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DATE: December 28, 2007

Supplements of the Indian herbal Coccinia indica may reduce blood sugar levels by about 20 per cent, says a new study from India that adds to the Indian herb linked potential to aid diabetics.

A one gram daily dose of C. indica extract led to an 18 per cent reduction in blood sugar levels after meals, according to a double blind, placebo control, randomised study published in the journal Diabetes Care. The study adds to an ever-growing body of evidence behind the herb's benefits for diabetics, highlighted a few years back in a review by researchers from the Harvard Medical School. They stated that Coccinia indica had the most evidence supporting their potential benefits, with results available from adequately designed randomised controlled trials (RCTs).

The authors, led by Rebecca Kuriyan from Institute of Population Health and Clinical Research, Bangalore, recruited 60 people with mild type-2 diabetics (age range 35-60) and randomly assigned them to receive either the one gram C. indica extract or placebo for 90 days. The extract was obtained using alcohol. None of the subjects was receiving medication, but was controlling their diabetes using dietary means. Kuriyan and co-workers report that fasting and post-prandial blood sugar levels among the diabetics receiving the C. indica supplement were reduced by 16 and 18 per cent, respectively, by the end of the trial. These decreases were statistically significant when compared to placebo. In addition, no significant changes were observed in blood lipid levels, they added.

"This study suggests that Coccinia cordifolia extract has a potential hypoglycemic action in patients with mild diabetes," stated the authors.

"However, further studies are needed to elucidate mechanisms of action," they concluded.

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

Source: Diabetes Care

DATE: December 21, 2007

Cyberonics is teaming up with Johnson & Johnson to create a new way to fight fat: What if people's nervous systems told them that they aren't hungry?

This week the company unveiled a deal in which it will license patent rights for a nerve stimulation device to Johnson & Johnson. The device, developed by Cyberonics' founders in the late 1980s, has several uses, but Johnson & Johnson's subsidiary plans to develop the so-called vagus nerve stimulator as a way to combat obesity. Obesity is the Holy Grail for modern healthcare companies. Some two-thirds of Americans are overweight, and fat is also a global epidemic. This year, the World Health Organization said it expects the number of obese adults worldwide to grow from 400 million today to roughly 700 million by 2015. For some, being overweight is mostly a vanity issue, but it can lead to real health problems such as diabetes, heart failure, and high blood pressure. To date, a variety of methods have been used to fight fat; Cyberonics' "neural modulation therapy" sounds like science fiction, but it has established a track record in recent years.

How does it work? The company markets the Vagus Nerve Stimulation device (VNS), a pocket watch-sized transmitter which, when surgically implanted into a patient's upper chest, sends impulses to the vagus nerve endings along the neck. It has multiple uses: In 1997, the Food and Drug Administration approved the device for treatment of epilepsy after the company showed VNS could reduce the frequency of seizures. In 2005, the FDA approved VNS for treatment of severe and recurrent depression for patients who don't respond to medication. (Some 20% of depression sufferers aren't helped by antidepressants and other drugs.)

Since 1997, Cyberonics has sold 46,000 VNS units worldwide. The device and its surgery cost patients $25,000. Cyberonics is currently testing its device as a possible treatment for Alzheimer's disease, anxiety disorders, migraines, and bulimia. The vagus nerve is a primary pathway between the brain, the stomach, and abdomen. In preliminary animal studies, researchers have found that vagus nerve stimulation can affect appetite and can be used to induce a sense of fullness in obese patients. Johnson & Johnson will conduct broader animal and human studies of the link between vagus nerve stimulation and appetite. It could take as much as five to seven years before the company is ready to submit a final product for FDA approval. It's a novel approcach to a problem that healthcare companies have been racing to address. Drug companies have tried for years to fashion elegant treatments for obesity. Wyeth was famously forced to take fenfluramine (or fen-phen) off the market in 1997 after several patients developed heart complications. The resulting product liability lawsuits cost the company $15 billion.

But even the weight-loss therapies currently on the market, such as Roche's Xenical and Abbott's Meridia, contain disquieting side-effects like excessive gas and anal leakage. This year, Sanofi-Aventis tried and failed to gain FDA approval for its weight-loss drug rimonabant. Merck has said it is working on a similar drug. And in late August, Pfizer and Bristol-Myer announced they would collaborate on research into metabolic disorders including obesity and diabetes. Johnson & Johnson, with its expertise in both drugs and medical devices is taking a different tack with its newly acquired Cyberonics patents. The company agreed to make an upfront payment of $9.5 million, with a promise that Cyberonics would receive royalties on sales of products that result from its patents. Cyberonics CEO Dan Moore told Fortune he believes the Johnson & Johnson deal proves that a "third way" is gaining acceptance in healthcare. "Chemicals - or drugs - have done wonderful things in our lives. And mechanical devices like stents have done amazing things. In the next ten years, we will learn a lot about what can happen when you stimulate the electrical systems of the body. I'm a believer in this third platform of neural modulation."

DATE: December 14, 2007

Glucosamine at commonly taken doses does not increase HDL ("good") cholesterol in people with diabetes, researchers have found. "Many people take glucosamine for arthritis-like symptoms and, from previous research, we thought glucosamine may also have a beneficial effect on HDL cholesterol," Dr. Stewart G. Albert noted in comments to Reuters Health.Albert, from Saint Louis University School of Medicine, Missouri, and his colleagues evaluated the effects of glucosamine (500 milligrams taken three times daily) versus matching "placebo" capsules in ten people with type 2 diabetes and two with type 1 diabetes.The three men and nine women in the study, all with low HDL cholesterol, were randomly assigned to take glucosamine or placebo for 2 weeks, and then to cross over to a 2-week course of the alternate therapy."We did not find any benefit of glucosamine on HDL cholesterol or any worsening of the diabetes control," Albert said.

In their report of the study in the journal Diabetes Care, the investigators note that the lack of an effect on diabetes control "is consistent with previously published studies on the effect of glucosamine in both diabetic and nondiabetic individuals." However, "This study does not answer whether higher doses or longer duration of glucosamine may make any difference" to HDL levels, Albert said.

SOURCE: Diabetes Care

DATE: December 07, 2007

Could insulin in a capsule be the answer in the fight against diabetes? Researchers are conducting studies to find out. In April of 2006, three-year-old Daniel Hurtado was diagnosed with Type One Diabetes. Blood tests have revealed his six-year-old brother Javier has a 25 to 50 percent chance of developing it in the next five years. Javier Senior is also at increased risk. Now father and son are enrolled in two studies at the Diabetes Research Institute.

In an effort to prevent little Javier from developing diabetes he takes oral insulin, one capsule once a day. "By presenting it that way, it really serves in a vaccine kind of approach of stimulating the protective forces of the body's own immune system to turn off the destructive forces," explained Dr. Jay Skyler of the Diabetes Research Institute. 37-year old Javier is taking part in the natural history study, which assesses his risk for developing diabetes and tracks any changes. "What we're trying to do is look at everybody who's a relative of somebody with type one diabetes to see what happens as time goes on. If they have some degree of marker, do they really develop the disease, or do they just smolder for a while," said Dr. Skyler.

These studies are done through a collaborative effort called Trialnet. Other research looks at interventions for people newly diagnosed with diabetes. The Diabetes Research Institute in Miami is one of 20 centers around the world participating in Trialnet. It's a network focusing on research to learn about type one diabetes and keep it from developing.

DATE: November 30, 2007

You might think Arizona's desert-dwelling Pima Indians and the ocean-loving Chamorros would have little in common, but experts at yesterday's Micronesian Medical Symposium argued that if Guam's childhood obesity epidemic continues, they will share one fate -- crippling diabetes. Leslie Baier, of the Phoenix Epidemiology and Clinical Research Branch, explained that because of a genetic disposition for obesity and diabetes in indigenous populations called the "thrifty gene theory," 85 percent of the Pimas suffer from type-2 diabetes, the highest frequency in the world. Guam is catching up, she said.

"The problem is, when an entire population gains weight at once, it becomes normal. People accept it. They say 'I'm a Pima. This is how we are,'" Baier said. Symposium coordinator Dr. Saied Safa estimated that 25 percent of Guam's population already has diabetes, which can cause heart disease, kidney failure, stroke, blindness and amputation. Even scarier, he said, is that youth obesity is causing the disease in children under the age of 10. The average diabetic population for Pacific Islanders is around 15 percent, and the disease is traditionally not diagnosed until middle age. Type-2 diabetes is completely preventable through a balanced diet and exercise. Another presenter, Dr. Robert Nelson, explained that as pregnancy and diabetes overlap on Guam, children will be born predisposed toward the disease and it will spread exponentially. He said Chamorros currently reflect the Pimas around the 1940s, just before their diabetes skyrocketed when they entered into this cycle of diabetic birth. "We need major changes in the lifestyle and diet of families and the community ... to at the very least delay the onset of this disease into adulthood to slow the spread," he said.

Dr. Larry Agodoa, Director of the Office of Minority Health Research Coordination explained yesterday that diabetes can easily shorten a person's lifespan by 20 years. If the disease is left unchecked on Guam, "parents will start to bury their children," he said. But that's not all -- it's expensive, too. According to Agodoa, less than 1 percent of the United States' Medicare-dependent population suffers from diabetes-induced kidney failure, but they consume around 8 percent of the total funds. Last year, $32 billion was spent to treat this symptom alone. Nelson agreed that widespread diabetes could cripple Guam not just physically, but economically as well. "When (the people of Guam) should be saving for retirement, or spending money on their children's education -- all the things middle-aged people do to contribute to society -- instead they'll be paying for dialysis," he said.

DATE: November 23, 2007

Two landmark research studies on people with pre-diabetes found some very simple but challenging changes in lifestyle that had a profound effect on who went on to develop diabetes ... and who did not. Participants who were able to achieve one or more of the following were more likely to stop or reverse the progression of their condition:

• Eat no more than 30 percent of calories from fat. Interestingly, fat intake (rather than carbohydrates) is a major predictor of "insulin resistance" -- a condition that can lead to diabetes. This level of fat intake -- an average of 50 to 60 grams a day for most people -- is considered a "low fat" diet.
• Cut saturated fat intake to less than 10 percent of total calories.This calculation translates to less than 15 to 20 grams of saturated fat per day for most people. And lest we think this is an easy goal, remember that 1 ounce (one slice) of cheese contains 6 grams of saturated fat. And 1 tablespoon of butter contains 7 grams. Gulp.
• Get at least 150 minutes of "moderately intensive" physical activity every week. Brisk walking meets this goal; strolling to the refrigerator between commercials does not. How does exercise help prevent diabetes? Working muscle cells become more sensitive (less resistant) to the actions of the hormone insulin. Improved insulin sensitivity helps prevent diabetes.
• Eat more food rich in dietary fiber. Volunteers in these studies were instructed to eat at least 15 grams of dietary fiber (totals can be found on food labels) for every 1,000 calories in their diet. That's about 25 to 35 grams a day for most of us. Hint: Fiber is only found in foods of plant origin -- fruits, vegetables, seeds, nuts, legumes and whole grains.
• Eat at least three servings of "whole grains" each day. Research studies have found a strong correlation between the intake of whole grain foods and improved blood sugar control. Look for bread, cereal and other grain products labeled "excellent source of whole grains."
• Drop a few pounds. Surprise! When we eat less fat and more fiber and exercise more, our weight tends to drop. And even a modest weight loss (10 to 20 pounds) can significantly slow or prevent the advance of pre-diabetes to diabetes.

