, diabetes will be taking center stage. A special symposium titled “Clinical Trials Targeting Glycemia: What Do We Expect to Learn?” will consider the impact of glucose control through studies including ACCORD, ADVANCE, VADT, and others. Other sessions of interest include “Insulin Resistance and Atherosclerosis: The Missing Link,” “Diabetes: A Cardiac Condition,” and “Hypoglycemia: The Limiting Factor in the Glycemic Management of Diabetes.”

Posted by dlife at 11:28 AM | Comments (2)

Studies of Diet Offer Little Insight to Preventing Pregnancy-Related Diabetes

April 29, 2009 (Newswise) — Many health care professionals suspect that a low glycemic diet may play a significant role in controlling pregnancy-related diabetes, but a recent review of evidence evaluating the effects of diet proved inconclusive.

One of the more troubling threats to a healthy, uncomplicated pregnancy is a metabolic disorder known as gestational diabetes mellitus. The condition affects an estimated 4 percent of mothers in the United States, and up to 14 percent worldwide. Pregnancy-related diabetes increases health risks for mothers and their babies, so researchers are searching for a means to prevent the disorder.

“The main implications of our research are suggestions for more high quality, long-term trials in healthy pregnant women, with larger sample sizes and reporting all clinically relevant outcomes, to address dietary issues more thoroughly and provide more conclusive results,” said lead review author Joanna Tieu.

“Our results suggest that a low glycemic index diet may be a benefit to mother and child, however,” said Tieu, at the Women and Children’s Hospital at the University of Adelaide in Australia.

“This is because low glycemic index diets — such as fresh fruits and vegetables and unprocessed whole-grain foods — tend to slow down the digestion of food. Slow digestion allows the body to better adjust to the load of sugar coming in after a meal,” she said.

“While our results were promising, the evidence is not sufficient to recommend changes in clinical practices, because of the limited number of trials,” Tieu said.

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.

The review authors found few clinical trials to include in their review. The three eligible studies included only 107 women living in the United States, Australia and the United Kingdom.

Doctors do not understand exactly what causes gestational diabetes, but they suspect that hormones from the placenta block the action of the mother’s insulin. Without enough insulin, sugar (glucose) cannot enter cells, where it is needed to fuel cell activity. Instead, sugars build up in the bloodstream, causing hyperglycemia.

These excess sugars and other nutrients flow through the placenta and into the baby’s cells, giving the baby more energy than it needs to develop. Stored as fat, these excess sugars may cause the baby to grow quite large — more than 8.8 pounds — or greater than the 90th percentile, compared to other babies.

A large baby may get wedged on the mother’s pubic bone during delivery, for example, putting the baby at risk for a number of health problems, including fractures or brachial plexus injuries, which can damage the network of nerves connecting the spine with the shoulder, arm and hand.

“Gestational diabetes also has been associated with spontaneous labor and premature birth,” Tieu said. “And children of women with gestational diabetes are at increased risk of obesity, glucose intolerance and diabetes in late adolescence and young adulthood.”

Mothers with gestational diabetes are at increased risk for preeclampsia (hypertension) or placental abruption during pregnancy. Induced births or Caesarean sections are more common, adding even more health risks. These women also have an increased risk of developing diabetes in the future.

Obstetrician Seth Brody, with Wake Medical Center in Raleigh, N.C., said that very large studies with longer follow-up are necessary to determine whether dietary changes can alter significant health outcomes. He suggests that in the future studies, researchers should go beyond simply knowing the difference in babies’ weights and serum glucose levels because these are not health outcomes of clinical significance.

“If the difference in birth weight were significant enough to be reflected as a difference in birth injury rates, Caesarean delivery rates and the need for operative deliveries, then that difference is of clinical importance, as is studying rates of brachia plexus injuries, fractures or neonatal mortality.” he said. “If a low glycemic diet altered the incidence of treatment for short- or long-term metabolic issues for either mom or baby, then those would be very important health outcome differences to determine, as well.

“At this point, it is most reasonable to continue to recommend the appropriate diet, weight gain, and exercise guidelines to all pregnant women, as outlined by the American College of Obstetrics and Gynecology,” Brody said.

The Cochrane Collaboration is an international non-profit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.

American College of Obstetrics and Gynecology guidelines for pregnant women are available at http://www.acog.org

Tieu J, Crowther CA, Middleton P. Dietary advice in pregnancy for preventing gestational diabetes mellitus (Review). Cochrane Database of Systematic Reviews 2008, Issue 2.

Posted by dlife at 11:30 AM | Comments (0)

Researchers Important Markers Of High Risk Of Type 2 Diabetes

April 25, 2008 (EurekAlert) - Doctors are aware of a range of risk factors, mostly related to the patients’ family history, overweight, and lifestyle, that contribute to the risk of developing type 2 diabetes. Now researchers at the University of Warwick have found markers that indicate endothelial dysfunction (changes in the cells which line the blood vessels) and sub-clinical systemic inflammation can also help identify a far greater number of people at high risk for future development of type 2 diabetes.

In a study led by Dr Saverio Stranges, Associate Professor of Cardiovascular Epidemiology at Warwick Medical School at the University of Warwick, the team looked at a protein called E-selectin, whose presence is an indication of endothelial dysfunction, white blood cell count and levels of albumin, which are marker for sub-clinical systemic inflammation.

They found high levels of E-selectin and white blood cell count with low levels of serum albumin were clear predictors of high risk for type 2 diabetes. The researchers found that traditional risk factors such as obesity or family history helped identify 65% of all patients who were at high risk of developing type 2diabetes. But when the information from these three markers was added this increased from 65% to 73% which means doctors could be able to spot a greater number of people at risk of type 2 diabetes at an early stage.

The research used data taken from the Western New York Health Study. This was a six-year longitudinal study of diabetes and cardiovascular risk factors among residents of Erie and Niagara Counties, New York.

Dr Stranges said: "High levels of E-selectin and white blood cells with low levels of serum albumin can indicate endothelial dysfunction and sub-clinical systemic inflammation. These findings corroborate the notion that both these conditions play an important role in the development of the disease. Endothelial dysfunction is also regarded as a key event in the development and progression of atherosclerosis. Finding new markers for type 2 diabetes will help us gain a greater understanding of the condition and possibly open up new possibilities for the way we prevent and treat it."

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

Promising Early Evidence Of The Superior Benefits Of Drug Therapy For Diabetic Eye Disease

April 29, 2009 (EurekAlert) - A JDRF collaboration between Johns Hopkins researchers and Genentech has shown that a drug for the treatment of diabetic eye disease has performed better in clinical trials than the current standard treatment using laser surgery.

These findings, representing the six-month end-point evaluation of the READ-2 clinical trial coordinated by The Johns Hopkins University, were presented Monday at the 2008 Annual Meeting of The Association for Research in Vision and Ophthalmology, in Fort Lauderdale, Florida.

According to Barbara Araneo, Ph.D., director of the complications program at JDRF, “These are very encouraging results, showing that drugs we have been testing in human clinical trials can be effective in slowing or stopping the effects of eye disease brought on by diabetes.”

The multi-center READ-2 Study (Ranibizumab for Edema of the mAcula in Diabetes), which began in December 2006, was designed to test the long-term safety and effectiveness of injections of the drug ranibizumab in patients with diabetic macular edema, a condition characterized by swelling of the central portion of the retina, or macula, at the back of the eye. In addition, the trial sought to determine the comparative efficacy of ranibizumab versus conventional treatment – laser photocoagulation therapy – or both together.

Macular edema, one of the most common causes of blindness, occurs when fluid and protein deposits collect on or under the macula, causing it to thicken and swell.

Participating in the clinical trial were 126 diabetic patients (average age 62) with documented Diabetic Macular Edema prior to enrollment; the majority had 20/80 vision in the eye that was treated. Patients were randomly assigned to receive one of three interventions: ranibizumab, laser photocoagulation, or a combination of the two treatments. At each visit over the course of the six-month treatment period, patients were evaluated for vision, retinal thickening, and general eye health. Although the study ended at six months, patients will be monitored for two years.

Patients treated with ranibizumab experienced significantly greater improvements in visual acuity, or clarity of vision, compared with patients receiving either of the other interventions. On average, the vision of ranibizumab-treated patients improved to 20/63 at month six, compared with essentially unchanged acuity scores of about 20/80 in both the laser and the combination treatment groups.

