October 7, 2009 (EurekAlert) - One of the biggest mysteries about diabetes is why specialized cells in the pancreas stop secreting insulin, which the body needs in order to store glucose from food. A team from the Children's Hospital of Eastern Ontario (CHEO) Research Institute has identified a protein that inhibits insulin production in mice - work that offers a new way of understanding, and perhaps of one day treating, both Type 1 and Type 2 diabetes.A study to be published today in the leading international journal Cell Metabolism describes how a research group led by Dr. Robert Screaton, who holds the Canada Research Chair in Apoptotic Signaling at the University of Ottawa, used sophisticated genetic engineering to remove or 'knock out' the Lkb1 gene from beta cells of laboratory mice. The result was an increase in both the size and number of beta cells, as well as greater amounts of insulin stored and released by the cells.

Importantly, the improved beta cell function lasted for at least five months, even in mice fed a high-fat diet designed to mimic the high caloric intake associated with Metabolic Syndrome and Type 2 diabetes in humans.

"We were surprised by the impressive accumulation of Lkb1 in beta cells of diabetic mice, which suggested that Lkb1 might contribute to their impaired function. After removal of the Lkb1 gene, the beta cells grow larger, proliferate more, and secrete more insulin. It's a one-stop shop for the much needed insulin", said Dr. Screaton.

"The knockout mice on a high-fat diet have lower blood glucose. If this observation is confirmed in humans, it may give us another clue into the development of Type 2 diabetes, and perhaps new treatment options".

"Type 1 and 2 diabetes, already common diseases, are showing disturbingly steady growth in incidence. The two conditions are among Canada's, and indeed the globe's, greatest health challenges," said Dr. Alex MacKenzie, CEO of the CHEO Research Institute and a physician who treats children with diabetes at CHEO. "The findings of Dr. Screaton's team introduce a novel and unanticipated potential therapeutic avenue for this costly and serious condition. It is some of the most important work to come out of our institute."

October 6, 2009 (EurekAlert) - More research is required to establish whether Chinese herbal medicines can reduce the likelihood of developing diabetes, according to Cochrane Researchers. Although herbal medicines are widely used in Asian countries to treat pre-diabetes (impaired glucose tolerance or IGT), the precursor of the disease, researchers say there is still not enough hard scientific evidence to confidently recommend their use."People with impaired glucose tolerance are more likely to develop full blown diabetes and it may be possible to prevent or delay the onset of the disease through lifestyle changes and medication. Chinese herbal medicines have been used for this purpose for a long time, so there is plenty of anecdotal evidence for their safety and effectiveness, but we were interested to find out whether scientific research could provide a basis for recommending these alternative treatments," says lead researcher, Suzanne Grant of the Centre for Complementary Medicine Research at the University of Western Sydney in Australia.

Pre-diabetes is recognised by higher than normal blood sugar levels. People with pre-diabetes are advised to change their diets to control their blood glucose levels and prevent progress to diabetes. In China, Korea and Japan herbal pills, teas and powders have been used for a long time to treat pre-diabetes and diabetes. They are thought to work in a number of different ways to help normalise blood sugar levels, including by improving pancreatic function and increasing the availability of insulin, a hormone that regulates blood sugar levels.

The researchers considered data from 16 clinical trials including 1,391 people who received 15 different herbal formulations. According to their findings, combining herbal medicines with lifestyle changes is twice as effective as lifestyle changes alone at normalising patients' blood sugar levels. Those given the herbal formulations were less likely to develop full blown diabetes during the study period. Trials included in the review lasted from one month to two years. No adverse effects were reported in any of the trials.

"Our results suggest that some Chinese herbal medicines can help to prevent diabetes, but we really need more research before we can confidently say that these treatments work," says Grant. "The real value of the study is as guidance for further trials. We need to see more trials that make comparisons with placebos and other types of drugs, and better reporting on the outcomes of these trials."

October 1, 2009 (EurekAlert) - Kidneys recovered from deceased donors with acute renal failure (ARF) - once deemed unusable for transplant - appear to work just as well as kidneys transplanted from deceased donors who do not develop kidney problems prior to organ donation, according to a new study by researchers at Wake Forest University Baptist Medical Center.The findings, reported in the October issue of Surgery, suggest the possibility of safely expanding the donor kidney pool by at least 10 to 15 percent, potentially making an additional 1,000 kidneys or more per year available to those waiting for a donor organ.