The good news from these studies is that people who are given specific guidance to change their lifestyle can reduce their risk for developing diabetes by 58 percent. The sad news is that Medicare and many other health insurance providers cover nutrition therapy and diabetes education for people with diabetes, not for those with pre-diabetes

DATE: November 16, 2007

Diabetes treatment could get a whole lot easier to swallow.

A research team at Syracuse University led by Dr. Robert Doyle, assistant professor of chemistry, has designed, tested, reproduced and patented a system for delivering insulin through an oral pill to rats. Their results will be published in the December issue of the pharmaceutical journal "ChemMedChem." The system could potentially be used by humans battling diabetes. Currently, individuals with diabetes must inject themselves with insulin to balance their blood sugar levels, which are not maintained because of unnatural output by the pancreas. With Doyle's method, they could simply swallow a vitamin pill.

More than 21 million individuals in the United States have diabetes, yet taking insulin orally has not been possible because it must go through the gastrointestinal tract, which prevents it from reaching the bloodstream. Being able to orally receive insulin would drastically change the lives of diabetics and the scope of the diseases' treatment, researchers said. The innovation in Doyle's research is that they have found a way to attach the insulin to vitamin B-12. The vitamin protects the insulin as it journeys through the gastrointestinal tract in a "Trojan horse" strategy. "It's really like the holy grail of diabetes research…in terms of treatable things," said Tony Vortherms, a graduate student who worked on the project.

Vortherms was part of Doyle's laboratory team that included Timothy J. Fairchild, an assistant professor of exercise science in the School of Education, and Amanda Petrus, a doctoral candidate and the project's principle researcher. Now the team will determine whether they can attach more insulin to the vitamin so that it can remain in the bloodstream for 12 hours. The ultimate goal would be for a diabetic to take two insulin pills a day - one in the morning and one at night - which would help them to maintain their metabolic control throughout the day, according to a news release announcing the discovery. "This would be a way to minimize the roller coaster of blood sugar levels the best we can," Vortherms said. "We still have a long way to go." The ultimate question is if and when this strategy can be used in humans. "There is a great deal that has to be done before clinical use," the principle researcher Petrus said. "We are excited but aware of the great amount of work left to do."

It will probably take at least five years before a pharmaceutical company will take interest in the project - which has great commercial possibilities - and test it, Petrus said. The first stage would be a more elaborate test on rats and then trials to determine its effect in humans. Petrus is optimistic. "From what I've seen so far," she said, "I do believe it's possible." "The goal of this project would be to give people who are not able to produce insulin on their own at least a base level of insulin in their blood," Vortherms said. He added that one of the biggest problems currently is the drastic swings in blood sugar levels that diabetics go through daily. The sugar highs and lows over the long term lead to wear and tear on the individuals.

The research began to seriously focus on insulin delivery a year and half ago, Petrus said, and they have been spending approximately 50 hours a week in the lab working on the project. Doyle has had the idea of the Trojan horse delivery system since he was a graduate student at Yale University, and SU hired him specifically to work on it. "Dr. Doyle had been doing a lot of thinking about it for years - before he came to SU," Petrus said. The delivery system was already being pursued simultaneously with other diabetes research, and the chemistry research already being conducted lent itself to diabetes treatment, Vortherms said."He was interested in 'the how' and I think insulin just came in at the right time," said Vortherms, adding this research has the potential to go beyond diabetes. "I see it more of a team that's changing the conversation of what's possible," he said. "We've added to what people know they can do, and that's a great feeling."

Vortherms said he is very interested in the other fields in which oral delivery like this could work and added there was a "decent to good chance" of it being used in humans in the future. Neither Doyle nor Fairchild were able to comment Sunday. In the news release, Doyle said he was pleased because of the rare payoff in scientific research, where results must be tested and re-tested to ensure reproduction."In the case of insulin, we had a hypothesis, we set about testing our hypothesis and we were rewarded for the effort," he said. "Having things go your way doesn't happen in science often enough, so when it does it's very rewarding." Fairchild sees the benefit of removing needles from the equation of diabetic treatment. "The possibility of having an oral insulin medication has tremendous feasibility, particularly with children and in less-developed countries where sterile needles and adequate training - for injection site and frequency, as well as needle disposal - may not always be available," he said.

He added that there is a lot of research being conducted in the field of diabetes treatment and other teams are looking at their own means for getting insulin into the bloodstream without the pain of injections.

All four researchers involved expressed excitement on the research, but also some hesitance because of the work left to be done before it could alter the lives of diabetics. For Petrus, it is a personal endeavor. Her uncle has diabetes and some of her friends are exhibiting early signs of the disease. To ease their daily struggle motivates her. "It's one of the driving forces of going to work every day," she said.

By Matt Reilly

DATE: November 09, 2007

Smoked cannabis eased pain induced in healthy volunteers, according to a study by researchers at the University of California, San Diego (UCSD) Center for Medical Cannabis Research (CMCR.) However, the researchers found that less may be more.

In the placebo controlled study of 15 subjects, a low dose of cannabis showed no effect, a medium dose provided moderate pain relief, and a high dose increased the pain response. The results suggest a "therapeutic window" for cannabis analgesia, according to lead researcher Mark Wallace, M.D., professor of anesthesiology at UCSD School of Medicine and Program Director for the UCSD Center for Pain Medicine.

The paper, to be published in the November issue of the journal Anesthesiology, is the second published study out of the CMCR. Headquartered at UCSD, the CMCR is collaboration between UCSD and UC San Francisco that was funded by a state-funded initiative in 1999 to rigorously study the safety and efficacy of medicinal cannabis in treating diseases.

The study used capsaicin, an alkaloid derived from hot chili peppers that is an irritant to the skin, to mimic the type of neuropathic pain experienced by patients with HIV/AIDS, diabetes or shingles -- brief, intense pain following by a longer-lasting secondary pain. The subjects were healthy volunteers who inhaled either medical cannabis or a placebo after pain was induced. The marijuana cigarettes were formulated under NIH supervision to contain either zero, two, four or eight percent delta-9-tetrahydrocannabinol (THC.)

"Subjects reported a decrease in pain at the medium dose, and there was also a significant correlation between plasma levels of THC, the active ingredient in cannabis, and decreased pain," said Igor Grant, M.D., F.R.C.P.(C), professor and Executive Vice-Chair of the Department of Psychiatry, the director of the CMCR. "Interestingly, the analgesic effect wasn't immediate; it took about 45 minutes for the cannabis to have an impact on the pain," he said.

The results, showing a medium-dose (4% THC by weight) of cannabis to be an effective analgesic, converged with results from the CMCR's first published study, a paper by UCSF researcher Donald Abrams, M.D. published in the journal Neurology in February 2007. In that randomized placebo-controlled trial, patients smoking the same dose of cannabis experienced a 34% reduction in HIV-associated sensory neuropathy pain -- twice the rate experienced by patients receiving a placebo.

"This study helps to build a case that cannabis does have therapeutic value at a medium-dose level," said Grant. "It also suggests that higher doses aren't necessarily better in certain situations -- something also observed with other medications, such as antidepressants."

The researchers stated that more and larger studies need to be conducted to measure the efficacy of cannabis, noting that medical marijuana could play an important role in treating patients who don't respond well to the usual pain relievers or can't tolerate drugs such as ibuprofen or opioids used for severe pain.

"The results of this study might help guide others doing clinical research into pain management," said Wallace.

----------------------------
Article adapted by Medical News Today from original press release.
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Additional contributors to the study include Gery Schulteis, Ph.D., UCSD Department of Anesthesiology; J. Hampton Atkinson, M.D., professor, and Deborah Lazzaretto, M.S., UCSD HIV Neurobehavioral Research Center; Ian Abramson, Ph.D., UCSD Department of Mathematics and HIV Neurobehavioral Research Center; Tanya Wolfson, M.A., UCSD Department of Family and Preventive Medicine; and Heather Bentley and Ben Gouaux, UCSD Center for Medicinal Cannabis Research.

Source: Debra Kain
University of California - San Diego

DATE: November 02, 2007

The Center for Disease Control chronicles a 153 percent increase in diabetes diagnoses from 1994 to 2005.

Dr. Fadi Yacoub, a nephrologist with Internists Associates of Iowa, has been practicing 13 years in Iowa, eight in Cedar Rapids. The incidence of Type I Diabetes has remained fairly stable, Yacoub says, but there is “no question about it” that Type II Diabetes has “skyrocketed for one single reason – weight. The more weight the more diabetes the more kidney disease.” Dr. Alan Reed, chief of the division of transplantation at University Hospitals and director of its organ transplant center, says “Type II Diabetes is a real scourge on our society.” Reed, who has performed “several hundreds” of kidney transplants says “we tend to be a victim of our own success.” People are living longer in large part because of medical advances and Type II Diabetes and the many complications it spawns, including kidney failure, is mostly seen in aging patients. “All you have to do,” Reed says, “is look at the number of people on dialysis and waiting for transplants.” Dr. Yacoub has experienced those growing numbers in his own practice. In the last “two to five years,” the number of kidney patients Yacoub sees has “increased dramatically” and many of those patients are “a lot older, more frail.”

There are 20.8 million children and adults in the United States, or 7 percent of the population, who have diabetes, according to the American Diabetes Association, including 6.2 million people (or nearly one-third) who are unaware that they have the disease. Add to that the 54 million people in the United States who have pre-diabetes. Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes. Is there a need for more nephrologists and support staff to deal with the increasing numbers? There may be, Yacoub says, but beefing up medical professional numbers is not the answer. “The bigger question,” he says, “is how are we going to make diabetes go away? If you remove diabetes in the future, 50 percent – if not more” of the number of kidney patients alone would disappear. In the 1970s when statistics on kidney failure patients were first being gathered only a “very few were from diabetes,” Yacoub says, and so when projections of patient numbers were made “we grossly underestimated the impact of diabetes.” The predictions were off by about 400 percent: the 40 patients then predicted compared to the actual 200 seen today. “Today half to 60 percent” of kidney failure cases are caused by Type II Diabetes, Yacoub says. Those numbers are “very different from most European countries and Japan.” Diabetes – especially Type II – is “not glamorous,” Yacoub says, so there are “not enough dollars spent” on researching how to make Type II Diabetes go away or how to control obesity. The long term answer, Yacoub says, is “to start in childhood. Keep kids healthy, active, thin and trim. Type II is totally controllable if you prevent it” and prevention starts early. Reed agrees that prevention is the answer and says “we need to do things that reward prevention.” Another problem, Reed says, “one that hit me squarely between the eyes,” is “there is no money to be made in prevention only in treatment.” Society sees obesity “not as a disease but as a lifestyle,” Yacoub says, and so instead of spending money to find ways to combat obesity and Type II Diabetes “we tend to spend on treating the complications” of diabetes, Yacoub says. Those complications can include hypertension, heart problems, neuropathy, blindness and kidney failure. None of the above addresses the personal impact of diabetes. The ripples have “tremendous effect on those surrounding, the whole family and friends,” Yacoub says. “They are very dramatic, expensive and often debilitating and affect family, friends and social life.”

DATE: October 26, 2007

Disease of and injury to the feet and lower legs is a lifelong concern for diabetes patients. They are twice as likely to suffer from these conditions as non-diabetic patients. These problems also affect 30% of patients dealing with diabetes who are over the age of 40.

However, new research offers more hope for effective treatment of lower extremity disease, as well as prevention of the condition. "What's New in Orthopaedic Rehabilitation," a paper published in the October, 2007 issue of www.ejbjs.org "The Journal of Bone and Joint Surgery", reviews some of these discoveries, as well as other innovations on the horizon in the field of orthopaedic surgery.