In addition, patients treated with ranibizumab had a 56 percent reduction in excess retinal thickness, whereas only an 11 percent reduction was seen in those receiving laser treatments.

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

Diabetes Drugs May Be Related To Fracture Risk

April 18, 2008 (EurekAlert) - A widely used class of diabetes medications appears to be associated with an increased risk for fractures, according to a report in the April 28 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

“The insulin-sensitizing thiazolidinediones are a relatively new and effective class of oral antidiabetic agents that have gained wide use in clinical conditions characterized by insulin resistance,” the authors write as background information in the article. Two drugs in this category, pioglitazone and rosiglitazone, account for 21 percent of oral diabetes medications prescribed in the United States and 5 percent of those in Europe. Recent studies have suggested that these therapies may have unfavorable effects on bone, resulting in slower bone formation and faster bone loss.

Christian Meier, M.D., of University Hospital Basel, Basel, Switzerland, and colleagues studied 1,020 patients with diabetes who had fractures diagnosed at British general practitioners’ offices between 1994 and 2005. For each of those patients, up to four control patients with diabetes who were the same age and sex and had the same physician but did not have fractures were selected, for a total of 3,728 matched controls.

After adjusting for other risk factors, individuals who were currently taking rosiglitazone and pioglitazone had approximately double or triple the odds of hip and other non-spine fractures than those who did not take these drugs. The odds for fracture were increased among patients who took the drugs for approximately 12 to 18 months and the risk was highest for those with two or more years of therapy.

“This analysis provides further evidence of a possible association between long-term use of thiazolidinediones and fractures, particularly of the hip and wrist, in patients with diabetes mellitus,” the authors conclude. “No such effect was seen for other antidiabetic drugs in this study population. These findings, although they are consistent with recently reported data from a randomized trial, are based on relatively few thiazolidinedione-exposed patients and need to be confirmed by additional observational studies and by controlled clinical trials.”

Posted by dlife at 10:22 AM | Comments (0)

Kaiser Permanente Study Finds Diabetes Doubling Before Motherhood

April 27, 2008 (EurekAlert) - Diabetes before motherhood more than doubled in six years among teenage and adult women, according to a Kaiser Permanente study published in the May issue of Diabetes Care. http://care.diabetesjournals.org/

While previous studies have looked exclusively at gestational diabetes (diabetes that develops during pregnancy, then usually disappears after the baby is born), this is the largest and most diverse study to examine pre-pregnancy type 1 and type 2 diabetes, which is more dangerous than gestational diabetes and potentially harder to treat, as well as gestational diabetes.

Researchers at Kaiser Permanente’s Department of Research & Evaluation in Pasadena looked at 175,249 women who gave birth in 11 Kaiser Permanente hospitals in Southern California between 1999 and 2005. Researchers found that there were twice as many births to women with diabetes in 2005 as there were in 1999. Fifty-two percent of the women in the study were Hispanic, 26 percent were White, 11 percent were Asian/Pacific Islanders and 10 percent were African-American.

This study found significant jumps in pre-pregnancy diabetes in every age, racial and ethnic group:

* Diabetes increased fivefold among 13- to 19-year-olds giving birth

* Diabetes doubled among women 20- and 39-year-olds giving birth

* Diabetes increased by 40 percent among women 40 and older giving birth

* African-American, Hispanic, and Asian/Pacific Islander women were more likely to have diabetes before pregnancy than White women.

“More young women are entering their reproductive years with diabetes, in part due to the fact that our society has become more overweight and obese,” said lead author Jean M. Lawrence, ScD, MPH, MSSA, a research scientist at Kaiser Permanente’s Department of Research & Evaluation. “While we currently don’t know how to prevent type 1 diabetes, the steps to reducing risk of type 2 diabetes must start before childbearing years: healthy eating, active living and maintaining a healthy weight. These habits should begin in childhood and continue through adulthood.”

Given that two-thirds of Americans are overweight or obese, and nearly 15 million children are overweight or obese, these study findings are especially relevant.

The health risks of having diabetes before becoming pregnant are greater to mother and baby than gestational diabetes, which occurs in 8 percent of pregnancies. Gestational diabetes occurs when pregnancy triggers insulin resistance in the second trimester and raises a woman’s blood glucose level and is associated with larger babies, childhood obesity, and increased maternal risk of developing type 2 diabetes. Women with pre-existing diabetes are more likely to have miscarriages, stillbirths, and babies with birth defects because they may have elevated blood sugar during the critical first trimester of pregnancy when the infants’ organs are developing.

“My advice to women who have type 1 or type 2 diabetes and are thinking about becoming pregnant is: work with your health care professional to get your blood sugar in good control. If you are pre-diabetic or have type 2 diabetes and are overweight, work on reducing your weight by a few pounds before becoming pregnant,” Lawrence said. “And women with gestational diabetes should have their blood sugar level tested after they’ve given birth to make sure it returns to normal.”

Limiting obesity is the best way to reduce the rising incidence of type 2 diabetes in young women, says study co-author David Sacks, MD, a Kaiser Permanente perinatologist who specializes in maternal fetal medicine and treats up to 50 diabetic moms-to-be a year. “We’ve become a more sedentary and obese society so naturally type 2 diabetes has risen too. For Latina women, the risk is even higher for developing type 2 diabetes, so it’s really important to defy family history and work on achieving a healthy weight.”

Sacks said Kaiser Permanente’s electronic health record, Kaiser Permanente HealthConnect™, makes it easier for physicians to monitor and treat their patients’ diabetes.

“KP HealthConnect™ gives me an immediate record of my patient’s pre-pregnancy performance, and how compliant she has been with her diabetes protocol and follow-up,” Sacks said.

Posted by dlife at 10:19 AM | Comments (0)

Aspirin-Like Compounds Increase Insulin Secretion in Otherwise Healthy Obese People

April 26, 208 (Newswise) — Aspirin-like compounds (salicylates) can claim another health benefit: increasing the amount of insulin produced by otherwise healthy obese people. Obesity is associated with insulin resistance, the first step toward type 2 diabetes.

Aspirin and other salicylates are known to reduce blood glucose in diabetic patients. New research accepted for publication in the Journal of Clinical Endocrinology & Metabolism reveals a similar beneficial effect among obese individuals by increasing the amount of insulin secreted into the bloodstream.

“The administration of a salicylate led to the lowering of serum glucose concentrations,” said Jose-Manuel Fernandez-Real of the Institut d’Investigacio Biomedica de Girona and CIBEROBN Fisiopatologia de la Obesidad, Spain, and lead author of the study. “These findings highlight the importance of further research on the possible therapeutic benefit of aspirin in the fight against type 2 diabetes.”

For their study, Fernandez-Real and his colleagues evaluated the effects of triflusal (a derivative of salicylate) on 28 subjects (nine men and 29 women). The average age of the participants was 48 years old and their average Body Mass Index (BMI) was 33.9. A BMI of over 30 is considered obese. During three, four-week treatment periods, the study participants received a 600 mg dose, a 900 mg dose, or a placebo once per day.

The researchers found that administration of triflusal led to decreased fasting serum glucose. Contrary to their expectations, insulin sensitivity did not significantly change during the trial. Insulin secretion, however, significantly increased in relation to the dose size.

In conjunction with the human studies, the researchers also conducted laboratory studies on insulin-producing cells (known as islets of Langerhans) from mice and humans. The researchers observed that triflusal significantly increased the insulin secreted by these cells.

“Aspirin therapy has been recognized to improve glucose tolerance and to reduce insulin requirements in diabetic subjects,” said Fernandez-Real. “To our knowledge, this is the first study to show that salicylates lowered serum glucose in non-diabetic obese subjects. We believe that this effect was due to a previously unsuspected increase in insulin secretion rather than enhanced insulin sensitivity.”

The paper “Salicylates increase insulin secretion in healthy obese subjects” will appear in the July issue of JCEM, a publication of The Endocrine Society.”

Other researchers involved in the study include Abel Lobez-Mermejo, Ana-Belen Ropero, Sandra Piquer, Angel Nadal, Judit Bassols, Roser Casamitjana, Roman Gomis, Eva Arnaiz, Inaki Perez, and Wifredo Ricart.