"There is a critical shortage of donor organs and we are continually making efforts to expand the donor pool," said Robert J. Stratta, M.D., professor of surgery and director of transplantation at Wake Forest Baptist and senior investigator on the study. "While kidneys from deceased donors with ARF have been considered unusable in the past, our study shows they can work quite well. The function of the new kidney may be slow or delayed - and patients may have to continue dialysis for a week or two until the kidney is up and running - but that's really the only downside. Choosing to utilize these kidneys will greatly shorten the waiting time for people who are willing to accept a kidney from this kind of donor."

Stratta and colleagues transplanted 25 kidneys from 17 deceased donors with ARF, which is impaired kidney function that can result from many things, including traumatic injury, exposure to medications toxic to the kidneys, infection, dehydration, shock, and the breakdown of muscle fibers. Unlike chronic kidney failure, ARF can often be reversed if the underlying cause is treated or removed, Stratta said.

All of the kidneys were refused by multiple centers before being offered for transplantation at Wake Forest Baptist. The patients receiving the kidneys had an average waiting time of 24 months until a donor kidney was made available to them and each chose to accept the organ. All of the recipients were monitored for at least 11 months post-transplant. At an average follow-up of 20 months, patient and graft survival rates were 100 percent and 92 percent, respectively - comparable, Stratta said, to the outcomes typically seen when healthy deceased donor kidneys are transplanted.

"As long as the donor kidneys are still producing urine and do not have evidence of scarring from pre-existing conditions such as diabetes or a history of high blood pressure, they appear to restore to a healthy condition when transplanted," he said.

"Each transplant center has its own level of comfort regarding the criteria they use to determine what organs they will and will not accept for transplant," Stratta added. "In the past, kidneys from donors with ARF were considered an absolute 'no.' Then they became a relative 'no.' After this study, I think it's safe to say that they are a relative 'yes' - there is a subset of these donor kidneys that can be safely and successfully transplanted with very good short-term results."

Over the last decade, the number of patients waiting for a kidney transplant has outpaced growth in the number of transplants performed each year. Between 1997 and 2006, the number of patients waiting for a kidney transplant increased by 81 percent from 49,208 to 88,877. During the same time, the number of annual kidney transplants performed in the United States increased by only 41 percent from 11,703 to 16,483. This escalating disparity in the number of end stage renal disease patients on the waiting list relative to those actually receiving kidney transplants has been accompanied by a startling increase in the number of deaths while waiting for transplants, from 2,184 in 1997 to 4,456 in 2006. In addition, median waiting times for kidney transplants have doubled in the last decade.

"Now that we know we can successfully transplant these kidneys and they will work just as well as other deceased donor kidneys, it becomes a decision of personal preference - the transplant center's level of comfort with using these kidneys, the patient's preference with accepting the kidney, and the general public's decision on whether or not to donate life," Stratta said.

October 1, 2009 (Newswise) - A regular tai chi exercise program can help people better control their diabetes and lower glucose levels, according to a University of Florida study.In a study of adults diagnosed with type 2 diabetes, those who participated in a supervised tai chi exercise program two days a week with three days of home practice for six months significantly lowered their fasting blood glucose levels, improved their management of the disease, and enhanced their overall quality of life, including mental health, vitality and energy.

"Tai chi really has similar effects as other aerobic exercises on diabetic control. The difference is tai chi is a low-impact exercise, which means that it's less stressful on the bones, joints and muscles than more strenuous exercise," said Beverly Roberts, Ph.D., R.N., the Annabel Davis Jenks endowed professor at the UF College of Nursing.

Roberts, with Rhayun Song, Ph.D., R.N., of Chungham National University, studied tai chi's effect on older Korean residents. The research was featured in the June issue of The Journal of Alternative and Complementary Medicine.

About 23.6 million children and adults in the United States, or 7.8 percent of the population, have diabetes. It occurs when the body does not produce or properly use insulin, a hormone that is needed to convert sugar, starches and other food into energy needed for daily life.

