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Archive - 06 - 2014

Inhaled Insulin for Diabetics

Posted by dlife on Mon, Jun 30, 14, 11:53 AM 0 Comment

June 30, 2014 (Medscape) - Be on the lookout in the ED for patients taking a new, rapidly-acting inhalable form of insulin powder. Known as Afrezza, it was approved by the FDA last week for treating types 1 and 2 diabetes. In those with Type 1 Diabetes, Afrezza is taken with meals and is used as a supplement to long-acting insulin. Afrezza comes in cartridges of 4 and 8 units. Afrezza was shown to be noninferior to standard injectable insulin for reducing hemoglobin A1c levels in clinical trials. According to information in the FDA's press release, "The drug's safety and effectiveness were evaluated in a total of 3,017 participants–1,026 participants with type 1 diabetes and 1,991 patients with type 2 diabetes. The efficacy of mealtime Afrezza in adult patients with type 1 diabetes patients was compared to mealtime insulin aspart (fast-acting insulin), both in combination with basal insulin (long-acting insulin) in a 24 week study. At week 24, treatment with basal insulin and mealtime Afrezza provided a mean reduction in HbA1c (hemoglobin A1c or glycosylated hemoglobin, a measure of blood sugar control) that met the pre-specified non-inferiority margin of 0.4 percent. Afrezza provided less HbA1c reduction than insulin aspart, and the difference was statistically significant. Afrezza was studied in adults with type 2 diabetes in combination with oral antidiabetic drugs; the efficacy of mealtime Afrezza in type 2 diabetes patients was compared to placebo inhalation in a 24 week study. At week 24, treatment with Afrezza plus oral antidiabetic drugs provided a mean reduction in HbA1c that was statistically significantly greater compared to the HbA1c reduction observed in the placebo group." Patients with asthma and COPD and those who smoke should not use Afrezza as a result of increased risk for bronchospasm associated with inhalation of the drug. In addition, Afrezza should not be used to treat patients with DKA. The most common side effects noted include cough, throat pain as well as hypoglycemia. Afrezza was actually rejected two times in the recent past by the FDA, but it was approved in April of 2014. Ongoing studies by the manufacturer will study if there is an increased risk for lung cancer, whether it is safe for use in pediatric patients and whether the inhaled form of insulin affects lung function in any potential adverse way in those with normal lung function.

Missing Protein Explains Link Between Obesity and diabetes

Posted by dlife on Mon, Jun 30, 14, 10:43 AM 0 Comment

June 30, 2014 (EurekAlert) - A*STAR scientists pioneered a molecular connection between the two health conditions Scientists from the Institute of Molecular and Cell Biology (IMCB), a research institute under the Agency for Science, Technology and Research (A*STAR), have discovered that obese individuals lack a protein that is essential for regulating blood glucose levels, causing them to face higher risks of developing diabetes. The protein is one of the first molecular links found between obesity to diabetes and is potentially a target for treatment or prevention of diabetes in obese individuals. Obesity and diabetes are two common health problems faced today. Based on a recent analysis reported in The Lancet medical journal, nearly a third of the world's population is obese or overweight . In Singapore, one in nine Singaporeans is obese and the situation is becoming more prevalent with an increase of one percent each year. Obesity inflates the risks of diabetes, which already affects more than 11 percent of the country's population . While statistics indicate a link between the two conditions, the mechanism of how obesity leads to diabetes has always been unclear. How Diabetes Develops from Obesity in the Absence of NUCKS Protein In the latest study reported in Cell Reports journal online, researchers at IMCB discovered that a protein, called NUCKS , is missing in obese individuals. The NUCKS protein is a key player in insulin signalling, an important biochemical pathway that is needed to respond to insulin hormones, which promote the uptake of glucose to regulate blood glucose levels. Without NUCKS, obese individuals develop insulin resistance and are unable to regulate their blood glucose levels effectively. This causes their bodies to constantly experience high levels of blood glucose, making them more susceptible to developing diabetes. These findings were supported by Singapore Bioimaging Consortium's (SBIC) cutting-edge bioimaging and metabolic profiling technologies, for identifying the parameters for obesity and diabetes. The NUCKS protein is an important clue for controlling diabetes development in obese individuals. It is the first direct molecular link found between the two health conditions and will open up new areas of research to identify drugs and explore lifestyle changes, such as dietary habits and exercises that could restore the level of NUCKS in the body. Dr Vinay Tergaonkar, Principal Investigator at IMCB and the lead scientist for the study, said, "It is alarming that obesity is a huge risk factor for many ailments, including diabetes. Having identified this protein, we are now a step closer towards removing one of these complications from individuals suffering from obesity." "The world is paying a lot of attention to diabetes. Every year, billions of dollars are spent on metabolic diseases and a big part of the expenditure goes to the drugs for diabetes. The findings in our study have immense therapeutic implications as they will be applicable not only to diabetes in obesity, but also to diabetes as a whole," Dr Tergaonkar added. Professor Hong Wanjin, Executive Director at IMCB, said, "IMCB is now focusing research on molecular mechanisms underlying diseases, which is important in developing future treatments for prevailing human diseases. We are excited to be a pioneer in uncovering a molecular link between these two common health problems. The incidence of metabolic disorders such as diabetes and obesity has been rising over the years, and these findings will prove valuable in further developing therapeutic approaches for them."

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