Diabetes can damage nerves, making injuries difficult to detect in the early stages; the disease can also inhibit circulation, preventing effective healing. Patients with diabetes that have nerve involvement (neuropathy) and poor circulation (micro angiopathy) need to maintain additional precautions to prevent injury and infection. Uncontrolled infections, poor healing and progressive neuropathy can in some cases lead to gangrene and surgical amputations. This condition is frequently seen by orthopaedic surgeons.

"Prevention is the goal and should be the goal," says Harish S. Hosalkar, MD, co-author of the paper and an orthopaedic surgery clinical instructor at the University of Pennsylvania. "Once an injury has occurred the risk is much greater, so it's best if we can prevent or stop it before it happens."

One recent study found that patients who monitored the temperatures of their feet and reduced their activity when those temperatures were elevated had a lower rate of infection and other subsequent complications. Hosalkar notes that this finding is especially exciting because of its simplicity. "This is not only an effective prevention strategy, but it's also very easy for patients and caregivers to carry out," he says.

Another study showed that the detailed assessments currently used by healthcare providers to identify diabetes patients at risk for foot ulcers were largely effective. These assessments allowed care providers to initiate interventions such as:

• Patient education
• Prescription footwear
• Intensive foot care

Two additional studies, found that some quicker casting methods were just as effective at healing lower extremity disease as the standard total contact casts (TCCs) currently used. This could be good evidence for clinicians who work in extremely busy foot clinics and other similar settings (like diabetic camps) where they might see 100 or more patients with foot problems each day.

DATE: October 19, 2007

Clear plastic containers, the lining of some food cans containing some forms of epoxy are manufactured using bisphenol-A (BPA). As time goes by a small amount of the chemical BPA leaches from the plastic containers or epoxy lining of cans to contaminate whatever is in the container. The degree of contamination is exceedingly small and has until recently been regarded as insignificant. Recently a number of very interesting studies done with animals is causing considerable concern among people involved with public health among them the writer of this column.

A number of well-controlled experiments with an assortment of laboratory animals (mostly small ones with rapid reproduction and rate of maturing) has produced some very interesting observations. Exposing certain strains of mice to exceedingly small amounts of BPA (as little as one part per trillion) during pregnancy or while nursing their young resulted in a significant number of alterations in the young mice as they matured. The abnormalities involved both physical structure and functions of the nervous system involving both behavior and function. Examples of this was the fact that the offspring of mice exposed to BPA were significantly heavier, some had diabetes, and more had cancer. Neurological and behavioral differences were studied in rats that were not exposed and significant differences could be demonstrated. Stimuli, which usually produce anxiety in rats, was reduced or eliminated in exposed rats. Grooming of pups by mother rats was less in exposed animals. How does this relate to humans?

A number of health and psychological disorders such as obesity, diabetes, some cancers, attention deficit, and hyperactivity disorders, and disorders in the autistic spectrum are thought to be increasing significantly in our society. Could that bottled water and other things we drink from clear plastic containers have something to do with the problem? A steadily increasing body of good research strongly suggests that. Maybe bad parenting is not the only explanation for what we see in the younger generation. This is an area in which considerably more research will be done in the future.

Richard S. Buker, Jr., M.D., - Liberty County Montana Health Officer

DATE: October 12, 2007

More than 60 percent of American women are overweight, with nearly a third falling into the category of obese and at greater risk of cancer, heart disease and diabetes. Until now, there has been no safe, long-term medical remedy that tackles unwanted weight gain. Dr. Nir Barak of Tel Aviv University’s Sackler School of Medicine has developed what could be a new weight-loss wonder drug. In conjunction with the drug company Obecure, Dr. Barak developed a new formulation called HistaleanTM, based on betahistine, an approved drug marketed worldwide for the treatment of vertigo. Betahistine has been available to health authorities for over 30 years.

Betahistine is believed to block receptors in the brain – the H1 and H3 receptors – which are connected to one’s sense of fullness and desire to eat fatty foods. It has an excellent safety profile and has been used for treatment by more than 100 million patients suffering from vertigo and dizziness in Canada and Europe. The repurposed pill, Histalean, has been found to quell the desire to consume fatty foods, and the effects have been most pronounced in women. According to the U.S. Center for Disease Control, about 32% of adult American women under 54 (about 25 million women) suffer from obesity. “Our new results suggest a strong gender-and-age-effect and support the potential of the drug as a breakthrough anti-obesity agent in women 50 years old or less,” confirmed Dr. Yaffa Beck, Obecure’s CEO.

According to some estimates, obesity results in thousands of deaths a year and accounts for $117 billion in U.S. health care expenses annually. Clearly, a breakthrough in this area will not only make women look and feel better, but it could save their lives as well. A recent Phase II clinical trial of the new drug in the U.S. suggests that women under the age of 50 who took Histalean for 12 weeks lost 7 times the weight of those taking a placebo. What’s most important to the researchers involved is that none of the 281 patients, males and females aged 18-65, complained of any serious side effects. The trial, completed this August, was supervised by U.S. weight-loss guru Dr. Robert Kushner. The women who took the pill reported, “It wasn't hard.” “I wasn't thinking about food.” “I was content.”

Dr. Barak explains why this is good news, “All the drugs in the diet pill market today have serious side effects. They may help a woman lose weight, but with that weight loss comes all sorts of bad things like depression and even suicide. Safety issues are a real concern for the FDA. But because this new drug has already been proven safe for other indications, we think Histalean has real blockbuster potential.” The recent results were based on a double-blind, placebo-controlled study on people with a Body Mass Index ranging from 30 to 40. (A BMI of 30 and above indicate obesity.) The study was conducted at 19 investigation sites across the U.S. over a 12 week treatment period. The subgroup of high-dose Histalean-treated women lost an average of 2.91% of their weight versus placebo group which lost only 0.4 %. Dr. Barak’s drug is also expected to compete for the $28 billion market of cholesterol-reducing drugs such as Lipitor. It could also be used in parallel with anti-psychotic drugs, which have unwanted side effects of extreme weight gain among mental health patients.

DATE: October 05, 2007

Insulin, it turns out, may be as important for the mind as it is for the body. Research in the last few years has raised the possibility that Alzheimer's memory loss could be due to a novel third form of diabetes.

Now scientists at Northwestern University have discovered why brain insulin signaling -- crucial for memory formation -- would stop working in Alzheimer's disease. They have shown that a toxic protein found in the brains of individuals with Alzheimer's removes insulin receptors from nerve cells, rendering those neurons insulin resistant. (The protein, known to attack memory-forming synapses, is called an ADDL for "amyloid ß-derived diffusible ligand.") With other research showing that levels of brain insulin and its related receptors are lower in individuals with Alzheimer's disease, the Northwestern study sheds light on the emerging idea of Alzheimer's being a "type 3" diabetes. The new findings, published online by the FASEB Journal, could help researchers determine which aspects of existing drugs now used to treat diabetic patients may protect neurons from ADDLs and improve insulin signaling in individuals with Alzheimer's. In the brain, insulin and insulin receptors are vital to learning and memory. When insulin binds to a receptor at a synapse, it turns on a mechanism necessary for nerve cells to survive and memories to form. That Alzheimer's disease may in part be caused by insulin resistance in the brain has scientists asking how that process gets initiated.

"We found the binding of ADDLs to synapses somehow prevents insulin receptors from accumulating at the synapses where they are needed," said William L. Klein, professor of neurobiology and physiology in the Weinberg College of Arts and Sciences, who led the research team. "Instead, they are piling up where they are made, in the cell body, near the nucleus. Insulin cannot reach receptors there. This finding is the first molecular evidence as to why nerve cells should become insulin resistant in Alzheimer's disease." ADDLS are small, soluble aggregated proteins. The clinical data strongly support a theory in which ADDLs accumulate at the beginning of Alzheimer's disease and block memory function by a process predicted to be reversible. In earlier research, Klein and colleagues found that ADDLs bind very specifically at synapses, initiating deterioration of synapse function and causing changes in synapse composition and shape. Now Klein and his team have shown that the molecules that make memories at synapses -- insulin receptors -- are being removed by ADDLs from the surface membrane of nerve cells. "We think this is a major factor in the memory deficiencies caused by ADDLs in Alzheimer's brains," said Klein, a member of Northwestern's Cognitive Neurology and Alzheimer's Disease Center. "We're dealing with a fundamental new connection between two fields, diabetes and Alzheimer's disease, and the implication is for therapeutics. We want to find ways to make those insulin receptors themselves resistant to the impact of ADDLs. And that might not be so difficult."

Using mature cultures of hippocampal neurons, Klein and his team studied synapses that have been implicated in learning and memory mechanisms. The extremely differentiated neurons can be investigated at the molecular level. The researchers studied the synapses and their insulin receptors before and after ADDLs were introduced. They discovered the toxic protein causes a rapid and significant loss of insulin receptors from the surface of neurons specifically on dendrites to which ADDLs are bound. ADDL binding clearly damages the trafficking of the insulin receptors, preventing them from getting to the synapses. The researchers measured the neuronal response to insulin and found that it was greatly inhibited by ADDLs. "In addition to finding that neurons with ADDL binding showed a virtual absence of insulin receptors on their dendrites, we also found that dendrites with an abundance of insulin receptors showed no ADDL binding," said co-author Fernanda G. De Felice, a visiting scientist from Federal University of Rio de Janeiro who is working in Klein's lab. "These factors suggest that insulin resistance in the brains of those with Alzheimer's is a response to ADDLs." "With proper research and development the drug arsenal for type 2 diabetes, in which individuals become insulin resistant, may be translated to Alzheimer's treatment," said Klein. "I think such drugs could supercede currently available Alzheimer's drugs."

Klein, Grant A. Krafft, formerly at Northwestern University's Feinberg School of Medicine and now chief scientific officer at Acumen Pharmaceuticals, Inc., and Caleb E. Finch, professor of biological sciences and gerontology at the University of Southern California, reported the discovery of ADDLs in 1998. Krafft is a co-author of the FASEB Journal paper. Northwestern and USC hold joint patents on the composition and use of ADDLs in neurodisorders. The patent rights have been licensed to Acumen Pharmaceuticals, based in South San Francisco, for the development of drugs that treat Alzheimer's disease and other memory-related disorders. In addition to Klein, De Felice and Krafft, other authors on the paper are Wei-Qin Zhao, a former visiting scientist at Northwestern, now with Merck & Co., Inc. (lead author); Hui Chen, from the National Center for Complementary and Alternative Medicine at the National Institutes of Health; Michael Quo, from Blanchette Rockefeller Neurosciences Institute; and Sara Fernandez and Mary Lambert, from Northwestern University.

DATE: September 28, 2007

The study, published in the Journal of the American Medical Association, looked at the incidence of the disease among 1770 children at high risk of developing type-1 diabetes, with increased omega-3 intake associated with a 55 per cent reduction in risk. "Our study suggests that higher consumption of total omega-3 fatty acids, which was reported on the FFQ, is associated with a lower risk of islet autoimmunity (IA) in children at increased genetic risk of type 1 diabetes," wrote lead author Jill Norris from the University of Colorado at Denver. "This association is further substantiated by the observation that a higher proportion of omega-3 fatty acids in the erythrocyte membranes is associated with a decreased risk of IA in a subset of this same population," she added.

Type-1 diabetes occurs when people are not able to produce any insulin after the cells in the pancreas have been damaged, thought to be an autoimmune response.