Posted by dlife at 10:29 AM | Comments (0)

100M Pounds a Year Spent on Self-Monitoring in Diabetes That May Increase Anxiety and Depression

Research: Efficacy of self-monitoring of blood glucose in patients with newly diagnosed type 2 diabetes: Randomized controlled trial

April 17, 2008 (EurekAlert) - The National Health Service (NHS) in the UK is spending £100 million a year to help people with non-insulin treated type 2 diabetes monitor their own blood sugar levels, but the process is more likely to make them depressed than provide any long-term health benefits, according to a series of articles published ahead of print on bmj.com today.

Globally one in twenty people have diabetes. The majority (85–95%) have type 2 diabetes, in which the body has either stopped making insulin or has difficulty making enough to convert blood sugar into the fuel our bodies need. Cases of type 2 diabetes are on the increase in the UK.

It has been generally acknowledged that self monitoring of blood glucose levels is beneficial for patients who have type 1 diabetes and those with type 2 diabetes who use insulin to treat their condition. However, the majority of people with type 2 diabetes do not use insulin, and it is for this group of people that there has been debate over the effectiveness of self monitoring. Yet, despite a lack of evidence, self monitoring has been widely promoted for this group in clinical practice.

Dr Maurice O’Kane and colleagues from the University of Ulster, report on a randomised controlled trial to assess whether self monitoring has an effect on blood glucose levels and the incidence of hypoglycaemia in people with newly diagnosed type 2 diabetes.

The researchers found no significant effect of self monitoring on blood sugar levels or cases of hypoglycaemia after a year. However, the patients in the self-monitoring group reported higher levels of depression and anxiety.

Evidence suggests that some patients find self monitoring “uncomfortable, intrusive and unpleasant”. And the researchers suggest that the negative feelings reported in the study might be due to the enforced discipline of regular monitoring without any obvious benefit, rather than due to “feelings of powerlessness in the face of high blood glucose readings.”

Self monitoring of blood glucose is the largest single management cost associated with implementing more intensive blood glucose control in the UK, with costs of providing test strips increasing from £85m to £118m between 2001 and 2003. Thus, it is important to establish if self monitoring represents a cost effective use of resources that could otherwise be used to finance other aspects of diabetes care.

In a separate study, Dr Judit Simon and colleagues from the University of Oxford, analysed the cost-effectiveness of helping patients with non-insulin treated type 2 diabetes self monitor their blood glucose levels in addition to standardised usual care, using data from the diabetes glycaemic education and monitoring (DiGEM) trial.

Their analysis confirms that self monitoring of blood glucose is significantly more expensive than the standardised usual care. They found that the additional healthcare costs of self monitoring were about £90 per patient each year. Furthermore, people who self monitored reported a lower quality of life probably owing to significant increases in their levels of anxiety and depression.

The authors say that self monitoring in addition to standardised usual care is unlikely to provide this group of patients with significant lifetime health benefits or be cost effective for the NHS. They conclude: “This study therefore provides no convincing evidence for routinely recommending self monitoring to patients with non-insulin treated type 2 diabetes.”

In an accompanying editorial, Professor Martin Gulliford argues that the £100 million that is spent each year on self monitoring for this group of patients: “Represents a substantial opportunity cost in terms of alternative interventions that might have improved the health of people with diabetes…[such as] more effective disease control measures aimed not at blood glucose but also at blood pressure, cholesterol, smoking, body weight, and physical activity.”

Posted by dlife at 11:45 AM | Comments (11)

What You Don't Know Could Hurt You

April 17, 2008 (PRNewswire) - Whether listed on the menu or not, the American Diabetes Association provides tips for translating calorie information

Pop quiz -- which has more calories -- a tuna salad sandwich or a roast beef with mustard? You might be surprised to learn the tuna fish salad normally has at least twice the number of calories. But what does this mean for your daily diet? And how many calories a day are you supposed to eat anyway?

Counting calories, whether in the kitchen or at a restaurant, is important to maintaining or losing weight according to the American Diabetes Association (ADA). Consuming excess calories without increased physical activity can lead to weight gain, a major risk factor for pre-diabetes and type 2 diabetes which affects nearly one in four Americans. In addition, people with diabetes and those at risk for diabetes need to work toward achieving a healthy weight to prevent deadly diabetes complications, such as heart disease and stroke.

"It is easy to underestimate the number of calories in food items, especially in a restaurant where you didn't prepare the meal yourself," commented Ann Albright, PhD, President, Health Care & Education, American Diabetes Association. "Since Americans are eating out more, they are receiving more of their calories via restaurant meals. People need to be well informed to make healthier choices."

Yesterday a federal court upheld a New York City regulation, which ADA supports, that requires chain restaurants to provide the calorie content of foods on their menus and menu boards. This ruling came in response to a challenge to the regulation filed by the New York State Restaurant Association.

ADA will host a live web chat "Tips, Tactics, and Tools for Healthier Restaurant Eating" on Tuesday, May 6, with ADA author Hope S. Warshaw, RD. Visit http://www.diabetes.org/adalive/default.jsp for more information or to submit a question ahead of time.

According to the ADA, the first step to making healthy choices is knowing how many calories a day to consume. The daily calorie ranges below are a general guide. Talk to your health care team about your specific dietary goals.

-- 1,200-1,400 calories/day - Women who want to lose weight, are small in size, and/or are sedentary

-- 1,400-1,600 calories/day - Women who are older and smaller, are larger and want to lose weight, and/or are sedentary

-- 1,600-1,900 calories/day - Women who are moderate to large size, men who are older, are small to moderate size and want to lose weight

-- 1,900-2,300 calories/day - Children, teen girls, women who are larger in size and active, men who are small to moderate size and are at desired body weight

-- 2,300-2,800 calories/day - teen boys and men who are active and moderate to large in size

In addition, the ADA offers healthy tips for eating out:

-- Doggie bag - If the portion is more than you usually eat, split it with a friend or take half home for later.

-- Snack time - If you had a lower calorie option for lunch, grab a healthy snack mid-afternoon, such as an apple or a handful of nuts, to avoid binging later in the day.

-- Want a drink? - Substitute 16 oz. of water for 16 oz. of soda. This will save you approximately 200 calories.

-- Hold, please - Skip the mayo and other fatty sides, which can save you hundreds of calories.

-- On the side - Rather than putting the dressing in the salad or sauces on the entree, try dipping your fork in the dressing or sauce before putting a bite on your fork.

-- Made to Order - Ask if meats or fish can be grilled instead of fried. Order an extra vegetable instead of a starch as a side.

Posted by dlife at 10:28 AM | Comments (3)

Discovery Leads to Earlier Diagnosis of Type 1 Diabetes

April 16, 2008 (PRNewswire) - Researchers at Children's Research Institute, located in Milwaukee, recently made significant discoveries in juvenile diabetes diagnosis. Led by Martin Hessner, PhD, associate, professor, Medical College of Wisconsin, the research team applied a new approach, finding that type 1 diabetes patients during the honeymoon phase create a unique genomic fingerprint.

The research team used a new type of blood test that identifies inflammation associated with type 1 diabetes though a unique genomic fingerprint. Remarkably, this fingerprint is evident years prior to disease onset. This discovery offers insight into the pathways responsible for type 1 diabetes. This fingerprint will be useful in identifying at-risk children earlier in the disease process. This offers hope for earlier treatment and even delay or prevention of full-blown diabetes. The Journal of Immunology recently published this research.

This research was accomplished through the Max McGee National Research Center for Juvenile Diabetes, established by football legend Max McGee. Diabetes is prevalent in the McGee family. Max's brother fought diabetes in his lifetime, and today, the McGees' son, Dallas, lives every day with this life-threatening disease. The late McGee, who died last October, co-founded the center to find a cure not only for his son, but for all people living with type 1 diabetes.

The center is one of few in the world studying the role of genetics in childhood diabetes. While diabetes is prevalent in some families, like the McGees, only 10 percent of newly diagnosed cases occur in families here that history exists. The Diabetes Program at Children's Hospital of Wisconsin is one of the largest in the country, serving more than 1,700 children with type 1 and type 2 diabetes and their families.

Posted by dlife at 02:56 PM | Comments (0)

How And Where Fat Is Stored Predicts Disease Risk Better Than Weight

April 16, 2008 (EurekAlert) - A new study in mice indicates that overeating, rather than the obesity it causes, is the trigger for developing metabolic syndrome, a collection of heath risk factors that increases an individual’s chances of developing insulin resistance, fatty liver, heart disease and type 2 diabetes.