Risk factors include obesity, sedentary lifestyle, unhealthy eating habits, high blood pressure and cholesterol, a history of gestational diabetes and increased age, many of which can be reduced through exercise.

"People assume that for exercise to be beneficial you have to be huffing and puffing, sweating and red-faced afterward," Roberts said. "This may turn people off, particularly older adults. However, we have found that activities like tai chi can be just as beneficial in improving health."

Tai chi is an ancient Chinese martial art that combines deep breathing and relaxation with slow, gentle circular movements. This low impact exercise uses shifts in body position and stepping in coordination with arm movements.

Sixty-two participants, mostly Korean women, took part in the study. Half the group participated in at least 80 percent of two supervised sessions one hour per week, with three days of home practice for six months, and the other half served as a control group. Those who completed the sessions had significantly improved glucose control and reported higher levels of vitality and energy.

"Those who participated in the tai chi sessions actually had lower blood glucose at three and six months," Roberts said. "Those individuals also had lower hemoglobin A1c, which means they had better diabetic control."

In addition to improved blood glucose levels, participants also reported significantly improved mental health. This was very encouraging especially since people with less depression are typically more active and independent, Roberts said.

Tai chi has also been used for people with arthritis and disabilities to increase balance, muscle strength and mobility and to reduce the risk of falls. It is worth investigating its effects in other conditions, especially in older people, Roberts said.

"Tai chi provides a great alternative for people who may want the benefits of exercise on diabetic control but may be physically unable to complete strenuous activities due to age, condition or injury," Roberts said. "Future studies could examine if tai chi could similarly benefit conditions such as osteoporosis or heart disease."

Since tai chi is an exercise that involves so many parts of the body and also helps to relax the mind, it is more likely participants will adhere to the exercise, said Paul Lam, M.B.B.S., a lecturer with the University of South Wales School of Public Health and Community Medicine and a practicing family physician in Sydney, Australia.

"This study shows that tai chi can have a significant effect on the management and treatment of diabetes - a significant and growing health challenge for all Western countries," Lam said.

September 24, 2009 (Newswise) - The Society for Vascular Surgery® (SVS) and the American Podiatric Medical Association (APMA) announce formation of a strategic collaboration to help advance the care of patients with critical limb ischemia, especially in the diabetic population. The multidisciplinary team approach was outlined during a meeting between leaders of both associations in August.The collaboration includes an agreement approved by the respective boards of SVS and APMA to identify clinical issues, questions important to both memberships, and to work together to find solutions that will benefit our patients. Specifically, in the August leadership meeting, it was agreed to:

1. Appoint a group representing both organizations to write a joint statement on the multidisciplinary team approach to the care of diabetic foot
2. Produce a supplement on the care of the diabetic foot that will be jointly published in the Journal of Vascular Surgery® and the Journal of the American Podiatric Medical Association
3. Establish joint postgraduate courses to be held at the annual scientific meetings of both organizations
4. Collaborate on practice guidelines and reporting standards dealing with the care of diabetic foot
5. Collaborate on advocacy and public awareness efforts in areas of common interest

"Vascular surgeons and podiatrists have always worked together to provide the best care for patients with diabetic foot problems," said Anton N. Sidawy, president, SVS. "We are pleased to formalize an alliance with APMA so that we can jointly work on the prevention and management of diabetic foot, which would positively impact the care of our patients. Our staffs will conduct public education programs to raise awareness and promote prevention."

A Management of the Diabetic Foot session was a highlight at the SVS' 2009 Vascular Annual Meeting®. The video of this session has been made available to APMA through a VascularWeb.org at http://tinyurl.com/ycdy8tx.

July 7, 2009 (Newswise) - A study comparing how two common dietary oil supplements affect body composition suggests that both oils, by themselves, can lower body fat in obese postmenopausal women with Type 2 diabetes.The two oils compared were safflower oil, a common cooking oil, and conjugated linoleic acid (CLA), a compound naturally found in some meat and dairy products that has been associated with weight loss in previous studies. Both are composed primarily of polyunsaturated fatty acids, which are considered "good fats" that, when consumed in proper quantities, are associated with a variety of health benefits.