"Type 1 diabetes mellitus is an autoimmune disease that is characterized by the destruction of insulin-producing beta cells in the pancreatic islets. Although it is not yet known what initiates the autoimmune process, it is likely that both genetic background and environmental factors contribute to the disease process," explained the authors. In order to investigate the potential role of dietary factors in the development of type-1 diabetes, Norris and coworkers from her own institution, the University of Florida, and Roche Molecular Systems examined whether consumption of omega-3 and omega-6 fatty acids was associated with the development of pancreatic islet autoimmunity (IA). Dietary intakes were evaluated using a 111-item food frequency questionnaire (FFQ) completed annually by the children's mothers. The children were recruited at age two and followed for an average of 6.2 years. Children were identified as having a high risk of type-1 diabetes by either possessing a high diabetes risk HLA (human leukocyte antigen) genotype or having a sibling or parent with type 1 diabetes.

The researchers also conducted a case-cohort study with a subset of 244 children in order to investigate the risk of IA related to the levels of polyunsaturated fatty acids in red blood cell (erythrocyte) membranes. For the whole study population, the researchers document 58 positive cases of IA during the follow-up period, and after adjusting for confounding factors including HLA genotype, family history of type-1 diabetes, caloric intake, and total omega-6 fatty acid intake, found that total omega-3 fatty acid intake was inversely associated with 55 per cent reduction in IA risk In the case-cohort study, omega-3 fatty acid content of erythrocyte membranes was associated with a 37 per cent decreased risk of IA. Levels of the three marine omega-3 fatty acids eicosapentaenoic acid (EPA, 20:5n-3), docosahexaenoic acid (DHA, 22:6n-3), and docosapentaenoic acid (DPA, 22:5n-3) were combined with the plant omega-3 alpha-linolenic acid (ALA) to estimate the total omega-3 fatty acid intake.While no direct mechanistic study was performed by Norris and coworkers, they do suggest that the benefits of the omega-3 fatty acids may be due to their anti-inflammatory properties, and their ability to reduce oxidative stress. "Overall, our data suggest that ingestion of omega-3 fatty acids throughout childhood may decrease the risk of IA," wrote the researchers. They noted that a newly established clinical trial, called "The Nutritional Intervention for the Prevention of Type 1 Diabetes," is testing if dietary supplementation with anti-inflammatory doses of DHA during pregnancy and infancy could inhibit early islet inflammatory events key to the development of type-1 diabetes. "If this trial confirms this hypothesis, dietary supplementation with omega-3 fatty acids could become a mainstay for early intervention to safely prevent the development of type 1 diabetes," concluded Norris. Commenting independently on the research, Cathy Moulton care advisor at leading charity Diabetes UK, said: "This is an interesting new study. Diabetes UK recommends that people follow a healthy, balanced diet that includes portions of oily fish, which are naturally rich in a variety of fatty acids and vitamin D, rather than taking additional supplements. "More research needs to be done to find out how beneficial fish oil can be in reducing the risk of developing type-1 diabetes."

Source: Journal of the American Medical Association 26 September 2007, Volume 298, Number 12, Pages 1420-1428

Omega-3 Polyunsaturated Fatty Acid Intake and Islet Autoimmunity in Children at Increased Risk for Type 1 Diabetes

Authors: Jill M. Norris, X. Yin, M.M. Lamb, K. Barriga, J. Seifert, M. Hoffman, H.D. Orton, A.E. Baron, M. Clare-Salzler, H.P. Chase, N.J. Szabo, H. Erlich, G.S. Eisenbarth, M. Rewers

DATE: September 21, 2007

A1C is an important tool to reduce the risk of deadly complications like heart attack and stroke

The Ad Council, the nation's leading producer of public service advertisements (PSAs), the American Diabetes Association (ADA), and the Juvenile Diabetes Research Foundation International (JDRF), with the American Association of Diabetes Educators (AADE) and the National Council of La Raza (NCLR), are launching the first ever national public education campaign geared to raise awareness of A1C, a key indicator of diabetes management. The new campaign was unveiled today by the Ad Council, ADA and JDRF.

The unprecedented collaboration will educate Americans with diabetes on the critical importance of knowing their A1C. A1C is a test that measures a patient's blood glucose level over the previous three months that might also help predict serious health complications like heart attack and stroke. People with diabetes must know their A1C level to manage diabetes, and the goal for most people with diabetes is to maintain a consistent A1C score of less than 7 percent. Unfortunately, many people do not know their A1C level. For example, a New York City Department of Health report found that in 2003 eighty-nine percent of patients with diabetes in New York City did not know their A1C level. National figures from the Centers for Disease Control and Prevention suggest that 63 percent of all diabetes patients have A1C levels above 7 percent.

"We are proud to work with ADA and JDRF to increase awareness of A1C, and its importance in helping patients manage their diabetes and prevent diabetes-related complications," said Peggy Conlon, President and CEO of the Ad Council. "This unique campaign, with its simple and clear message, holds great promise to help Americans with diabetes successfully manage this potentially devastating disease and improve their quality of life."

The multimedia PSA campaign will aim to reach Americans with provocative television, radio, print, outdoor and Web messaging using a strategic "warning signs" approach. The central theme builds on the failure of life's risks to come with warning signs, but for individuals with diabetes, A1C is a warning sign for out of control diabetes and complications like heart attacks and strokes. Recognizing the high incidence of diabetes among the Hispanic population the campaign will also use an integrated approach featuring Spanish-language messaging to reach the Hispanic community.

Diabetes is a major health issue in today's society with deadly consequences. Nearly 21 million children and adults have diabetes. People can live for years with unmanaged diabetes causing irreparable damage that can lead to heart attack and stroke. An A1C test could have been their warning sign. In addition, the Centers for Disease Control states that diabetes when not properly managed increases the risk of kidney failure, blindness, nerve damage and amputations.

"Our mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes," said John Buse, MD, President, Medicine & Science, American Diabetes Association. "Today two out of three people with diabetes die of a heart attack or stroke. Increasing the awareness of A1C is one of the most important steps that we can take to help those living with diabetes."

Paul Strumph, MD, Vice President of Research and Chief Medical Officer at JDRF adds, "Educating people with diabetes about the importance of knowing their A1C is essential in improving the short- and long-term outcomes of children and adults with diabetes, while we continue to search for a cure. Given the devastating complications that can result from diabetes, and the ability to reduce those risks by managing A1C levels, this campaign is launching at a pivotal time."

Tom Boyer, Executive Director of the Diabetes Care Coalition, said, "We have been involved in educating people with diabetes about the importance of A1C awareness since 2005, and are excited about joining with the Ad Council to launch this vital campaign. The ultimate goal is to improve understanding of the role that A1C control plays in managing diabetes. The Diabetes Care Coalition hopes this campaign will help every person with diabetes strive to live with an A1C level that will reduce their risk of complications such as heart attack or stroke."

The campaign will direct all audiences to visit a new interactive Web site and dial toll-free numbers to obtain information explaining the importance of talking to a healthcare provider about the A1C test and the role it can play in reducing the risk of diabetes complications. For more information about the A1C test or the campaign, call 1-877-TEST-A1C (1-877-837-8212) or visit www.diabetesA1C.org.

The campaign is made possible by educational grants from Abbott Diabetes Care Inc., Bayer HealthCare LLC, Diabetes Care, LifeScan, Inc., Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Roche Diagnostics Corporation and sanofi-aventis U.S. LLC.

ABOUT THE ADVERTISING COUNCIL

The Ad Council is a private, non-profit organization with a rich history of marshalling volunteer talent from the advertising and media industries to deliver critical messages to the American public. Having produced literally thousands of PSA campaigns addressing the most pressing social issues of the day, the Ad Council has effected, and continues to effect, tremendous positive change by raising awareness, inspiring action and saving lives. To learn more about the Ad Council and its campaigns, visit www.adcouncil.org.

ABOUT THE AMERICAN DIABETES ASSOCIATION (ADA)

The American Diabetes Association is the nation's premier voluntary health organization supporting diabetes research, information and advocacy. Founded in 1940, the Association has offices in every region of the country, providing services to hundreds of communities. The mission of the Association is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. For more information, please visit www.diabetes.org or call 1-800- DIABETES (1-800-342-2383). Information is available in English and Spanish.

ABOUT THE JUVENILE DIABETES RESEARCH FOUNDATION INTERNATIONAL (JDRF)

JDRF is the leading charitable funder and advocate of type 1 (juvenile) diabetes research worldwide. The mission of JDRF is to find a cure for diabetes and its complications through the support of research. Type 1 diabetes is a disease which strikes children suddenly and requires multiple injections of insulin daily or a continuous infusion of insulin through a pump. Insulin, however, is not a cure for diabetes, nor does it prevent its eventual and devastating complications which may include kidney failure, blindness, heart disease, stroke, and amputation. For more information, please visit www.jdrf.org.

ABOUT THE AMERICAN ASSOCIATION OF DIABETES EDUCATORS

Founded in 1973, the American Association of Diabetes Educators is a multidisciplinary professional membership organization of healthcare professionals dedicated to integrating successful self-management as a key outcome in the care of people with diabetes and related conditions. Its mission is driving professional practice to promote healthy living through self-management of diabetes and related conditions. ABOUT THE NATIONAL COUNCIL OF LA RAZA

The National Council of La Raza (NCLR) – the largest national Hispanic civil rights and advocacy organization in the United States – works to improve opportunities for Hispanic Americans. Through its network of nearly 300 affiliated community–based organizations, NCLR reaches millions of Hispanics each year in 41 states, Puerto Rico, and the District of Columbia. To achieve its mission, NCLR conducts applied research, policy analysis, and advocacy, providing a Latino perspective in five key areas – assets/investments, civil rights/immigration, education, employment and economic status, and health. In addition, it provides capacity-building assistance to its Affiliates who work at the state and local level to advance opportunities for individuals and families.

Media Contacts:

Ellyn Fisher
The Ad Council
212-984-1964
efisher@adcouncil.org

Tom Boyer
Diabetes Care Coalition
415-512-5230
tboyer@diabetesA1C.org

Marina Carter
Fleishman-Hillard
202-828-8878
Marina.carter@fleishman.com

Related Links
www.diabetesA1C.org
www.jdrf.org
www.adcouncil.org
www.midiabetesA1C.org
www.Diabetes.org

DATE: September 14, 2007

Mutations in an insulin-linked gene can cause permanent neonatal diabetes, say American and U.K. researchers.

They have identified 10 such mutations in 21 people from 16 families.

Permanent neonatal diabetes is a rare form of diabetes that affects infants and leads to lifelong dependence on insulin injections. This is the first study to link insulin gene mutations to severe diabetes with onset early in life, the researchers said.

The mutations may influence the way insulin folds during its synthesis. These improperly folded proteins interfere then with other cellular processes in ways that eventually result in the death of cells that produce insulin, the researchers said.

The findings were published online by the journalProceedings of the National Academy of Sciencesand were expected to be in an upcoming print issue.

"This is a novel and potentially treatable cause of diabetes in infants," study author Dr. Louis Philipson, professor of medicine at the University of Chicago, said in a prepared statement.

This research "is exciting, because each of these patients has one normal insulin gene as well as one mutated gene. If we could detect the disease early enough and somehow silence the abnormal gene, or just protect insulin-producing cells from the damage caused by misfolding, we might be able to preserve or restore the patient's own insulin production," Philipson said.

More information

The U.S. National Diabetes Information Clearinghouse has more about neonatal diabetes.