How and where the body stores excess, unused calories appears to matter most when determining a person’s risk of developing metabolic syndrome, researchers at UT Southwestern Medical Center suggest.

“Most people today think that obesity itself causes metabolic syndrome,” said Dr. Roger Unger, professor of internal medicine at UT Southwestern and senior author of the study. “We’re ingrained to think obesity is the cause of all health problems, when in fact it is the spillover of fat into organs other than fat cells that damages these organs, such as the heart and the liver. Depositing fatty molecules in fat cells where they belong actually delays that harmful spillover.”

The study, available online, is to be published in a future issue of the Proceedings of the National Academy of Sciences. It is among the first to suggest that weight gain is an early symptom of pre-metabolic syndrome, rather than a direct cause.

“Obesity delays the onset of metabolic syndrome, but it doesn’t prevent it,” said Dr. Unger, who has investigated diabetes, obesity and insulin resistance for more than 50 years. “People who are obese or overweight are on the road to developing metabolic syndrome unless they stop overeating. Sooner or later, it will happen.”

Currently about 50 million Americans suffer from metabolic syndrome. The exact cause of metabolic syndrome is unknown, but obesity and lack of exercise have been considered to be the primary underlying contributors to its development. Several studies in Dallas have shown that overweight patients with metabolic syndrome have increased fat levels in their liver, heart and pancreas.

Individuals with congenital generalized lipodystrophy – a genetic condition in which people are born with no fat cells in which to store fat – develop metabolic syndrome at an earlier age than people who are obese. They also develop more severe cases of metabolic syndrome earlier than their obese counterparts.

The goal of this study was to determine whether an individual’s capacity to store fat in fat cells plays a role in whether they develop metabolic syndrome and type 2 diabetes and at what point that occurs.

For the study, the researchers compared mice genetically altered to prevent their fat cells from expanding when overfed to mice with no such protections against becoming obese. The normal mice got fat when overfed, but didn’t develop signs of metabolic syndrome until about 7 weeks into the experiment, at about 12 weeks of age.

The mice engineered to remain slim, however, enjoyed no such “pre-diabetic honeymoon period,” the study authors said. Some became seriously ill at 4 to 5 weeks of age and displayed evidence of severe heart problems and marked hyperglycemia by 10 weeks of age, a full 8 weeks before the normal mice displayed even minimal heart problems. The genetically altered mice also suffered devastating damage to heart cells and to the insulin-secreting cells in their pancreas.

“The genetically altered animals were perfectly normal as long as they were on a normal diet and not overfed. But as soon as we put them on a high-calorie diet, they got terribly sick very fast,” said Dr. May-yun Wang, assistant professor of internal medicine at and lead author of the study.

She said the mice engineered to stay slim got sick quicker because the extra calories were not stored in the fat cells, the one place in the body equipped to store fat. Instead, fat was stored in other tissues, mimicking what happens in people with congenital generalized lipodystrophy.

“Recognition of this should encourage physicians and obese patients to pursue more aggressive interventions before they develop metabolic syndrome, rather than after the onset of disease, as is customary,” Dr. Wang said.

The new results complement earlier findings by diabetes researchers at UT Southwestern who investigated why mice genetically engineered to be obese are at no more risk of developing metabolic syndrome than normal mice. The results of that study, which was led by Dr. Philipp Scherer, professor of internal medicine and director of the Touchstone Center for Diabetes Research, also suggested that it’s not the amount of body fat, but where it is stored in the body that appears to matter most to health.

Dr. Unger said the most recent findings, like Dr. Scherer’s, in no way condone obesity.

“It’s best to eat only what you need to replace the energy you burn,” he said. “But, if you eat more than you need, as most Americans do, it’s better to put the surplus calories in fat cells than in the rest of the body because fat cells are designed specifically for fat storage. You won’t be as trim, but you’ll be healthier,” Dr. Unger said.

The study results also imply that any gene that impairs the ability to store fat in the fat cells likely predisposes an individual to metabolic syndrome and type 2 diabetes, Dr. Unger said.

Posted by dlife at 11:37 AM | Comments (1)

Statins Shown to Lower Blood Pressure

April 14, 2008 (EurekAlert) - A large, randomized drug trial has shown for the first time that statin drugs result in a modest, but significant, reduction in blood pressure. These effects may contribute to the reduced risk of stroke and cardiovascular events reported for patients on statins, according to lead investigator Beatrice Golomb, M.D., Ph.D., associate professor of medicine at the University of California, San Diego School of Medicine and director of UC San Diego’s Statin Study.

The results of the double-blind, placebo-controlled study of 973 men and women in Southern California will be published in the April 14 edition of the journal Archives of Internal Medicine.

“Statins, of course, are known to lower LDL cholesterol levels, but lower LDL cholesterol levels are not generally linked to lower occurrence of stroke,” said Golomb. “However, lower blood pressure is strongly related to lower stroke risk, and these findings provide one means by which statins may reduce rates of stroke and other cardiovascular events in patients.”

Study participants had no known cardiovascular disease or diabetes. Equal numbers of participants were either given 20 milligrams of simvastatin, 40 milligrams of pravastatin or a placebo daily for six months. Reductions in both systolic and diastolic blood pressure readings occurred in patients taking both simvastatin and pravastatin, two forms of statin drugs.

“We found that statins lower both systolic and diastolic blood pressure, and that the effect extends to patients with pre-hypertension, those with normal blood pressure and persons not on blood-pressure lowering medications,” said Golomb. “While reductions in blood pressure with statins were measurable as early as one month into the trial, the lowered blood pressure was significant at six months.”

Posted by dlife at 01:44 PM | Comments (0)

Experimental Treatment for Type 1 Diabetes Patients Shows Promise

April 9, 2008 (Newswise) - New research monitoring the effects of Islet cell transplantation resulted in near-normal metabolic control and decreased hypoglycemia. This research will be presented at the American Association of Clinical Endocrinologists (AACE) 17th Annual Meeting & Clinical Congress, on Friday, May 16th, at the Walt Disney World Dolphin Resort in Orlando.

During the 18 month study, physicians used Continuous Glucose Monitoring Systems to monitor the effects of the islet cell transplant procedure on patients with type 1 diabetes. The results were intriguing.

“Our findings suggest that the majority of patients with Type 1 diabetes who have received an islet transplant benefit from near normal metabolic control, with fewer and shorter episodes of hypoglycemia,” said Lisa Gorn, DO, the study’s primary author. “These patients also spent longer periods of time in normoglycemia overall.

At the 2008 AACE Annual Meeting diabetes will be taking center stage. A special symposium titled “Clinical Trials Targeting Glycemia: What Do We Expect to Learn?” will consider the impact of glucose control through studies including ACCORD, ADVANCE, VADT, and others. Related sessions of interest include “Insulin Resistance and Atherosclerosis: The Missing Link,” and “Hypoglycemia: The Limiting Factor in the Glycemic Management of Diabetes.”

Posted by dlife at 09:53 AM | Comments (2)

Potential Drug Target Identified for Diabetes

April 9, 2008 (Newswise) — Scientists at the Toronto General Hospital Research Institute have discovered a novel signaling pathway between three organs – the gut, the brain, and the liver – which lowers blood sugar when activated.

A team led by Dr. Tony Lam used a rat model to discover that fats can activate a subset of nerves in the intestine, which then send a signal to the brain and subsequently to the liver to lower glucose or sugar production. But eating a high-fat diet for just three days can interfere with this signal, disabling it so that it does not signal the other organs to lower blood glucose levels.

The research was published in a paper entitled, “Upper intestinal lipids trigger a gut-brain-liver axis to regulate glucose production” as an advance on-line publication of the international science journal Nature.

“This is a new approach in developing more effective methods to lower glucose or blood sugar levels in those who are obese or have diabetes,” said Dr. Lam, who holds The John Kitson McIvor (1915 – 1942) Chair in Diabetes Research at the University Health Network and University of Toronto. Currently, those with diabetes lower their glucose through diet, exercise, anti-diabetic tablets or insulin injections (usually several times a day) and must regularly monitor blood glucose levels. High glucose levels can result in damage to eyes, nerves and kidneys and increase the risk of heart attack, stroke, blindness, erectile dysfunction, foot problems and amputations. Many laboratories around the world are in a race to find alternative and effective ways in which to lower glucose levels because of the severe complications which can result from high sugar levels.