In the study, 16 weeks of supplementation with safflower oil reduced fat in the trunk area, lowered blood sugar and increased muscle tissue in the women participants.

Conjugated linoleic acid supplementation for the same length of time, on the other hand, reduced total body fat and lowered the women's body mass index (BMI), a common health measure of weight relative to height.

All of the women in the study took one oil for 16 weeks, followed by the other oil for an equal amount of time. The participants were instructed not to change their diets or exercise patterns over the course of the study so the research would measure the effects of only the supplementation.

"Making this subtle change in the intake of high-quality dietary fats in an effort to alter body composition is both achievable and affordable to postmenopausal women in the United States who are managing the difficult combination of obesity and diabetes," said Martha Belury, professor of human nutrition at Ohio State University and senior author of the study.

Among the most surprising findings: that in 16 weeks, these women could lose between about two pounds and four pounds of trunk fat simply by taking safflower oil supplements.

"I never would have imagined such a finding. This study is the first to show that such a modest amount of a linoleic acid-rich oil may have a profound effect on body composition in women," Belury said. The dose of either oil taken each day was approximately 1 2/3 teaspoons.

Postmenopausal women tend to lose muscle at the same time that body fat accumulates toward their middle, so this research shows how dietary oils can complement lifestyle and medication in helping older diabetic women manage their health, she said.

The research appears online and is scheduled for later print publication in the American Journal of Clinical Nutrition.

Thirty-five women participated in the study. All were considered obese based on their BMI measures of 30 or higher, were postmenopausal but younger than age 70, and had Type 2 diabetes but did not need to take insulin to treat the disease. Many did take other medications, such as those used to manage blood sugar levels, cholesterol or blood pressure.

The women were randomized into two groups to determine which supplement they took first. Each initial 16-week supplementation was followed by a four-week washout period to remove the first supplement from their systems before the next 16-week supplementation period began. The supplements were contained in eight pills; the women took two pills four times per day, at meals and bedtime.

"The power of the crossover is that it tells you the different effects of the dietary oils in the same woman," Belury said.

The daily supplementation contained 6.4 grams of each oil's active fatty acid: linoleic acid in safflower oil and, in CLA, specific fatty acid isomers - compounds that share the same chemical formula but differ in chemical structure.

The researchers used dual-energy X-ray absorptiometry, commonly known as DXA and usually used to measure bone density, to determine the women's baseline and follow-up lean mass and fat throughout their bodies and specifically in their trunk region.

Researchers asked the participants to keep diet and activity records for three consecutive days at four points over the course of the study to account for the potential for calorie intake or exercise to affect the results, Belury said. Physical activity remained unchanged throughout the study, and no significant differences were seen between the two groups' reported calorie intake.

The study showed that CLA supplementation significantly decreased body mass index and total body fat over both diet periods, typically showing effects in the last half of each 16-week period. The BMI levels of the women taking CLA dropped on average by about half a point, and their total body fat decreased by an average of 3.2 percent, reducing the weight of the fat tissue by an average of between 2.3 pounds and 3.5 pounds.

Safflower oil supplementation showed no effect on total body fat readings, but reduced the weight of trunk fat tissue by between 2.6 pounds and 4.2 pounds, or an average of 6.3 percent. It also increased lean tissue, or muscle, by between an average of about 1.4 pounds and 3 pounds.

Safflower oil also lowered fasting blood sugar levels by between 11 and 19 points on average. Blood sugar is considered normal if it falls below 110 milligrams per deciliter; the women's average blood sugar levels ranged from 129 to 148 after 16 weeks of safflower oil supplementation.

"Lowering fasting glucose is important for these women. The overall effect in just 16 weeks wasn't bringing them back to normal, but safflower oil still improved it significantly," Belury said.

The dietary oils did not have significant effects on other health measurements, such as waist circumference, waist-to-hip ratio and skinfold thickness measures of body fat, Belury noted.

The CLA also did not appear to affect the variety of hormones involved in fat burning. However, safflower oil increased a hormone called adiponectin. Increasing this hormone may have instilled an improved ability to burn dietary fats, said Belury, who hopes to investigate this mechanism in a follow-up study.