SOURCE: University of Chicago Medical Center

DATE: September 07, 2007

Diabetes patients could benefit from new research at the University of Liverpool that has identified a molecule in the intestine that can ‘taste’ the sugar content of the diet. Researchers found that the sweet taste receptor that senses sugar and artificial sweeteners is not only present in the tongue, but also in the intestine. The discovery will open new avenues for the treatment of diabetes and obesity, as well as suggest reasons for why artificially sweetened foods and beverages sometimes fail to result in weight loss, according to Eurekalert, the news service of the American Association for the Advancement of Science. Scientists have previously shown that the absorption of dietary sugars in the intestine is mediated by a protein – a sugar transporter – that varies in response to the sugar content of foods. The intestine uses a glucose sensing system to monitor these variations, but until now the nature of this system was unknown. Professor Soraya Shirazi-Beechey, from the Faculty of Veterinary Science, said: “We found that the sweet taste receptor and the taste protein, gustducin, are present in the taste cells of the gut. These sweet sensing proteins allow humans and animals to detect glucose within the intestine. We discovered that mice missing the gene for either of these proteins were unable to process the production of the intestinal sugar and were therefore unable to regulate the intestinal capacity to absorb dietary sugars. “Surprisingly we also found that the receptor was able to detect artificial sweeteners in foods and drinks resulting in increased capacity of the intestine to absorb dietary sugars, which would explain why these sweeteners are unsuccessful at helping people lose weight. “We are now researching mechanisms in which these receptors can be adjusted to benefit those with diet-related disorders. Diabetes for example, is where the body’s blood sugar level is higher than normal; if we could use the taste receptor like a dimmer switch we could set it so that the appropriate amount of sugar is absorbed in the body. “From a veterinary perspective, the discovery could also have implications for race horses. Horses need high levels of glucose to sustain them in long races; activating the receptor through dietary supplements, before and during the race, will increase intestinal absorption of glucose.”

DATE: August 31, 2007

People with type 2 diabetes who drag themselves through the day may be among the 36 percent of diabetics suffering from obstructive sleep apnea, according to new research. Sleep apnea occurs when impaired breathing due to collapsed airways triggers multiple nighttime awakenings. Researchers at The Whittier Institute for Diabetes in La Jolla, Calif., analyzed health data from 279 adults with type 2 diabetes. They found that one out of three diabetics also suffered from obstructive sleep apnea. Men, particularly those over the age of 62, were more than twice as likely as women to experience interrupted sleep.

Previous research has indicated a relationship between obstructive sleep apnea, glucose intolerance and insulin resistance, so the connection with type 2 diabetes is not surprising. This is the first study to analyze data from both men and women at a diabetes clinic, the researchers said. "These findings demonstrate that obstructive sleep apnea has a high prevalence in adults with type 2 diabetes," principal investigator Dr. Daniel Einhorn said in a prepared statement. "Given that treatment of obstructive sleep apnea has the potential to both decrease blood pressure and improve glycemic (blood sugar) control, individuals with type 2 diabetes should be regularly screened for the presence of sleep apnea," he said. The researchers published their findings in the August issue of Endocrine Practice. According to previous research, treating people who have both obstructive sleep apnea and type 2 diabetes with "continuous positive airway pressure" therapy not only helps manage the sleep interruptions but also reduces blood sugar levels. The researchers recommend that clinicians screen patients with type 2 diabetes for obstructive sleep apnea.

DATE: August 24, 2007

High fructose corn syrup has become the sweetener of choice for many food manufacturers. It is more economical and easy to blend into drinks. But your health may be paying for it. A new study supports a link between the development of diabetes and high fructose corn syrup.

Diabetes is at an epidemic level in the United States. Adults and children are affected by the trend. Some scientists have suggested high fructose corn syrup may be contributing to the increase in diabetes and obesity, but it's a claim the food industry disputes.

Researchers from Rutgers University in New Brunswick, N.J., analyzed the chemical content of 11 different carbonated drinks containing high fructose corn syrup.

Lead study author Chi-Tang Ho, Ph.D., reports they found astonishingly high levels of reactive carbonyls in the sodas tested. Reactive carbonyls are highly reactive compounds believed to cause tissue damage. Reactive carbonyls are also elevated in the blood of individuals with diabetes and linked to complications of that disease. Dr. Ho reports one can of soda contains five-times the concentration of reactive carbonyls compared to the concentration found in the blood of an adult person with diabetes.

"People consume too much high fructose corn syrup in this country," Dr. Ho was quoted as saying. "It's in way too many food and drink products, and there's growing evidence that it's bad for you."

Researchers also report adding a compound found in tea -- epigallocatechin gallate (EGCG) -- to soda significantly reduces the levels of reactive carbonyl, and they are conducting more research to understand why.

SOURCE: American Chemical Society

DATE: August 17, 2007

Recent research has found that diabetes is associated with decreases in life expectancy, as well an increased risk of developing heart disease. The study, published in Archives of Internal Medicine, one of the JAMA/Archives journals, shows that men and women with diabetes at age 50 and older appear not to live as long in general, or have as many years without cardiovascular disease, than individuals without diabetes.

"Globalization of the Western lifestyle led to diabetes mellitus being a major and progressive health care problem worldwide," the authors write as background information in the article. By 2000, more than 171 million individuals had diabetes, a number that is likely to double in 25 years. Research has shown that individuals with diabetes have an augmented risk of illness and death, including double the risk of cardiovascular disease. Oscar H. Franco, M.D., D.Sc., Ph.D., of University Medical Center Rotterdam, the Netherlands, and Unilever Corporate Research, Sharnbrook, England, and colleagues used data from the Framingham Heart Study, a group of 5,209 men and women age 28 to 62 years recruited between 1948 and 1951 and followed for more than 46 years.

The researchers selected three follow-up periods of 12 years each that began in 1956 to 1958, 1969 to 1973, and 1985 to 1989. Participants were followed during each of the three periods until they developed cardiovascular disease or died, and their diabetes status was measured again at the beginning of each interval. "Women with diabetes had more than double the risk of developing cardiovascular disease and, among those already with cardiovascular disease, mortality compared with non-diabetic women," the authors write. "Diabetic men, compared with non-diabetic men, had more than double the risk of developing cardiovascular disease and a 1.7 times higher risk of dying once cardiovascular disease was present," the authors add.

Among those age 50 and older, diabetic men lived an average of 7.5 years less than men without diabetes, and diabetes reduced women's life expectancy by an average of 8.2 years. Life expectancy free of cardiovascular disease was abridged by 7.8 years in men and 8.4 years in women with diabetes. "Having diabetes at age 50 years and older represents not only a significant increase in the risk of developing cardiovascular disease and mortality but also an important decrease in life expectancy and life expectancy free of cardiovascular disease. These findings underscore the importance of diabetes prevention for the promotion of healthy aging. Toward this end, it is essential to implement global strategies to change the current Western lifestyle and to promote the adoption of physical activity and healthy diets," the authors write. "Prevention of diabetes is a fundamental task facing today's society, with the aim to achieve populations living longer and healthier lives," the authors conclude.

DATE: August 10, 2007

People with diabetes suffer from a lack of vitamin B1 which could be linked to a range of complications, new research shows. Experts found that diabetics had a far lower concentration of the vitamin - called thiamine - in their blood plasma and that patients "cleared" B1 from the body too quickly. Researchers at Warwick Medical School in Coventry UK, said they believed the deficiency was linked to a range of vascular complications in diabetics, including damage to the kidney, retina and nerves, and heart disease and stroke. Cardiovascular disease accounts for around 80% of all diabetic deaths.

Lead researcher, Professor Paul Thornalley, said the problem was not that diabetics were failing to get enough vitamin B1 from their diet. He said: "There was no indication that there was a deficiency in nutritional input. Nutritional thiamine was of normal levels but there was this deficiency in the blood, which was caused by the kidney washing it out of the body." Prof Thornalley said thiamine was being cleared from the body of diabetics at 15 times the normal rate. His team are now investigating whether raising thiamine levels in diabetics would decrease the risk of vascular problems, as he expects. The study was carried out on 74 diabetic patients and 20 healthy controls through taking blood and urine samples. The study found that thiamine concentration in blood plasma was decreased by 76% in Type 1 diabetic patients and 75% in Type 2 diabetics. These news feeds are provided by an independent third party and Channel 4 is not responsible or liable to you for the same.

DATE: August 03, 2007

Eating citrus fruits rich in Vitamin C such as papaya, oranges and blackcurrant may be good for diabetes. New research has found that Vitamin C might help reduce some of the complications linked with the disease. Researchers from the University of Warwick in the UK have found that the nutrient helps "mop-up" free radicals that are produced in excess in diabetics. Free radicals are tissue-damaging molecules, and Vitamin C 'normalizes' their levels in the body, said lead researcher Professor Antonio Ceriello. "Vitamin C scavenges free radicals and normalizes free radical levels, thus avoiding their effects," the BBC quoted him, as saying.

High blood-sugar levels linked with type-1 diabetes can cause changes to the mitochondria which increases the amounts of free radicals produced. Even after blood-sugar levels are normalized in diabetics, the researchers found evidence that free radicals continue to be produced. This is harmful as this can cause tissue damage and lead to possible amputations, heart disease or blindness. In another study, the researchers found that it was possible to normalize free radical levels by first treating diabetic people with type 1 diabetes with insulin, and then with vitamin C. This helps "mop-up" free radicals. But there is a catch. The treatment with Vitamin C is only effective if continued long-term. The answer to this might be in using the blood pressure-lowering drug Telmisarten which had the same effect as Vitamin C, and might possibly be a safer alternative. The researchers are now looking for other drugs to try to permanently stop the free radical production.

DATE: July 27, 2007

A type 2 diabetes drug taken orally and in widespread use for more than a decade has been found to have distinct advantages over nine other, mostly newer medications used to control the chronic disease, according to a study by researchers at Johns Hopkins.

In their report, published online July 16 in the journal Annals of Internal Medicine, the Hopkins team found that metformin, first approved by the U.S. Food and Drug Administration in 1995 (and sold as Glucophage, Riomet and Fortamet), not only controlled blood sugar levels but also was less likely to cause weight gain and more likely than others to lower bad cholesterol levels in the blood.

Researchers say these health benefits are important because they can potentially ward off heart disease and other life-threatening consequence from diabetes. More than 15 million Americans have type 2 diabetes.

"Sometimes newer is not necessarily better," says lead study author Shari Bolen, M.D., an internist at Hopkins. "Issues like blood sugar levels, weight gain and cost could be significant factors to many patients struggling to stay in good health," says Bolen, an instructor at The Johns Hopkins University School of Medicine.

In what is believed to be the largest drug comparison of its kind, the scientists showed that all of the commonly used oral medications worked much the same at lowering and controlling blood sugar levels, and were equally safe. But metformin stood out because it offered the same level of effectiveness without lowering glucose measurements too much, and it did so for a lower price.

Metformin was found to lower LDL or bad cholesterol by about 10 milligrams per deciliter of blood, while newer medications studied, such as pioglitazone (Actos) and rosiglitazone (Avandia), or so-called thiazolidinediones, were found to have the opposite effect, increasing levels of the artery-clogging fat by the same amount.

Researchers say the main drawbacks to metformin are digestive problems and diarrhea. Previous reports have found evidence that the medication leads to the buildup of lactic acid in the blood in people with moderate kidney or heart disease, and they note that it should not be prescribed to anyone with either of these conditions. The main advantages to both newer thiazolidinediones were a small increase in HDL or good cholesterol, and less too-low blood sugar levels than three other older, cheaper drugs studied -- glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Micronase, DiabBeta, Glynase PresTab) -- known as second-generation sulfonylureas.

Annual treatment with metformin or the sulfonylureas, they note, costs on average $100, roughly one-fourth the cost of oral diabetes medications FDA-approved since then, including the two newer thiazolidinediones, both approved in 1999. (Their price is expected to drop once generic versions become available.)

