Diabetes risk factors develop earlier in women than men

[waltky]

Artificial pancreas in the works...

Artificial pancreas just years away, experts say
Sun., July. 27, 2008 - Device could offer effortless way for diabetics to monitor blood, insulin

Researchers working on an artificial pancreas believe they are just a few years away from a nearly carefree way for people with diabetes to monitor blood and inject insulin as needed. They believe they can link two current technologies — continuous glucose monitoring and insulin pumps — into a seamless package. Such a mechanical pancreas could greatly reduce the need for fingersticks and injections of insulin that diabetics must now endure several times a day, researchers told a meeting this week at the National Institutes of Health.

"I think we are on the brink of a first-generation artificial pancreas," said Dr. Roman Hovorka of Britain's University of Cambridge, who is testing some experimental devices with components by Abbott Laboratories and Medtronic, the No. 1 maker of insulin pumps and continuous monitors. Hovorka's team has been testing devices in patients with type-1 diabetes, an autoimmune disease caused when the body mistakenly destroys the insulin-making cells in the pancreas. A continuous glucose sensor is implanted under the skin, and transmits blood sugar readings to a monitor. A computer calculates the right dose of insulin, which is delivered by an insulin pump — something many patients already wear.

His team is ready to send some patients home with the device, but has to work out the logistics of keeping a nurse full-time in each volunteer's home, just in case. U.S. Food and Drug Administration regulators are working closely with the researchers to ensure they design studies in a way that can lead to quick review, said Dr. Aaron Kowalski of the Juvenile Diabetes Research Foundation, which funds many of the artificial pancreas study teams.

Constant monitoring

[waltky]

Converting pancreas cells...

Regular pancreas cells switched into insulin-producing kind
27 Aug.`08 — Scientists have transformed one type of cell into another in living mice, a big step toward the goal of growing replacement tissues to treat a variety of diseases.

The cell identity switch turned ordinary pancreas cells into the rarer type that churns out insulin, essential for preventing diabetes. But its implications go beyond diabetes to a host of possibilities, scientists said. It's the second advance in about a year that suggests that someday doctors might be able to use a patient's own cells to treat disease or injury without turning to stem cells taken from embryos. The work is "a major leap" in reprogramming cells from one kind to another, said one expert not involved in the research, John Gearhart of the University of Pennsylvania. That's because the feat was performed in living mice rather than a lab dish, the process was efficient and it was achieved directly without going through a middleman like embryonic stem cells, he said.

The newly created cells made insulin in diabetic mice, though they were not cured. But if the experiment's approach proves viable, it might lead to treatments like growing new heart cells after a heart attack or nerve cells to treat disorders such as ALS, also known as Lou Gehrig's disease. Douglas Melton, co-director of the Harvard Stem Cell Institute and a researcher with the Howard Hughes Medical Institute, cautioned that the approach is not ready for people. He and his colleagues report the research in a paper published online Wednesday by the journal Nature. Basically, the identity switch comes about by a reprogramming process that changes the pattern of which genes are active and which are shut off.

Scientists have long hoped to find a way to reprogram a patient's cells to produce new ones. Research with stem cells, and similar entities called iPS cells that were announced last year, has aimed to achieve this in a two-step process. The first step results in a primitive and highly versatile cell. This intermediary is then guided to mature into whatever cell type scientists want. That guiding process has proven difficult to do efficiently, especially for creating insulin-producing cells, Gearhart noted. In contrast, the new method holds the promise of going directly from one mature cell type to another. It's like a scientist becoming a lawyer without having to go back to kindergarten and grow up again, Melton says. So, he says, someday scientists may be able to replace dead nerve or heart cells in people by converting some neighboring cells. At the same time, he stressed that it's still important to study embryonic stem cells and iPS cells.

MORE

[waltky]

Aspirin and diabetes...

Diabetes aspirin use questioned
Thursday, 16 October - Aspirin should not routinely be used to prevent heart attacks in people with diabetes, Scottish researchers say.

The British Medical Journal reported that in 1,300 adults with no symptoms of heart disease the drug, which can cause stomach bleeds, had no benefit. The findings contradict many guidelines which advocate people with diabetes use aspirin to counter the underlying high risk of heart attack and stroke. But there are key high-risk groups who still need the drug, experts said. In people who have already had a heart attack or stroke, or have been diagnosed with coronary artery disease, aspirin has been shown to reduce the risk of future "events" by around 25%. "We have got a bit ahead of ourselves with aspirin" - Professor Jill Belch

However, in recent years doctors have begun to focus on people who have not yet developed so-called cardiovascular disease, but are at high-risk of having it in the future - such as people with diabetes. There are around two million people over 40 with diabetes in the UK. Around 80% of people with diabetes die of cardiovascular disease including strokes and heart attacks. A daily dose of aspirin is recommended by several UK guidelines as a "preventive" treatment in these groups.