Belury said that other work she is conducting in animals suggests that at least in the case of CLA, the fatty acid appears to allow the body to burn calories in a heat-producing way. Questions remain about the long-term safety of any kind of supplementation that lowers body fat, because some research has suggested that the fat that leaves fat tissue ends up in the liver or muscles - a condition that could lead to insulin resistance and diabetes if that fat can't be used.

Neither CLA nor the linoleic acid in safflower oil is naturally produced in the human body, so both must be obtained from food or dietary supplements. Linoleic acid is an omega-6 fatty acid that is important in growth and maintenance of tissues and lipid metabolism. The American Heart Association recently issued recommendations suggesting that omega-6 fatty acids are among the polyunsaturated fats that should be consumed for heart health.

CLA is found naturally in trace amounts primarily in beef, lamb and milk, but obtaining levels comparable to those used in Belury's study likely requires concentrated doses similar to those found in dietary supplements.

"Essentially what we're trying to understand with nutrition is how dietary approaches can complement Westernized medicine," Belury said. "In an ideal world, we'd love it if women like those in our study could use diet, activity and other aspects of a healthy lifestyle to manage their health. But most will probably be on oral medications for the rest of their lives for managing their diabetes and metabolism, which is fine as long as the medications work. We think there's a chance that nutrition can complement medication and help drugs work even better."

July 7, 2009 (Newswise) - Thanks to a new collaboration between the nutrition department at the University of Massachusetts Amherst and a highly regarded Oriental medicine center in Korea, researchers are now exploring Asian medicinal herbs as a tool for managing the global epidemic of Type II diabetes and obesity now sweeping through developed and developing countries alike.Through a recent Memorandum of Understanding between the university and Chungbuk Oriental Medicine Center, South Korea, Young-Cheul Kim, a UMass Amherst assistant professor of nutrition and an expert in how fat cells develop in the body, will study molecular-level biological function of certain medicinal herbs such as the vetch, Astragalus, also known as milk vetch or huang chi.

In particular, Kim's laboratory will use his well characterized fat cell differentiation model to test a number of plant-based compounds or phytochemicals for potential anti-obesity and anti-diabetes properties, first in in vitro cell culture, then in whole animals and finally in humans. He says, "Overall, we are trying to understand the cellular and molecular mechanisms underlying the development of fat cells in the body, especially by bioactive food components, with the goal to find therapeutic strategies for not only preventing chronic diseases such as obesity, cancer and heart disease, but promoting overall health. These chronic disorders are all related to our diet, illustrating the importance of nutrition."

On a recent visit to UMass Amherst, representatives of Chungbuk Oriental Medicine Center were quite impressed with the collaborative environment here, Kim says, where he and other university researchers are already working with clinicians at the Pioneer Valley Life Sciences Institute (PVLSI) and Bay State Medical Center in Springfield on obesity research, for example. They expressed great interest in creating similar inter-disciplinary partnerships at the center in Chungbuk.

Despite its use for hundreds of years in Asia to prevent or treat certain diseases, evidence for health claims of the herb Astragalus is "limited" at present, according to the U.S. National Center for Complementary and Alternative Medicine. This is partly because one herb may contain so many different active components. As Kim notes, with new interest the time has come to investigate, with rigorous scientific methods, what compounds are present and how they work. Therefore, he says, "one of the goals of our collaboration with this prestigious center of Asian medicine in Chungbuk will be to identify any biologically active ingredients."

There is already some preliminary evidence from experiments with mouse cells in Kim's laboratory that an extract of the hardy high-altitude shrub, Rhodiola, also known as "golden root," inhibits the generation of new fat cells from precursor cells called pre-adipocytes. It acts by interfering with the genes that determine the progression of adipogenesis, or the formation of fat. Future studies by Kim and colleagues will extend the work to test more compounds and explore effects in primary cultures of human cells. If replicated, studies can move on to test effectiveness in whole body systems.

Though some may be surprised by the Korean medical center's interest in research on obesity and diabetes, Kim says these conditions have emerged as public health problems in Asia over the past two decades with the availability of fast foods and a tendency toward decreased physical activity.