"When you are dealing with an epidemic like diabetes, it is important for people to weigh their treatment options with their physician and to make informed decisions about which medication best suits their needs," says Bolen.

In the study, Bolen and her colleagues reviewed the scientific evidence from 216 previous studies and compared each drug for its clinical effectiveness, risks and costs. In addition to metformin, the thiazolidinediones and sulfonylureas, drugs included in their analysis were repaglinide (Prandin), miglitol (Glyset), acarbose (Precose), and nateglinide (Starlix).

Among the team's other findings were that glimepiride, glipizide, and glyburide led more frequently to too-low blood sugar levels than the other drugs. The sulfonylureas and acarbose appeared to have no effect on bad cholesterol. And except for metformin and acarbose, drug treatment led to an increase in weight from 2 to 11 pounds.

Researchers also noted the increased risk of heart failure, albeit small (less than three people in a hundred), in people taking thiazolidinediones who did not have a history of heart disease. They also caution that despite recent reports about the potential for increased risk of heart attack from rosiglitazone, there is not yet sufficient information to verify the finding.

Researchers say further studies are needed to compare the long-term effectiveness of one treatment to another and to compare drug effects on quality of life and life expectancy. Additional research will also be needed to compare these findings with results for injectible medications for diabetes, most notably insulin, which was not included in the latest report.

www.hopkinsmedicine.org

DATE: July 20, 2007

Calcium and vitamin D, whether from food or supplements, may help lower the risk of developing type 2 diabetes, according to a research review.

A number of studies have found links between type 2 diabetes risk and calcium, vitamin D and dairy food intake. When the results from these studies are combined, the new review found, people with the highest intakes of vitamin D and calcium had an 18 percent lower risk of diabetes than those with the lowest intakes.

Similarly, people who ate the most dairy food had a 14 percent lower diabetes risk than those who ate the least dairy.

Though it's not clear why calcium and vitamin D are linked to diabetes risk, lab research has pointed to some possibilities, according to the review authors, led by Dr. Anastassios G. Pittas of Tufts-New England Medical Center in Boston.

Both nutrients may be important in the functioning of insulin-producing cells in the pancreas, and in the body's proper use of insulin, the researchers explain in their report, published in the Journal of Clinical Endocrinology & Metabolism.

Insulin is a hormone that helps move sugar from the blood into the body's cells to be used for energy; type 2 diabetes develops when the body becomes resistant to insulin, allowing blood sugar levels to soar.

Only a limited number of studies have tested whether calcium or vitamin D supplements can improve the body's insulin sensitivity and blood sugar metabolism. And the studies that have been done have reached conflicting conclusions, the review found.

A few trials have, however, suggested that the supplements may forestall type 2 diabetes in people who are on the verge of developing diabetes, or "pre-diabetic," based on their blood sugar levels, according to Pittas and his colleagues.

It's too soon to recommend calcium or vitamin D for managing diabetes, the researchers conclude, but more clinical trials are warranted.

Many Americans do not get enough vitamin D or calcium, they note, and supplementing people's diets with the nutrients would be an easy, inexpensive way to prevent or treat type 2 diabetes.

SOURCE: Journal of Clinical Endocrinology & Metabolism, June 2007.

DATE: July 13, 2007

The Nutritional Intervention to Prevent Diabetes (NIP) Study

• Background
• Who can be in the study?
• What does participating involve?
• What are the benefits of being in the study?
• Where can I find clinical centers who are recruiting?

Background

Type 1 diabetes is an autoimmune disease which generally begins during childhood. It occurs when the immune system - there to help your body fight infection - mistakenly attacks your insulin producing cells. When these cells are destroyed your body can no longer make insulin. This is how type 1 diabetes happens.

The Nutritional Intervention to Prevent Type 1 Diabetes Pilot Study will help us learn more about a dietary substance, docosahexaenoic acid (DHA). DHA is important for brain and eye development and has also helped people with autoimmune diseases that are similar to diabetes. Everyone gets some DHA in his or her diet, but we want to see if giving more DHA will do even more good. To test this idea, we would have to start early, well before the immune system begins its attack. We want to start before 6 months of age, even before birth. DHA can be found in fish, but the DHA in this pilot is taken from plant sources, so there's no need to worry about the bad effects of mercury or other toxic materials. Remember this is a pilot study which will only tell us if a larger study can be done, it will not tell us if DHA will prevent the first step towards type 1 diabetes.

Who can be in the study?

• Pregnant women in their 3rd trimester (more than 24 weeks) may enroll in the study if the baby they are expecting has a relative (mother, father, sister, brother, half-sister, or half- brother) with type 1 diabetes. After the baby is born, a blood test is required to determine their eligibility.
• Babies up to five months old may also be enrolled in the study if they have a relative with type 1 diabetes. They will require a blood test to determine eligibility.

What does participating involve?

If pregnant, you will take four capsules a day during your third trimester. If nursing, you will also be asked to take four capsules a day.

• The capsules will contain either DHA or an ingredient that does nothing at all called a placebo.
• Neither you nor the study staff will know if you are taking the capsules with DHA or the capsules with placebo.

If your baby is on infant formula, you will be asked to use formula provided by the study. All study formula will contain some DHA.

You and your baby will need to make regular visits to the study site.

• We will collect a sample of your baby's blood.
• We will ask about your baby's diet and your diet (if you are pregnant or nursing).
• If you are nursing, you will need to bring in a sample of your breast milk.
• We will also ask other health questions.

It is anticipated that babies will participate in the study for at least 1 year.

What are the benefits of being in this pilot study?

• You might learn if your baby is at risk for developing type 1 diabetes.
• If the pilot study is successful your baby might become part of a larger study to determine if type 1 diabetes can be prevented.
• You and your baby will be contributing to diabetes research.

What clinical sites are recruiting for this pilot study?

If you wish to see if you and/or your baby might be eligible for this study and/or for more information, please contact one of the participating sites listed. Note that participants need to be within a reasonable distance of the site and the delivery hospital.

DATE: July 06, 2007

Recent research has found that diabetes is associated with decreases in life expectancy, as well an increased risk of developing heart disease. The study, published in Archives of Internal Medicine, one of the JAMA/Archives journals, shows that men and women with diabetes at age 50 and older appear not to live as long in general, or have as many years without cardiovascular disease, than individuals without diabetes.

"Globalization of the Western lifestyle led to diabetes mellitus being a major and progressive health care problem worldwide," the authors write as background information in the article. By 2000, more than 171 million individuals had diabetes, a number that is likely to double in 25 years. Research has shown that individuals with diabetes have an augmented risk of illness and death, including double the risk of cardiovascular disease. Oscar H. Franco, M.D., D.Sc., Ph.D., of University Medical Center Rotterdam, the Netherlands, and Unilever Corporate Research, Sharnbrook, England, and colleagues used data from the Framingham Heart Study, a group of 5,209 men and women age 28 to 62 years recruited between 1948 and 1951 and followed for more than 46 years.

The researchers selected three follow-up periods of 12 years each that began in 1956 to 1958, 1969 to 1973, and 1985 to 1989. Participants were followed during each of the three periods until they developed cardiovascular disease or died, and their diabetes status was measured again at the beginning of each interval. "Women with diabetes had more than double the risk of developing cardiovascular disease and, among those already with cardiovascular disease, mortality compared with non-diabetic women," the authors write. "Diabetic men, compared with non-diabetic men, had more than double the risk of developing cardiovascular disease and a 1.7 times higher risk of dying once cardiovascular disease was present," the authors add.

Among those age 50 and older, diabetic men lived an average of 7.5 years less than men without diabetes, and diabetes reduced women's life expectancy by an average of 8.2 years. Life expectancy free of cardiovascular disease was abridged by 7.8 years in men and 8.4 years in women with diabetes. "Having diabetes at age 50 years and older represents not only a significant increase in the risk of developing cardiovascular disease and mortality but also an important decrease in life expectancy and life expectancy free of cardiovascular disease. These findings underscore the importance of diabetes prevention for the promotion of healthy aging. Toward this end, it is essential to implement global strategies to change the current Western lifestyle and to promote the adoption of physical activity and healthy diets," the authors write. "Prevention of diabetes is a fundamental task facing today's society, with the aim to achieve populations living longer and healthier lives," the authors conclude.

DATE: June 29, 2007

As the first wave of baby boomers edges toward retirement, a growing body of evidence suggests that they may be the first generation to enter their golden years in worse health than their parents. While not definitive, the data sketch a startlingly different picture than the popular image of health-obsessed workout fanatics who know their antioxidants from their trans fats and look 10 years younger than their age.

Boomers are healthier in some important ways -- they are much less likely to smoke, for example -- but large surveys are consistently finding that they tend to describe themselves as less hale and hearty than their forebears did at the same age. They are more likely to report difficulty climbing stairs, getting up from a chair and doing other routine activities, as well as more chronic problems such as high cholesterol, blood pressure and diabetes. "We're seeing some very powerful evidence all pointing to parallel findings," said Mark Hayward, a sociologist at the University of Texas at Austin. "The trend seems to be that people are not as healthy as they approach retirement as they were in older generations. It's very disturbing." While cautioning that the data are just starting to emerge, researchers say the findings track with several unhealthy trends, notably the obesity epidemic. Two-thirds of Americans are overweight, and those extra pounds make joints wear out more quickly, boost cholesterol and blood pressure, and raise the risk of a host of debilitating health problems. And despite all those gym memberships, baby boomers tend to be less physically active than their parents and grandparents, their daily routines often dominated by desk jobs and the drive to and from work. "A lot of what we visualize about the baby boomers are the people who went to college -- the highly educated group that gets all the attention. They're the cultural icon," said David Weir, an economist at the University of Michigan, noting that studies have shown that better-educated people tend to have more healthful lifestyles and better access to health care. "But not everyone went to college, and not everyone is engaging in these healthful activities."

Even those who do try to take care of themselves are not always entirely successful. Take Larry Kirkland, a 57-year-old sculptor who lives in Washington, D.C. Kirkland walks and swims regularly to stay in shape, watches what he eats, and fights to keep his weight down. Ask him about his health, and Kirkland will tell you that it's good. Well, pretty good. There's his blood pressure, which has been high for years. He takes medication to keep it under control. His cholesterol jumped too, requiring another pill to keep that in check. Then his blood sugar started going up, prompting his doctor to remind him that he really should drop at least 10 pounds if he wants to avoid diabetes. "There are the creeping aches and pains. I dislocated my shoulder once, and that continues to bug me. I have knees that decide to be wobbly on occasion. I know that as you get older things tend to begin to fall apart," Kirkland said, adding that he gets fever blisters and his psoriasis flares up when he is stressed. "I can get under quite a bit of pressure from my work," Kirkland said.

In fact, boomers tend to report more stress than earlier generations -- from their jobs, their commutes, taking care of their parents and their kids -- all of which can take a physical toll, which is compounded by having less support from extended families and communities, experts say. "People are working two jobs. They are not sleeping as much. They're experiencing more job insecurity. They have less time to take care of themselves. They are more socially isolated," said Lisa Berkman of the Harvard School of Public Health. "This all could add up to a huge crisis and really calls for us to examine the things that perhaps we're not doing so well." Some researchers are skeptical, saying that U.S. life expectancy has increased consistently for decades, accompanied by a steady drop in disability rates. Rising rates of chronic disease may simply mean that such illnesses are being diagnosed earlier, which could translate into longer lives and less disability because boomers are getting their heart disease and diabetes under control sooner. "This doesn't cause me to despair," said Kenneth Manton, a demographer at Duke University. "You have to take this data in the context of other data, such as life expectancy." Others agree that the data are unclear because the baby boomers are not yet old enough to report major health problems in significant numbers, but they added that the findings so far are ominous. "We haven't seen any enormous effects yet," said David Cutler, an economist at Harvard University. "But we may be starting to see some inklings of what's coming."