“We already knew that the brain and liver can regulate blood glucose levels, but the question has been, how do you therapeutically target either of these two organs without incurring side effects?” noted Dr. Lam, who is also an Assistant Professor of Physiology and Medicine at the University of Toronto. “We may have found a way around this problem by suggesting that the gut can be the initial target instead. Much like a remote control device, the gut is able to relay a signal to the brain which in turn signals the liver to lower glucose production. If new medicines can be developed that stimulate this sensing mechanism in the gut, we may have an effective way of slowing down the body’s production of sugar, thereby lowering blood sugar levels in diabetes.”

Dr. Lam emphasized that it will take a number of years of experimental work to determine whether this approach is effective and safe in humans who have diabetes.

More than two million Canadians have diabetes. “Diabetes is an epidemic in Canada and around the world and its numbers are continuing to increase at an alarming rate, consuming our precious health care resources,” says Dr. Gary Lewis, Head of the Division of Endocrinology and Metabolism at the University Health Network and Mount Sinai Hospitals in Toronto and Professor of Medicine and Physiology at the University of Toronto. “We have good evidence from clinical trials which shows that lowering blood glucose levels towards normal in those who develop diabetes has a major impact in preventing its devastating complications, so it is critical that we learn how to control these levels in the most effective and least invasive ways possible. Dr. Lam’s work reveals a new regulatory circuit which provides novel sites and targets to lower these levels in diabetes and obesity.”

Dr. Richard Weisel, Director of the Toronto General Research Institute (TGRI), Professor and Chairman of Cardiac Surgery at the University of Toronto, welcomes any potential interventions which can help lower blood sugar levels. “Studies have shown that people with very high blood glucose levels are more likely to die from heart disease, so anything that we can discover to help lower these levels would help in decreasing the progression of and mortality from cardiovascular disease.”

"Tony's discovery represents an exciting breakthrough that could eventually lead to new ways to treat diabetes," observed Dr. Diane Finegood, Scientific Director of the Institute of Nutrition, Metabolism and Diabetes, part of the Canadian Institutes of Health Research (CIHR). "I am pleased that CIHR played a major role in funding this research".

Working with rats, Dr. Lam and colleagues designed and performed a series of elegant experiments which showed for the first time that the lipids or fats which enter the small intestine trigger the afferent neuronal signal to the brain which then sends signals to the liver to lower glucose production and blood glucose levels in as little as fifteen minutes. No drop in levels occurred when nerves were cut or blocked between the gut and the brain or between the brain and the liver. The trigger to lower glucose was also disabled when rats were fed a high-fat diet for three days prior to the experiment, a finding which may suggest that those who eat a high fat diet lose this beneficial signaling pathway.

Other researchers involved in the study include Penny Wang, Liora Caspi, Carol Lam, Madhu Chari and Michelle Ang from TGRI; Xiaosong Li, Roger Gutierrez-Juarez and Gary Schwartz from Albert Einstein College of Medicine; Peter Light from University of Alberta.

The work was funded by the Canadian Institute of Health Research.

About Toronto General Hospital, University Health Network
Toronto General Hospital is a partner in the University Health Network, along with the Toronto Western Hospital and the Princess Margaret Hospital. These research hospitals are affiliated with the University of Toronto. The scope of research at Toronto General Hospital has made this institution a national and international resource for education and patient care, and a leader in diabetes, transplantation, cardiology, surgical innovation, infectious diseases and genomic medicine.

Posted by dlife at 09:52 AM | Comments (0)

Diabetes in Mid-Life Linked to Increased Risk of Alzheimer's Disease

April 9, 2008 (EurekAlert) - Men who develop diabetes in mid-life appear to significantly increase their risk of developing Alzheimer’s disease, according to a long-term study published in the April 9, 2008, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“Our results have important public health implications given the increasing numbers of people developing diabetes and the need for more powerful interventions,” said study author Elina Rönnemaa, MD, with Uppsala University in Uppsala, Sweden.

The study involved 2,269 men in Sweden who underwent glucose testing at age 50 to test for diabetes, which is caused by abnormal insulin levels. During an average follow up of 32 years, 102 participants were diagnosed with Alzheimer’s disease, 57 with vascular dementia and 235 with other types of dementia or cognitive impairment.

The study found that the men with low insulin secretion capacity at age 50 were nearly one-and-a-half times more likely to develop Alzheimer’s disease than people without insulin problems. The risk remained significant regardless of blood pressure, cholesterol, body mass index and education.

“Our results suggest a link between insulin problems and the origins of Alzheimer’s disease and emphasize the importance of insulin in normal brain function,” said Rönnemaa. “It’s possible that insulin problems damage blood vessels in the brain, which leads to memory problems and Alzheimer’s disease, but more research is needed to identify the exact mechanisms.”

The study also found the association between diabetes and risk of Alzheimer’s disease was strongest in people who did not have the APOE4 gene, which is known to increase the risk of Alzheimer’s disease. Rönnemaa says this shows that insulin problems are an important risk factor for Alzheimer’s disease when the high risk gene is missing.

Posted by dlife at 09:49 AM | Comments (0)

People With Diabetes May Have All Natural Citrus Supplement

KGK Synergize Inc. presents Diabetinol, test results

April 9, 2008 (EurekAlert) - Two new studies presented at the Experimental Biology Annual Meeting suggest that an all-natural dietary supplement made from citrus may help people with type 2 diabetes lower their blood glucose numbers after a meal and their LDL-cholesterol levels.

Mal Evans, DVM, MSc, PhD, KGK Synergize Inc’s Scientific Director, said, “Our scientifically validated testing has consistently shown that Diabetinol™ improves blood glucose numbers. This time we saw a sizeable change in glucose intolerance in just a short time. This is good news for many of the 21 million Americans with diabetes. Tighter blood sugar control may mean less diabetic complications like nerve pain and kidney disease. And, that could mean less disability and expense from complications and associated medications and certainly less stress for the patient.

“Although there were no statistically significant changes in fasting blood glucose levels in either group, the Diabetinol™-treated subjects demonstrated an excellent favorable downward trend in their hemoglobin A1C levels. These results suggest that when administered to people with type 2 diabetes over a longer treatment period, Diabetinol™ significantly improves glucose tolerance or the blood glucose numbers following a meal.

“Additionally, the Diabetinol™-treated group showed improvements in LDL-cholesterol levels. An elevated LDL-cholesterol level is a risk factor for heart disease, and having type 2 diabetes increases an individual’s risk for developing heart disease two to four times. In fact, sixty-five percent of deaths from diabetes are related to cardiovascular causes such as heart attack and stroke,” said Evans.

Hemoglobin A1C is an indicator of average blood glucose control over two to three months and is correlated to an individual’s risk of developing diabetic complications such as diseases of the eye, kidney and nerves.

In a pilot study, twenty adults with diabetes who were taking oral diabetes medications were randomly assigned to receive either Diabetinol™ or a placebo twice per day for three months. Each subject had mildly to moderately elevated cholesterol levels at the start of the study as well.

After 84 days, the group receiving Diabetinol™ showed a significant 19 percent reduction in glucose intolerance measured as peak changes in blood glucose over the four hours of a standard oral glucose challenge. The placebo group showed no significant improvements in glucose intolerance. A standard glucose challenge involves ingesting 100 grams of glucose and having blood glucose measurements after 30 minutes and hourly for four hours. Neither the investigators nor the volunteers knew who was receiving the Diabetinol™ or the placebo.

The number of Americans with diabetes has been increasing as obesity rates continue to rise. At least 90% of Americans with diabetes have type 2 diabetes. In type 2 diabetes, the body either produces too little insulin or the cells do not respond properly to the insulin and leave the cells starved for energy while raising the blood glucose level.

Earlier animal studies led researchers to test Diabetinol in humans. Twelve hamsters were treated with a special high-fructose diet to induce diabetes-like symptoms including increased blood glucose, insulin, cholesterol and triglyceride levels. Half of the animals were then given Diabetinol™ for 42 days. The other six hamsters were given no anti-diabetic treatment. At the end of the study, the Diabetinol™-treated animals showed improvements in each blood glucose, insulin, and cholesterol and triglyceride levels.

Taken together, these studies suggest that Diabetinol™ may help lower blood glucose levels and be beneficial in lowering the risks of heart disease and diabetic complications in people with type 2 diabetes.

An additional six-month study is underway to evaluate Diabetinol™ treatment in a larger sample of people with type 2 diabetes.

