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Archive - 04 - 2008
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.Its exciting to see resveratrols 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.
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 Childrens 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 mothers 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 babys 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 mothers 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.orgTieu J, Crowther CA, Middleton P. Dietary advice in pregnancy for preventing gestational diabetes mellitus (Review). Cochrane Database of Systematic Reviews 2008, Issue 2.
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