One of the most alarming red flags was thrown up by the federally funded Health and Retirement Study, which is tracking more than 20,000 U.S. adults as they move through middle age toward retirement. When researchers examined the first wave of baby boomers to enter the study -- 5,030 adults born between 1948 and 1953 -- they were shocked to discover that they appeared to report poorer health than groups born between 1936 and 1941, and between 1942 and 1947. The baby boomers were much less likely to describe their health as "excellent" or "very good" than their predecessors and were more likely to report having difficulty with routine activities, such as walking several blocks or lifting 10 pounds. They were also more likely to report pain, drinking and psychiatric problems, and chronic problems such as high blood pressure, high cholesterol and diabetes. "It's not what I expected," said Beth Soldo of the Population Aging Research Center at the University of Pennsylvania, who led the analysis.

DATE: June 22, 2007

Painful jabs of insulin to check diabetes may soon become a thing of the past, for a British company has developed a form of the protein that can be taken orally. Scientists at Diabetology, a small research and development company that has spent may years trying to develop oral insulin, believe that it will better control of symptoms. The company has successfully enclosed the insulin in a capsule that prevents it from being digested by stomach acids, and carries it intact into the small intestine. Once the capsule has reached the small intestine, it is dissolved and releases a mixture of insulin and other materials that enhance the absorption of the insulin through the intestinal wall. Thereafter, the insulin is transported to the liver, where it creates a store that can be drawn on by the body.

The researchers say that the mechanism by which the capsule carries insulin into the body approximates the behavior of the pancreas, the source of insulin in healthy people that releases it as it is needed. Diabetology has already carried out a small trial of 16 patients with type 2 diabetes, the commoner type that usually develops in middle age, led by Cardiff University Professor David Owens. Dr Steve Luzio, another researcher at the university, is to present the results of the trial at the American Diabetes Association meeting in Chicago. Although the details of his presentation have not been revealed, it is believed that he may announce that the oral dose taken twice daily before breakfast and before dinner, controlled glucose levels successfully in the patients treated. Glen Travers, the Executive Chairman of Diabetology, hopes that the product will enable better control of the disease to be achieved, without the increased risk of heart attack that has been linked to the widely used diabetes drug rosiglitazone.

DATE: June 15, 2007

Scientists have made a major leap in unraveling the genetic causes of seven common diseases, including diabetes, arthritis and high blood pressure, by completing the largest analysis of the human genome. The discoveries pave the way for improved treatments and possible cures for the millions of people in the UK who develop the diseases every year. Using new techniques to examine the DNA of thousands of patients, scientists also found common genetic links in heart disease cases. The findings raise the prospect of improved medical treatment and preventative work with people identified as carrying a genetic risk of disease.

Peter Donnelly of Oxford University, who chaired the eighteen million dollar research program funded by the Wellcome Trust, said: "By identifying the genes underlying these conditions, our study should enable scientists to understand better how disease occurs, which people are most at risk and, in time, to produce more effective, more personalized treatments." Since the completion of the human genome project in 2000, which mapped every gene in the human body, scientists have quickly identified rare genetic variants that cause major inherited diseases such as cystic fibrosis. Today's development marks a real breakthrough in diseases affecting millions. "It's been much more challenging to identify the rather common variants in diseases such as diabetes and Crohn's disease, where there are multiple genes involved but the effects of individual genes has been much smaller," said Mark Walport, director of the Wellcome Trust.

By studying the DNA from 17,000 people, the 50 research groups identified 24 new genetic links for bipolar disorder, Crohn's disease, heart disease, type 1 and type 2 diabetes, rheumatoid arthritis and high blood pressure, tripling the number of genes already associated with them. "This study is a landmark in the field of diabetes research," said Karen Addington of the Juvenile Diabetes Research Foundation. Dr Walport said that the study, one of the largest genetic research projects to date, had carried out genetic analysis at a "scale that's never been done before." Research into the links between genes and disease has focused on small numbers of samples, often from relatives who share a higher than usual risk of suffering a particular illness. But the new approach pioneered by the research team, known as a genome-wide association study, heralds the future for this kind of research.

In the study, scientists analyzed DNA samples from 2,000 patients per disease, comparing them with 3,000 "control" samples from healthy volunteers and looking at around 500,000 genetic differences in each sample. The full results of the Wellcome trust Case Control Project are published today in Nature and Nature Genetics. "Just a few years ago it would have been thought wildly optimistic that it would be possible in the near future to study a thousand genetic variants in each of a thousand people," said Dr Walport. "This research shows that it is possible to analyze human variation in health and disease on an enormous scale. It shows the importance of studies such as the UK Biobank, which is seeking half a million volunteers aged between 40 and 69, with the aim of understanding the links between health, the environment and genetic variation." Prof Donnelly said that the gene discoveries would begin a new chapter of research. Genetics was only part of the story. "Many of the most common diseases are very complex, part nature and nurture, with genes interacting with our environment and lifestyles."

Main findings

• Crohn's disease:* Eight new genetic links were found to increase a person's susceptibility to this illness, which affects between 30,000 and 60,000 people in the UK. Having a single copy of any of the disease variants of these genes increases the risk by up to 40%.
• Diabetes:* Type 1 diabetes affects around 350,000 people in the UK; 1.9 million people have type 2. The study highlighted four new regions of the genome that increase the risk of type 1 diabetes. The research also confirmed that Type 2 diabetes has a genetic component.
• Bipolar disorder:* Also known as manic depression. It is marked by extreme mood swings and affects abut 100 million people worldwide. Many of the genes identified in the study seem to play a key role in the way nerve cells in the brain talk to each other.
• Coronary heart disease:* The study found several genetic regions that increased the risk of heart disease. The risk increased by 50% in people carrying one version of the disease variant. For those carrying both the risk was almost doubled. Coronary disease is Britain's biggest killer, claiming 105,000 lives each year.
• Hypertension (high blood pressure):* The research suggests that high blood pressure arises because of a wide range of interacting factors, including three genes identified in the study . The disorder affects more than 16 million Britons and a billion people worldwide.
• Rheumatoid arthritis:* This disease affects almost 400,000 people in the UK. The project identified three locations in the genome that had a possible role in predisposing people to the condition.

DATE: June 08, 2007

Researchers in Toulouse (France) and Berlin-Buch have successfully treated type 1 diabetic mice with a vaccination. The vaccine they designed in this model included structures that the immune system mistakenly attacks in this model of type 1 diabetes. The researchers showed that, in principle, it is possible to treat autoimmune diseases (diseases, in which the immune system attacks the own body) by inducing "active tolerance". That means activating the immune system so that it no longer attacks the body's own structures, but instead protects them from the immune attack. The paper of Dr. Roland S. Liblau of INSERM* of Purpan University Hospital in Toulouse, France, and Dr. Kirsten Falk and Dr. Olaf Rötzschke of the Max Delbrück Center for Molecular Medicine (MDC) Berlin-Buch, Germany, has now been published online in the American Proceedings of the National Academy of Sciences (PNAS)**.

Autoimmune diseases develop when the immune system can no longer distinguish between "non-self" and "self" and attacks the body's own structures as is the case in type 1 diabetes. In this severe metabolic disorder, misguided T cells of the immune system destroy the cells of the pancreas that produce insulin, a hormone essential for life. The affected persons, who often develop the disease already during childhood, are subjected to insulin injections throughout their entire lives.

Previously in an experiment with mice, Drs. Falk and Rötzschke proved that it is possible to block the misdirected immune system. They vaccinated mice with modified structures of the same organ against which the immune system runs amok. Structures which activate the immune system are referred to as antigens. The MDC researchers were able to show that the animals are protected from this autoimmune disease by means of the body's own antigens linked together in a repetitive chain of identical copies. However, how and why this protective mechanism works was not clear.

Immunization with body's own antigens opens up therapy for all autoimmune diseases In collaboration with Dr. Liblau in Toulouse, the two MDC researchers have now been able to prove that the protective effect of the immunization is due to the activation of the suppressor cells of the immune system. Suppressor cells block T cells. However, suppressor cells raised against the body's structures selectively inhibit only those T cells that attack the body's own tissue. T cells that attack foreign structures such as viruses or bacteria remain unaffected by these suppressor cells. The immune system is thus again able to recognize the body's own structures as "self" and tolerate them. "That is why suppressor cells have re-emerged as a promising research focus in immunology," Dr. Rötzschke pointed out. "Suppressing undesired immune reactions through specific immunizations with the body's own antigens will open up a fundamental new approach to treatment." The immunologist is convinced that it will be possible to treat not only type 1 diabetes but also other autoimmune diseases - both as prevention of the disease as well as therapy after disease onset.

DATE: June 01, 2007

Diabetic children who spent the most time glued to the TV had a tougher time controlling their blood sugar, according to a Norwegian study that illustrates yet another downside of too much television.

Type 1 diabetes is the less common form of the disease and used to be called juvenile diabetes. It is not related to obesity and is caused when the body cannot make insulin, which converts sugar from food into energy. People with Type 1 must take insulin daily and regulate their blood-sugar levels.

The study results "suggest that encouraging children with Type 1 diabetes to watch less television may be important for improved blood glucose control and better health outcomes," the study authors wrote.

"It‘s very clear that there is a relationship. Now the question is what underlies that relationship," she said.

The study involved 538 children with an average age of 13. In Norway, about 25,000 people have Type 1 diabetes. In the United States, there are 3 million with the condition and about 30 million worldwide.

The results didn‘t surprise Chicago diabetes educator Monica Joyce, who founded a basketball camp for diabetic children.

If the researchers‘ theory is right, then turning off the TV could be added to a list of remedies "that are very low-cost to the health care system," said Dr. Francine Kaufman, head of a diabetes program at Children‘s Hospital in Los Angeles.

DATE: May 25, 2007

Spending on diabetes treatments in the United States could soar nearly 70 percent by the end of 2009, according to a new study. That trend would further burden the health-care system but could ultimately benefit patients if more are seeking and getting proper treatment. The report, 2007 Drug Trend, by Franklin Lakes-based pharmacy benefits manager Medco Health Solutions Inc., found that year-over-year spending on diabetes drugs is expected to grow between 16 percent and 20 percent this year and in each of the next two years. If left unchecked, spending could jump by 60 percent to 68 percent.

"What's driving this is the epidemic in obesity in the U.S.," said Dr. Lon Castle, Medco's director of medical policy and clinical quality. Patient education and compliance, more widespread use of lower-cost generic drugs where appropriate, and cheaper methods of distribution were all cited by Castle as ways to rein in escalating costs. Castle said it will be difficult for some of Medco's clients -- mostly employers, unions and government agencies who hire the company to manage their pharmacy benefit programs -- to keep up with the rising cost of diabetes drugs, especially given the prevalence of Type 2 diabetes in the United States. Nearly 15 million people in the U.S. have been diagnosed with diabetes, about double the 1995 total, according to the American Diabetes Association. And between 90 percent and 95 percent of those currently diagnosed have Type 2, which is often attributed to bad lifestyle habits such as lack of exercise and poor diet. U.S. spending on diabetes treatments approached $10 billion in 2005, the most recent year for which statistics are available, according to IMS Health, a research company. According to the Medco study, costs are expected to rise as doctors increasingly turn to newer, more effective and more costly medicines earlier in the treatment process. In 2006, U.S. spending increases on diabetes treatments were second only to spending on cholesterol drugs, the study showed.