Posted by dlife at 09:47 AM | Comments (1)

No 'Convincing Evidence' That Glitazones Work Better Than Older Diabetes Drugs

Glitazones in type 2 diabetes: an update DTB

April 9, 2008 (EurekAlert) - There is no convincing evidence that the newer class of diabetes drugs, known as glitazones, offer real advantages over other diabetes drugs, when used on their own, concludes the Drug and Therapeutics Bulletin (DTB).

The glitazones (pioglitazone and rosiglitazone), which are also used in combined double and triple therapy, now account for over half of the NHS spend on oral drugs for the regulation of blood sugar (glycaemic control).

New guidance on glitazones from the National institute for Health and Clinical Excellence (NICE) is expected next month.

An exhaustive trawl of the available evidence leads DTB to conclude that glitazones have a place in combined treatments with either metformin or a sulphonylurea people with type 2 diabetes who are unsuited to one or other of these older drugs.

But DTB makes it clear that there is “no convincing evidence” that when taken alone the glitazones produce greater health benefits than either of the other types of treatment.

“Evidence for their use in triple therapy is also weak, and they should be reserved for patients in whom insulin is contraindicated or is likely to be poorly tolerated,” says DTB.

The drugs can have significant side effects, although the regulators still feel that the benefits outweigh the risks.

Heart failure is more common when treatment is combined with insulin.

And in 2007 the European medicines regulator, the EMEA, warned that patients with angina who had had certain types of heart attack should not be given rosiglitazone, and the drug was not recommended for those with ischaemic heart, or peripheral arterial, diseases.

And the US drugs regulator, the FDA, has also advised that rosiglitazone may increase the risk of a heart attack.

Heart failure is more common when glitazone treatment is combined with insulin, and research indicates higher rates of oedema (swelling) in both sexes and bone fractures in women.

DTB concludes that pioglitazone is probably the safer option of the two glitazones, but should still not be used in anyone at high risk of heart failure.

Although pioglitazone is licensed for use with insulin treatment, DTB says that this combination carries the risk of weight gain, oedema and potentially heart failure.

Posted by dlife at 09:45 AM | Comments (0)

Cholesterol, Blood Pressure Control May Reverse Atherosclerosis in Adults With Diabetes

April 8, 2008 (EurekAlert) - Aggressively lowering cholesterol and blood pressure levels below current targets in adults with type 2 diabetes may help to prevent – and possibly reverse – hardening of the arteries, according to new research supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. Hardening of the arteries, also known as atherosclerosis, is the number one cause of heart disease and can lead to heart attack, stroke, and death.

The three-year study of 499 participants is the first to compare two treatment targets for LDL (“bad”) cholesterol and systolic blood pressure levels, key risk factors for heart disease, in people with diabetes. Results are published in the April 9 issue of the Journal of the American Medical Association.

“This study provides good news for adults with type 2 diabetes,” said Elizabeth G. Nabel, M.D., NHLBI director. “These patients are two to four times more likely than people without diabetes to die from heart disease. For the first time, we have evidence that aggressively lowering LDL cholesterol and blood pressure can actually reverse damage to the arteries in middle-aged adults with diabetes.”

In the Stop Atherosclerosis in Native Diabetics Study (SANDS), approximately one-half of the participants (247) were asked to lower to standard levels their LDL cholesterol (to 100 milligrams per deciliter) and blood pressure (systolic blood pressure of 130 mmHg or lower), while the other half (252) aimed for more aggressive lowering of LDL cholesterol to 70 mg/dL or lower and of systolic blood pressure to 115 mmHg or lower. All participants were American Indians 40 years or older (average age of 56) who had diabetes, high blood cholesterol, and high blood pressure but no history of heart attack or other evidence of heart disease. The study was conducted at four clinical centers in southwestern Oklahoma; Phoenix, Ariz.; northeastern Arizona; and South Dakota. All participants continued to receive their medical care, including diabetes management, dietary and exercise counseling, and smoking cessation, from their health care providers with the Indian Health Service. Like the NIH, the Indian Health Service is part of the U.S. Department of Health and Human Services.

“American Indians have a high rate of diabetes and cardiovascular disease related to diabetes, but there are few clinical trials that address these issues in this population,” said Barbara V. Howard, Ph.D., of MedStar Research Institute in Hyattsville, Md., lead author of the paper. “These study results provide needed evidence to help develop community-based programs to treat and prevent the epidemic of cardiovascular disease among American Indians. At the same time, we are increasing our understanding of the effects of intensively lowering cholesterol and blood pressure in adults with type 2 diabetes, which might also apply to other populations.”

During the three-year study, participants were examined by study clinicians one month after enrollment, then every three months, to assess their blood cholesterol and blood pressure levels and general well being. Food and Drug Administration-approved blood pressure and cholesterol medications were added and adjusted as needed to help participants achieve their treatment goals. The same medications were available to participants in the standard and the aggressive treatment groups. Participants were also encouraged to follow lifestyle approaches to help meet their blood pressure and cholesterol treatment targets, such as following a heart-healthy eating plan, being physically active, maintaining a healthy weight, and not smoking.

To assess the impact of the treatments on the participants’ cardiovascular health, researchers used ultrasound to measure the thickness of the carotid (neck) artery -- an indication of hardening of the arteries, a leading effect of high blood pressure and cholesterol and an early sign of cardiovascular disease. In addition, ultrasound was also used to measure the size and function of the left ventricle, the heart's main pumping chamber. Enlarged hearts are known to be predictors of increased risk of heart attack and stroke. These measurements were taken at enrollment, at 18 months, and at 36 months, when the study ended.

On average, participants in both groups reached and maintained their target goals for blood cholesterol and blood pressure levels. The numbers of heart attacks and other cardiovascular events were similar between the two groups and lower than expected.

In addition, carotid artery thickness measurements of participants in the aggressive treatment group were significantly lower than those in the standard treatment group. Researchers report that, compared to baseline, carotid artery thickness increased slightly in the standard group and regressed in the aggressive treatment group, indicating a partial reversal of atherosclerosis. Furthermore, although heart size decreased from baseline in both groups, the beneficial change was significantly greater among participants in the aggressive treatment group.

“Many patients with diabetes do not reach their blood pressure and cholesterol goal levels and thus remain at high risk for heart attacks and stroke,” noted Howard. “In our study, participants successfully managed their blood cholesterol and blood pressure to reach their goal levels. Our message to doctors, nurses, and patients is that you can reach your goal levels, and we should work together to help you do that.”

As with any therapy, the benefits and risks must be considered for each patient. In SANDS, participants in the aggressive treatment group on average needed more medications and higher doses than the standard treatment group, and they were slightly more likely to have side effects from blood pressure-lowering medications than those in the standard group. Such adverse effects generally resolved, however, after the medication was changed or the dose reduced. There were no differences in side effects related to cholesterol-lowering drugs between the standard and the aggressive treatment groups.

“These encouraging findings from SANDS suggest that more aggressive blood pressure and cholesterol targets than those currently recommended in patients with diabetes may reduce their future cardiovascular risk,” said Jerome L. Fleg, M.D., NHLBI project officer of the study and a coauthor of the paper. “Longer term followup of this population as well as additional studies in other populations are needed to confirm the benefit and cost-effectiveness of these lower targets.”

Posted by dlife at 02:54 PM | Comments (0)

Adults Who Eat Apples, Drink Apple Juice Have Lower Risk for Metabolic Syndrome

April 7, 2008 (Newswise) — Not eating your apple a day? Perhaps you should be. Adults who eat apples, apple juice and applesauce have a significantly reduced risk of metabolic syndrome, a cluster of health problems that are linked to numerous chronic diseases such as diabetes and cardiovascular disease.

The study results, presented at the Experimental Biology 2008 meeting this week, were derived from an analysis of adult food consumption data collected in the 1999-2004 National Health and Nutrition Examination Survey (NHANES), the government’s largest food consumption and health database.

Dr. Victor Fulgoni analyzed the data, specifically looking at the association between consumption of apples and apple products, nutrient intake and various physiological parameters related to metabolic syndrome. When compared to non-consumers, adult apple product consumers had a 27% decreased likelihood of being diagnosed with metabolic syndrome.

Fulgoni notes, “We found that adults who eat apples and apple products have smaller waistlines that indicate less abdominal fat, lower blood pressure and a reduced risk for developing what is known as the metabolic syndrome.”