"We know from immigrant epidemiologic studies that a balanced diet and exercise play a critical role in maintaining health, preventing chronic diseases and reducing the incidence of metabolic syndromes such as diabetes and obesity. Unfortunately we can now see obese children throughout Asia, and many more people with diabetes," says Kim, who grew up in Korea. "So the major research centers and food industry are now very interested to investigate the possible functional and beneficial roles of plants and herbs, as well as their nutritional value."

In addition to calling for collaborative research with UMass Amherst, the agreement with Chungbuk Oriental Medicine Center is expected to lead to faculty and student exchanges, joint workshops and other activities, Kim notes. In September, he plans to speak about the impact of bioactive dietary compounds in preventing chronic diseases at an international symposium in Chungbuk, Korea, and the following year at the World Oriental Medicine Bio-Expo in Jecheon.

February 26, 2009 (EurekAlert) - How big is a serving of spaghetti or a cup of cranberry juice? Correctly estimating the size of a food serving is important for maintaining a healthy weight, but a new study suggests people with lower literacy levels might have a more difficult time sizing up the foods they eat.eople with high literacy levels are twice as likely as those with low literacy test scores are to dole out a single-sized portion of pasta, pineapple, ground beef and other common foods, according to the study in the April issue of the American Journal of Preventive Medicine.

Yet, people with higher literacy levels have troubles estimating portion sizes, too, said Johns Hopkins researcher Mary Margaret Huizinga, M.D., who led the study while at Vanderbilt University. When combining serving data for all the foods in the study, only 62 percent of study participants could serve a specific amount of food accurately when asked, she and colleagues discovered.

For individual foods, "accuracy ranged from 30 percent for beef to 53 percent for juice," Huizinga said.

"The current super-sizing of many foods may lead Americans to overestimate what a normal portion should be," she said, "and the overestimation of portion size may lead to overeating and contribute to obesity."

In their study of 164 patients at a primary care clinic, the researchers tested the participants' verbal and written literacy as well as their understanding of numerical information. They then measured how well the patients were able to estimate a single serving or a specified amount of a variety of foods, using guidelines from the U.S. Food and Drug Administration and the U.S. Department of Agriculture as a standard.

The participants' food preferences, or even how often they ate a particular food, did not seem to affect how well they estimated serving sizes, Huizinga and colleagues noted.

Ballooning portion sizes in restaurants is one factor that prompts people to see large portions as normal, but the same kind of "portion distortion" can happen at home, said Jennifer Fisher, Ph.D., an associate professor of public health at Temple University.

In her studies of how much children eat when faced with normal or super-sized entrees, Fisher found that a family's social and cultural perceptions of "how much is enough" also influenced the portions dished out to children.

"Seeing a large amount of food in front of you can lead you to believe that someone decided this portion was the right amount to eat," she said.

February 26, 2009 (EurekAlert) - Workers with diabetes and obesity improved their absenteeism and disability rate by as much as 87 percent with the help of a lifestyle intervention program administered by researchers at the University of Virginia Health System. The results appear in the February edition of the Journal of Occupational and Environmental Medicine. Improving Control with Activity and Nutrition (ICAN) is a dietitian-led lifestyle intervention aimed at improving health factors such as blood sugar control, weight, diet and physical activity. According to Anne Wolf, dietitian and lead researcher in the Department of Health Evaluation Sciences in the University of Virginia School of Medicine, models such as this should be available and affordable for people with chronic diseases."Lifestyle modification with weight loss has been recommended by every major medical group as the first line treatment for many chronic diseases. Yet access to lifestyle support is not covered by traditional medical insurance. It is now time to stop giving recommendations and start implementing policy," said Wolf. "This helps not only the individual with chronic disease, but helps the employer create a stronger, healthier and more economically viable work force."

Eligible study participants with type 2 diabetes and a body mass index of 27 or greater were randomly assigned to either the lifestyle intervention or usual care groups. For the lifestyle intervention group, participants were assessed and counseled by a dietitian. Participants attended six individual sessions and six small group sessions for one year. They received additional support over the phone each month. Usual care group participants received written educational materials and their usual medical care from their physicians.