Higher spending on a disease that is occurring in epidemic proportions is hardly a bad thing, however, said Dr. Antonio Morgado, chief of endocrinology at Palisades Medical Center in North Bergen. "We will spend more money on medication but ultimately that will prove to be a great savings in the long term,'' said Morgado. "If you can prevent a heart attack or a stroke, imagine the savings." Eighty-five percent of those who die from diabetes are killed by heart attacks and strokes, he said. "We have all these new medications that are better, but the problem is they're more expensive," he said. Morgado said that in most cases he supports the use of more expensive brand-name drugs over their cheaper generic competitors because he believes the branded drugs are more effective. If more effective drugs are used sooner, the cost for treating the patient down the road will be cheaper, he said.

by DUNSTAN PRIAL
prial@northjersey.com

DATE: May 18, 2007

Ann Albright, president-elect for health care and education at the American Diabetes Association, said the suggestion that fiber from cereal might be better than fiber from fruits and vegetables in preventing type 2 diabetes "warrants further investigation. But I don't think we should take away the idea that fruits and vegetables are not important," she added.

As for the nutrient magnesium, "there are a whole lot of challenges around the study of micronutrients," Albright said. "They are difficult to study. I don't think the public health message is that we should go out and up our intake of magnesium."

The mechanism by which magnesium intake might affect the risk of diabetes "is unclear," she said.

Type 2 diabetes, which generally occurs in the adult years as the body loses it ability to metabolize sugar adequately, is a growing problem, due largely to growing obesity rates, the German researchers noted. Estimates suggest that the number of people worldwide with type 2 diabetes may rise from 171 million in 2000 to 370 million by 2030, according to background information in the article. The associated illnesses, death and health-care costs linked to the disease underscore the need for effective preventive measures, the study authors noted.

For the study, conducted by researchers at the German Institute of Human Nutrition Potsdam-Rehbruecke, more than 9,700 men and 15,365 women, 35 to 65 years old, who completed a food questionnaire were then followed for an average of seven years.

The researchers also did a meta-analysis -- or review -- of previous studies about the relationship between fiber or magnesium intake and risk of diabetes.

Dividing people in the study into five groups based on their intake of fiber from cereals, the researchers found that those who ate the most had a 27 percent lower risk of developing type 2 diabetes than those who ate the least. Greater fiber intake from fruits and vegetables was not associated with diabetes risk, the study found.

Participants who consumed the most magnesium had a 23 percent lower risk of developing type 2 diabetes than those who consumed the least. Green vegetables such as spinach are good sources of magnesium, as are nuts like almonds and cashews.

The research did not touch directly on one important lifestyle issue, physical activity, Albright said. Many other studies have shown "strong evidence of physical activity, as it relates to weight loss, in preventing or delaying development of diabetes," she said.

"So, the take-home messages are that people do need to keep their weight in a healthy range," she said. "And fiber intake is a major component of a healthy diet."

The source of the fiber -- fruits, vegetables or cereals -- does not seem to be of major importance, Albright said. "Unfortunately, many people do not get a lot of fiber in their diet," she said.

And many people do not get enough physical activity -- 30 minutes a day, most days of the week, is recommended, Albright said.

DATE: May 11, 2007

The study, conducted by Medical College of Georgia researchers, studied an animal model for type I diabetes and primary Sjogren's syndrome, which damages the glands that generate tears and saliva. They found that there was considerably less salivary gland damage in a group treated with green tea extract, signifying a lessening of the Sjogren's symptom generally referred to as dry mouth. Dry mouth can also be caused by certain drugs, radiation and other diseases.

Around 30 percent of aged Americans are ill with degrees of dry mouth, says Dr. Stephen Hsu, a researcher in the MCG School of Dentistry and lead investigator on the study. On the other hand only 5 percent of the elderly in China, where green tea is extensively consumed, suffer from the problem. "Since it is an autoimmune disease, Sjogren's Syndrome causes the body to attack itself and produce extra antibodies that mistakenly target the salivary and lacrimal glands," he says. To search for inflammation and the number of lymphocytes, a type of white blood cells that congregate at sites of inflammation to repel foreign cells, the researchers studied the salivary glands of the water-consuming group and a green tea extract-consuming group. Results showed that the group treated with green tea had notably fewer lymphocytes, Dr. Hsu says. Their blood also showed lower levels of autoantibodies, protein weapons produced when the immune system attacks itself, he says. Researchers are already aware that one component of green tea , EGCG, helps suppress inflammation, according to Dr. Hsu. "So, we suspected that green tea would suppress the inflammatory response of this disease. Those treated with the green tea extract beginning at three weeks, showed significantly less damage to those glands over time," he says.

Researchers also suppose that the EGCG in green tea can activate the body's defense system against TNF-alpha, a set of proteins and molecules involved in systemic inflammation. Produced by white blood cells, TNF-alpha can stretch out to target and kill cells. "The salivary gland cells treated with EGCG had much fewer signs of cell death caused by TNF-alpha," Dr. Hsu says. "We don't yet know exactly how EGCG makes that happen. That will require further study. In some ways, this study gives us more questions than answers." According to Dr. Hsu additional studies could help find out green tea's defensive role in other autoimmune diseases, including lupus, psoriasis, scleroderma and rheumatoid arthritis. (ANI)

DATE: May 04, 2007

An older type of long-acting insulin is as effective in treating type 2 diabetes as newer and more expensive kinds, according to the results of a recent systematic review. However, the newer medications may cause fewer problems with low blood glucose while patients are sleeping. People with type 2 diabetes who need insulin take once-a-day insulin for longer-lasting or "basal" control. (The review did not cover shorter-acting insulins used to control the blood glucose spike that comes from eating.)

Doctors consider the older medication, NPH, to be the current gold standard for basal insulin. Newer drugs, insulin analogues such as insulin glargine (trade name Lantus) and insulin detemir (Levemir), have been marketed as an improvement over NPH. However, the reviewers found that Lantus and Levemir were almost identical to NPH in lowering levels of hemoglobin A1c, a widely used measure of long-term blood glucose control. The eight studies analyzed had enrolled 2,293 people and were published in major medical journals. The studies lasted between 24 and 52 weeks.

The review appears in a current issue of /The Cochrane Library/, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic. The reviewers said their study indicated "only a minor clinical benefit" came from using the newer drugs for those with type 2 diabetes when they looked at overnight low blood glucose. They suggested a "cautious approach" when using Lantus or Levemir, at least until longer studies of the effectiveness and safety of the newer medications are completed. Although NPH is less expensive than the other drugs, the reviewers could not come to any conclusion on cost-effectiveness or the effect of any of the drugs on quality of life. The relative impact on long-term complications such as blindness or kidney failure also was not clear. "For the patient the good news is that the older medication works very well," said John Buse, M.D., president-elect of the American Diabetes Association. "In most people it will lower blood sugar with little risk of hypoglycemia. The review also shows that Lantus and Levemir had fewer problems with low blood sugar at night, giving greater security for those who experience this while sleeping." Weight gain when starting insulin treatment is a concern because it can cause some to quit taking the medications if they feel they are getting fat. "Levemir has been shown to cause less weight gain than NPH in several studies," said Buse, who was not involved with the Cochrane review. Two review studies did find that patients treated with the newer drug gained up to 3.5 pounds less than those on NPH.

DATE: April 27, 2007

Diabetes has become the greatest public health crisis of the next quarter century. To address the burden of this disease, the American Diabetes Association (ADA) is issuing an urgent call-to-action for Americans to find out their risk for type 2 diabetes during the 19th annual American Diabetes Alert(R) Day. More than six million Americans have diabetes, but don't even know it. Another 54 million Americans have pre-diabetes, placing them at increased risk for developing type 2 diabetes. The ADA encourages people who are overweight, physically inactive, and over the age of 45 years to take the American Diabetes Risk Test, which asks seven simple questions about weight, age, lifestyle and family history -- all potential risk factors for type 2 diabetes. People scoring 10 points or more are at a high risk for diabetes and are encouraged to schedule an appointment to see their doctor. The risk test, in English or Spanish, is available by calling the Association toll-free at 1-800- DIABETES (1-800-342-2383) or by visiting www.diabetes.org/risktest.

"Today is a day for Americans to take charge of their health. The diabetes epidemic has taken a devastating toll on families and communities across the country," said Larry C. Deeb, MD, President, Medicine & Science, American Diabetes Association. "But there is hope. Early detection and treatment can help prevent type 2 diabetes or serious complications associated with diabetes such as heart disease, stroke, blindness, kidney disease, amputation, and even death. By taking the American Diabetes Risk Test, people can be one step closer to having the information they need to lead a healthier life." Among the primary risk factors for type 2 diabetes are being overweight, sedentary, over the age of 45 and having a family history of diabetes. African Americans, Latinos, Native Americans, Asian Americans and Pacific Islanders are at an increased risk, as are women who have had babies weighing more than nine pounds at birth. Unfortunately, people with type 2 diabetes can live for years without realizing that they have the disease. While people with diabetes can exhibit noticeable symptoms, such as frequent urination, blurred vision and excessive thirst, most people diagnosed with type 2 diabetes do not show these overt warning signs at the time that they develop the disease. Often, type 2 diabetes only becomes evident when people develop one or more of its serious complications, such as heart disease, stroke, kidney disease, eye damage, and nerve damage that can lead to amputations.

The American Diabetes Association is the nation's leading voluntary health organization supporting diabetes research, information, and advocacy. Founded in 1940, the Association has offices in every region of the country, providing services to hundreds of communities. To obtain a copy of the diabetes risk test or for more information about diabetes (in English or Spanish), please visit http://www.diabetes.orgor call 1-800-DIABETES (1-800- 342-2383). The Mission of the American Diabetes Association is to prevent and cure diabetes and to improve the lives of all people affected by diabetes.

DATE: April 13, 2007

A pilot study of people newly diagnosed with type 1 diabetes found that stem cell therapy eliminated the need for insulin therapy for varying periods of time. This is the first trial to look at stem cell therapy in humans with this form of the disease. But experts stressed that the research is preliminary and urged caution when interpreting the results, which are published in the April 11 issue of the Journal of the American Medical Association.

"This may be the first step in something that could be promising, but I need to see a control group and longer follow-up before I'd go out on a limb," said Dr. Jay S. Skyler, author of an accompanying editorial in the journal and associate director of the Diabetes Research Institute at the University of Miami Miller School of Medicine. "But this is worthy of further experimentation." Type 1 diabetes develops when the body's immune system attacks the pancreatic beta cells, which produce insulin -- the hormone that transports sugar from the blood to cells for energy. "In type 1 diabetes, the immune system is out of balance," Skyler explained. "Ordinarily, all of us have some cells with the potential to destroy the pancreas, but the regulatory immune system prevents those cells from becoming sufficiently active. In type 1 (diabetes), there's a greater proportion of activity of the destroying cells and lesser activity of the regulatory cells. The goal is to try to bring that back into balance."

By the time a person is diagnosed with the disease, some 60 percent to 80 percent of the beta cells have already been destroyed. And people who have more functioning beta cells tend to have fewer complications down the line, research has shown. Immunosuppression therapy, designed to dampen the immune system, can help, but these patients still need to take insulin to regulate their blood sugar. Meanwhile, stem cell therapy has had some success with other autoimmune diseases, such as lupus, but not with type 1 diabetes. "There has been use of this specific procedure in other autoimmune disease in human beings with some suggestion of promise of effect, and it's been advocated for a number of years that this kind of approach might be useful in type 1 diabetes," Skyler said.

The new study, conducted by scientists in Sao Paolo, Brazil, and in Chicago, involved 15 patients newly diagnosed with type