In addition to having a 30% decreased likelihood for elevated diastolic blood pressure and a 36% decreased likelihood for elevated systolic blood pressure, apple product consumers also had a 21% reduced risk of increased waist circumference – all predictors of cardiovascular disease and an increased likelihood of metabolic syndrome. Additionally, adult apple product consumers had significantly reduced C-reactive protein levels, another measurable marker related to cardiovascular risk.

Furthermore, apple product consumers’ diets were healthier than non-consumers – they had a greater intake of fruit and key nutrients, including dietary fiber, vitamins A and C, calcium and potassium. These consumers also ate less total fat, saturated fat, discretionary fat and added sugars.

Metabolic syndrome is believed to affect an estimated 36 million Americans. Metabolic syndrome, also known as Syndrome X and insulin resistance syndrome, is defined as having three or more of the associated symptoms, which include elevated blood pressure, increased waist size and abdominal fat, and elevated c-reactive protein levels.

Source: Fulgoni, V., Fulgoni S., Haaga, S., Ebert, A. Apple consumption is associated with increased nutrient intakes and reduced risk of metabolic syndrome in adults from the National health and Nutrition Examination Survey (1999-2004). Experimental Biology 2008 Poster Presentation (unpublished).

Posted by dlife at 03:00 PM | Comments (1)

Tart Cherries May Reduce Heart/Diabetes Risk Factors

April 7, 2008 (Newswise) — Tart cherries – frequently sold dried, frozen or in juice – may have more than just good taste and bright red color going for them, according to new animal research from the University of Michigan Cardiovascular Center.

Rats that received whole tart cherry powder mixed into a high-fat diet didn’t gain as much weight or build up as much body fat as rats that didn’t receive cherries. And their blood showed much lower levels of molecules that indicate the kind of inflammation that has been linked to heart disease and diabetes. In addition, they had significantly lower blood levels of cholesterol and triglycerides than the other rats.

The results, which were seen in both lean and obese rats that were bred to have a predisposition to obesity and insulin resistance, were presented Sunday at the Experimental Biology 2008 meeting in San Diego, CA by a team from the U-M Cardioprotection Research Laboratory.

In addition, the obese rats that received cherry powder were less likely to build up fat in their bellies – another factor linked to cardiovascular disease. All the measures on which the two groups of animals differed are linked to cardiovascular disease and Type 2 diabetes.

The new findings build on results that were reported last year at the same meeting by the U-M team. Those data came from experiments involving lean rats that were prone to high blood pressure, high cholesterol and impaired glucose tolerance, but that received a low-fat diet with or without cherries. In that case, cherry-fed rats had lower total cholesterol, lower blood sugar, less fat storage in the liver and lower oxidative stress. However, it was unknown if these benefits would be observed in obesity-prone animals, or in animals fed a higher fat, western-style diet containing elevated saturated fat and cholesterol.

While it’s still far too early to know whether tart cherries will have the same effect in humans, U-M researchers are preparing to launch a pilot-phase clinical trial later this spring. They note that if a human wanted to eat as many tart cherries as the rats in the new study did, they would have to consume 1.5 cups every day.

“These new findings are very encouraging, especially in light of what is becoming known about the interplay between inflammation, blood lipids, obesity and body composition in cardiovascular disease and diabetes,” says Steven Bolling, M.D., a U-M cardiac surgeon and the laboratory’s director. “The fact that these factors decreased despite the rats’ predisposition to obesity, and despite their high-fat ‘American-style’ diet, is especially interesting.”

The results were presented by E. Mitchell Seymour, M.S., a U-M research associate and the senior scientist on the project. “It was recently shown in humans that regular intake of darkly pigmented fruits like cherries is associated with reduced mortality from cardiovascular disease and coronary heart disease,” says Seymour. “The heart-health benefits of these colorful fruits were sustained even when corrected for age and other health conditions. We’re now invested in exploring the specific mechanisms of these benefits.”

The experiments are funded by an unrestricted grant from the Cherry Marketing Institute, a trade association for the cherry industry. CMI has no influence on the design, conduct or analysis of any U-M research it funds.

The correlation between cherry intake and significant changes in cardiovascular risk factors suggests — but does not directly demonstrate — a positive effect from the high concentrations of antioxidant compounds called anthocyanins that are found in tart cherries. The anthocyanins are responsible for the color of these and of other darkly pigmented fruits.

The potential for protective effects from antioxidant-rich foods and food extracts is a promising area of research, says Bolling, who is the Gayle Halperin Kahn Professor of Integrative Medicine at U-M.

The team performed the study using 48 obesity-prone rats, half of which were obese, and a diet in which 45 percent of calories came from fat and 35 percent came from carbohydrates. All the rats were six weeks old when study began. For the next 90 days they were fed either a cherry-enriched diet in which cherries made up 1 percent by weight, or a diet that contained an equivalent number of carbohydrates and calories.

At the end of the study, the rats had blood tests for glucose, cholesterol and triglyceride levels, received DEXA scans to measure their body fat and to see where the fat had collected, and had tests for two plasma inflammation markers: TNF-alpha and interleukin-6.

These two molecules are related to the level of vascular inflammation, or immune-system reaction to blood-vessel walls, that is often seen in people and animals with cardiovascular disease. While inflammation is a normal process the body uses to fight off infection or injury, according to recent science, a chronic state of inflammation may increase the risk for a number of diseases.

The cherries were Montmorency tart cherries grown in Michigan, which is the nation’s largest producer of tart cherries. They are different from the sweet Bing cherries that are often eaten fresh. Tart cherries have higher concentrations of antioxidant anthocyanins than sweet cherries.

By the end of the study, the rats that received the cherries had lower body weight, fat mass, total cholesterol, triglyceride, TNF-alpha and IL-6 than the rats that did not receive cherries. In all, TNF-alpha was reduced by 50 percent in the lean rats and 40 percent in the obese rats and IL-6 was lowered by 31 percent in the obese rats and 38 percent in the lean rats.

The obese rats that received cherries also had lower-weight retroperitoneal fat, a type of belly fat that has been associated with especially high cardiovascular risk and inflammation in humans.

In addition to Seymour and Bolling, the research team includes Daniel Urcuyo-Llanes, Ara Kirakosyan, Peter B. Kaufman, and Sarah K. Lewis of U-M, and Maurice Bennink of Michigan State University.

Even as the Cardioprotection Laboratory team continues its work in animals, U-M Integrative Medicine co-director Sara Warber, M.D., an assistant professor of family medicine at the U-M Medical School, is preparing to lead a pilot clinical trial of whole tart cherries in humans.

For more information on the University of Michigan Cardioprotection Laboratory, visit http://sitemaker.umich.edu/cardiac.phytomed. For information on participating in clinical trials at U-M, visit www.umengage.org. Reference: Experimental Biology 2008 poster #702.7

Posted by dlife at 11:58 AM | Comments (12)

Red Wine, Tea, May Help Regulate Blood Sugar in Type 2 Diabetics

April 2, 2008 (Newswise) — Red wine has been shown to protect people from heart disease, even when they follow a diet high in saturated fat, and the healing powers of tea are becoming the stuff of legend. Now, researchers at the University of Massachusetts Amherst have shown that these beverages may hold promise for regulating the blood sugar of people with type 2 diabetes.

Results have been published in the Journal of Food Biochemistry. Researchers include food scientists Kalidas Shetty, Young-In Kwon and Emmanouil Apostolidis.

“Levels of blood sugar, or blood glucose, rise sharply in patients with type 2 diabetes immediately following a meal,” says Shetty. “Red wine and tea contain natural antioxidants that may slow the passage of glucose through the small intestine and eventually into the bloodstream and prevent this spike, which is an important step in managing this disease.”

One of the main challenges in managing diabetes is keeping blood sugar levels as normal as possible with few major fluctuations, which can prevent the disease from contributing to heart disease and high blood pressure as well as damaging the eyes, kidneys, nerves and blood vessels.

Both red and white wines were tested in the laboratory using in vitro enzyme studies to determine how well they could inhibit the activity of a target enzyme called alpha-glucosidase, responsible for triggering the absorption of glucose by the small intestine. Red wine was the winner, able to inhibit the enzyme by nearly 100 percent. Values for white wine hovered around 20 percent.

This was clearly related to the amount of a specific type of antioxidants, called polyphenolics, found in the wines. “Our testing showed that red wine contains roughly ten times more polyphenolics than white wine,” says Shetty. “Laboratory results suggest that these compounds, found in many plant-based foods, may play a role in inhibiting alpha-glucosidase and slowing the passage of carbohydrates into the bloodstream.”