Participants in the usual-care group lost 3.49 work days per year. The lifestyle intervention group lost 0.92 work days per year. ICAN reduced the probability of lost work days by 64.3 percent. Disability and physical limitation days were used at a rate of 5.3 days for the usual-care group and 0.94 days for the lifestyle intervention group. ICAN reduced the probability of disability days lost by 87.2 percent. Depression, a strong predictor of work days lost due to diabetes and obesity, resulted in an average of 6.6 missed work days per year for the usual- care participants and 1.7 missed work days for the lifestyle intervention participants. Results were similar for depression's impact on disability days lost. The net cost of ICAN was $328 per person.

"The cost of doing nothing is great," Wolf said. "However, If we calculate the return on investment (ROI) based on program costs, savings from averted days missed at work and with disability and physical limitations, the ROI was $2.67-hence for every dollar invested in the program, the employer saw a return of $2.67, and this does not include the cost savings seen by reducing medical costs-a result we reported earlier."

According to Wolf, absenteeism and disability are indirectly related to health and can be costly for both workers ad their employers. In 2007, people with diabetes lost 15 million work days due to their condition. This cost the US economy approximately $2.6 billion. Wolf believes that lifestyle interventions could reduce these numbers.

"This finding underlines the importance of access to lifestyle intervention for people with diabetes and obesity, and particularly if they are depressed. We lose so much potential in our country due to chronic disease," Wolf adds. "We lose potential of the individual to live life more fully, potential of the family to be more solvent and potential of our nation to be more productive. We can no longer afford to lose this potential."

November 20, 2008 (EurekAlert) - The body's immune system hates strangers. When its security patrol spots a foreign cell, it annihilates it.

This is the problem when people with type 1 diabetes undergo human islet cell transplantation. The islet cells from a donor pancreas produce robust amounts of insulin for the recipient -- often permitting independence from insulin therapy. However, the immune system tries to kill the new hard-working islets.A person who has the transplant procedure must take powerful immunosuppressive drugs to prevent their bodies from rejecting the cells. The drugs, however, are toxic to the new islet cells and put patients at risk for infections and cancer.

Now researchers at Northwestern University's Feinberg School of Medicine have found a way to trick the immune system of mice into believing those transplanted islets are its own cells. This new technique eliminated the need for the immunosuppressive drugs in mice with chemically-induced diabetes after they had islet transplantation.

"We made the recipient feel that the donor cells are their own," explained Stephen Miller, co-principal investigator and the Judy Gugenheim Research Professor of Microbiology-Immunology at the Feinberg School. "This technique is a highly attractive potential therapy for human islet cell transplantation." The findings were reported in the journal Proceedings of the National Academy of Science in the fall.

As many as 3 million people in the U.S. may have type 1 diabetes, a disease that develops in children and adolescents. There are about 50 to 70 islet transplants, an experimental procedure, annually in North America.

Miller said he was happily surprised to see that such a high percentage of recipients of the transplanted islet cells -- greater than 70 percent -- maintained transplants long-term. His research showed the host's tolerance to these transplanted cells seemed to be permanent, lasting for at least 150 days. Xunrong Luo, assistant professor of medicine in nephrology at the Feinberg School, was co-principal investigator for the study.

In the study, researchers took a type of white blood cell from the islet donor's spleen, called splenocytes, and treated them with a chemical that masked the cells' identity. They then injected these chemically treated cells into diabetic mice before and after the mice underwent islet cell transplantation. As a result, the immune system of the mice didn't try to reject the cells, because it didn't perceive them as foreign and dangerous.

When the same test was done without pre-treated cells, the immune system rejected the transplanted islets within 15 days.

In an upcoming study, Miller and Luo will work with mice that have autoimmune disease that destroys their islet cells, as occurs in type 1 diabetes. Researchers will use therapies that prevent the autoimmune system's response against its own beta cells (which are part of the islets) as well as prevent the recipient's immune responses against the transplanted islet cells.

"We have ways we can do both," Miller said. "Hopefully this next study will show we can take combined therapies for underlying autoimmune disease and transplanted islets. If we do that together, we hopefully can cure an animal who became diabetic from autoimmune disease." If successful, the next step would be testing the technique on human subjects.

Miller said this technique also has applications for treating other autoimmune diseases such as multiple sclerosis.