No benefit

But in the latest study in adults over 40 years with type 1 or type 2 diabetes and no symptoms of cardiovascular disease, there was no difference over seven years in heart attacks or strokes between those given aspirin and those given a dummy pill. Study leader Professor Jill Belch, from the University of Dundee, said aspirin was one of the most common causes of hospital admission for gastrointestinal bleeding. "We have got a bit ahead of ourselves with aspirin. "We need to think again about using it for primary prevention." However she stressed the drug was beneficial in people who had already had a heart attack or stroke. "Patients shouldn't panic or stop taking aspirin" - Professor Steve Field, Royal College of GPs

More BBC NEWS | Health | Diabetes aspirin use questioned

[waltky]

Experimental diabetes treatment ok'ed...

Pig cell injections to fight diabetes
October 21, 2008 - A NEW Zealand biotech firm has been given the green light to inject pig cells into humans as part of a trial to tackle diabetes.

The ASX-listed Living Cell Technologies today learned it had been given the go-ahead for the controversial trial by New Zealand Health Minister David Cunliffe. "It is extremely exciting for lots of people, especially the diabetics, because it gives them new hope," said company founder David Collinson. He said the $2m two-year trial would kick off at Auckland's Middlemore Hospital with eight patients in February 2009.

Collinson said his company had sought approval from New Zealand regulators for the past 10 years, and he hoped that by 2010 drugs used in the trial would be made available in some parts of the world. As part of the process the company uses, pig cells coated in a type of purified seaweed are injected into diabetes patients to stimulate insulin production. "We put special coatings around the outside of the cells and that seems to stop the immune system from seeing them," Mr Collinson said.

"Once they have one of these implants, which is a very simple procedure, it seems to take away the wild swings (in insulin production) and helps the management. "The fear of a diabetic is that they don't know what is going to happen tomorrow. This takes away that fear," he said. He said news that the trial had been allowed was overwhelming. "We have been dealing with New Zealand regulators for close to 10 years. It is pig-headed perseverance is what made this happen," he said.

The company also had a trial underway in Russia, which had produced promising results, he said. Mr Cunliffe said the trial could make New Zealand a leader in treating diabetes and the use of xenotransplantation. "It remains clear to me that any such trial will always carry a very low residual risk, so the key issue has always been whether this risk is sufficiently small and can be successfully managed," Mr Cunliffe said.

Pig cell injections to fight diabetes | NEWS.com.au

[waltky]

Price tag just for diabetes...

Diabetes could cost U.S. well over $218 billion
Tues., Nov. 18, 2008 - Study estimates financial toll from rapidly increasing disease

As diabetes is rapidly becoming one of the world's most common diseases, its financial cost is mounting, too, to well over $200 billion a year in the U.S. alone. A new study, released Tuesday exclusively to The Associated Press, puts the total at $218 billion last year — the first comprehensive estimate of the financial toll diabetes takes, according to Danish pharmaceutical company Novo Nordisk A/S, which paid for the study. That figure includes direct medical care costs, from insulin and pills for controlling patients' blood sugar to amputations and hospitalizations, plus indirect costs such as lost productivity, disability and early retirement.

The study, conducted by the Lewin Group consultants, estimates costs to society for people known to have Type 1 or Type 2 diabetes at $174.4 billion combined, a total previously reported by Novo Nordisk, the world's top producer of insulin and the maker of diabetes pills such as NovoNorm and Prandin. That study was done with the American Diabetes Association. The new study adds estimates for people who haven't been diagnosed yet ($18 billion), women who develop diabetes temporarily during pregnancy ($636 million) and those on track to develop diabetes, an increasingly common condition called pre-diabetes ($25 billion).

"Diabetes has not seen a decline or even a plateauing, and the death rate from diabetes continues to rise," said Dana Haza, senior director of the National Changing Diabetes Program, an effort Novo Nordisk began in 2005 to improve diabetes care and prevention in the U.S. "The numbers just keep going higher and higher, and what we want to say is, 'It's time for government and businesses to focus on it,'" said Haza, who believes diabetes will be the country's biggest health problem in the future, worsened by the obesity epidemic.

More http://www.msnbc.msn.com/id/27783488/