Alpha-glucosidase is the target for current drugs used to treat type 2 diabetes and the development of new drugs.

The team also tested four kinds of tea, including black, oolong, white and green teas. Water extracts of black tea had the highest effect on inhibiting the activity of
alpha-glucosidase, followed by white tea and oolong tea.

Wine and tea had no effect on a pancreatic enzyme called alpha-amylase that breaks down starch, which could help patients avoid the side effects of medications used to control blood sugar.

“A major drawback of medications that control both enzymes is the bacterial fermentation of undigested carbohydrates, especially starch, in the colon, which can lead to side effects such as flatulence, bloating and diarrhea,” says Shetty. “Tea and wine had no effect on the breakdown of starch by alpha-amylase, which could potentially help patients avoid these side effects.”

Another benefit is that the polyphenolics in wine and tea could also help in protecting the rest of the body from the additional complications of diabetes such as high blood pressure and heart disease. Diabetes places a stress on the entire body by increasing the production of free radicals, including molecules that react with oxygen, which degrade cellular function. Both red wine and tea contain antioxidants with proven health benefits, and have the potential to manage heart disease, high blood pressure and perhaps contribute to the prevention of cancer, which are all linked to free radicals.

“These results provide strong evidence for further studying the use of wine and tea to manage some stages of type 2 diabetes using animal models and clinical studies, and point to the importance of an antioxidant-rich diet as part of an overall management strategy,” says Shetty. “This concept is not new, but we are finding clear cellular targets for the functions of dietary polyphenolics. Using specific beverage combinations could generate a whole food profile that has the potential to manage type 2 diabetes and its complications, especially in the early stages.”

Posted by dlife at 02:24 PM | Comments (22)

Trans Fat: Why It’s Time to Eliminate This Dietary Villain

April 2, 2008 (Newswise) — Trans fats are a cholesterol double whammy. Also known as trans-fatty acids, trans fats raise low-density lipoprotein (LDL or “bad”) cholesterol and lower high-density lipoprotein (HDL or “good”) cholesterol.

Experts consider trans fat the worst type of dietary fat. Trans fat contributes to heart disease by promoting low-grade inflammation in the blood vessels. And, trans fats are associated with a higher risk of developing type 2 diabetes.

The April issue of Mayo Clinic Women’s HealthSource provides information to better understand the health risks posed by trans fats as well as tips to avoid consuming them.

Trans fats are formed when liquid oils are made into solid fats such as shortening and hard margarine. Because of their long shelf life and appealing texture, synthetic trans fats have been favored ingredients in commercially baked goods such as cakes, cookies, crackers and crusts. Commercially fried foods, such as doughnuts and french fries, also often contain trans fats.

The use of trans fats is starting to change. New York City made headlines when it banned trans fats in restaurants. Other cities are considering going trans-fat free. Some food manufacturers are reducing or eliminating trans fats in their products.

But avoiding trans fats still takes diligence. The American Heart Association recommends limiting trans fats to less than 1 percent of daily calories. That’s just 20 calories (2 grams) in a 2,000-calorie per day diet. That amount can easily come from naturally occurring trans-fatty acids in dairy products and meat from cows, goats and sheep.

At the grocery store, product nutrition labels contain trans fat information. However, a product that has less than ½ gram of trans fat can be labeled as zero. Eating modest amounts of these products easily can add up to more than 2 grams of trans fats. Keys words such as “shortening,” “partially hydrogenated” or “hydrogenated” indicate the food contains trans fats even when the chart on the label indicates none. Many restaurants continue to use trans fats for deep-fried foods. Grilled or baked foods are more likely to be trans-fat free.

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

Drinking Tea May Offer Health Benefits, but Evidence Still Limited

April 2, 2008 (Newswise) — Tea drinkers who opt for black, oolong, green or white teas may find that these beverages offer health benefits. The April issue of Mayo Clinic Health Letter covers what is -- and isn’t -- known about the health effects of drinking tea.

Black, oolong, green or white teas have a common origin. Each is produced from the leaves of the Camellia sinensis bush. The leaves are loaded with flavonoids and other polyphenols that work as antioxidants, possibly lowering the risk of some diseases.

While numerous studies have found possible benefits, the actual benefits of drinking tea are not certain. Most research about tea’s benefits is based on population (epidemiological) studies. Findings are limited because factors other than tea consumption could influence the results. Here’s some of what’s known about tea’s potential benefits:

Cardiovascular: It’s still uncertain if drinking tea over long periods might positively affect cholesterol levels, blood pressure and atherosclerosis. There’s some early evidence that regularly drinking green tea may reduce heart attack risk or atherosclerosis. There’s conflicting evidence on black tea consumption and heart attack risk reduction.

Cancer: It’s still unknown whether regular black tea consumption influences cancer rates. Early lab tests with white tea indicate it may protect against colon cancer in particular. So far, well-designed studies haven’t proven this.

Bone and joint health: Early laboratory research indicates green tea could be beneficial in reducing inflammation related to arthritis and slowing cartilage breakdown. Some early data indicate that regular tea consumption might improve bone mineral density in older women.

Memory: Studies are limited, but a recent one found that older adults in Japan who drank green tea daily showed less risk of memory difficulty, compared with those who didn’t drink tea regularly.

While there’s still much to learn about tea’s health benefits, the potential benefits seem to be in the cup, not in supplements or tea extract capsules. So far, there’s no certainty that the compounds in supplements are the same ones in tea, and even less certainty that these supplements might provide the same potential health benefits as tea.

Mayo Clinic Health Letter

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Michigan Tech Researchers Link 11 Genetic Variations to Type 2 Diabetes

Doing the math: New statistical methods can pinpoint problem genes

April 1, 2008 (EurekAlert) - Mathematicians at Michigan Technological University have developed powerful new tools for winnowing out the genes behind some of humanity’s most intractable diseases.

With one, they can cast back through generations to pinpoint the genes behind inherited illness. With another, they have isolated 11 variations within genes—called single nucleotide polymorphisms, SNPs or “snips”—associated with type 2 diabetes.

“With chronic, complex diseases like Parkinson’s, diabetes and ALS [Lou Gehrig’s disease], multiple genes are involved,” said Qiuying Sha, an assistant professor of mathematical sciences. “You need a powerful test.”

That test is the Ensemble Learning Approach (ELA), software that can detect a set of SNPs that jointly have a significant effect on a disease.

With complex inherited conditions, including type 2 diabetes, single genes may precipitate the disease on their own, while other genes cause disease when they act together. In the past, finding these gene-gene combinations has been especially unwieldy, because the calculations needed to match up suspect genes among the 500,000 or so in the human genome have been virtually impossible.

ELA sidesteps this problem, first by drastically narrowing the field of potentially dangerous genes, and second, by applying statistical methods to determine which SNPs act on their own and which act in combination. “We thought it was pretty cool,” Sha said.

To test their model on real data, Sha’s team analyzed genes from over 1,000 people in the United Kingdom, half with type 2 diabetes and half without. They identified 11 SNPs that, singly or in pairs, are linked to the disease with a high degree of probability. Their work has been accepted by the journal Genetic Epidemiology and is available online at http://www3.interscience.wiley.com/cgi-bin/abstract/117890704/ABSTRACT .

ELA is used to compare the genetic makeup of unrelated individuals to sort out disease-related genes. The team has also developed another approach, which uses a two-stage association test that incorporates founders’ phenotypes, called TTFP, that can examine the genomes of family members going back generations.

“In the past, researchers have dealt with the nuclear family, parents and children, but this could go back to grandparents, great-grandparents . . . as far back as you want.”

The team has published their findings in the European Journal of Human Genetics. An abstract is available at www.nature.com/ejhg/journal/v15/n11/abs/5201902a.html.

Now that they’ve developed the software, the analysis is relatively simple, says Sha. But getting the genetic data to work on is not. “We don’t have the data sets yet to work with,” she says, clearly frustrated. “That’s the problem with having no medical school.”

Those who do have data sets, however, can use the team’s software to help find the cause—and hopefully, the cures—for a panoply of illnesses. ELA is available in Windows and Linux versions at www.math.mtu.edu/~shuzhang/software.html, and TTFP is available by request.

Posted by dlife at 09:25 AM | Comments (0)