Diabetes risk factors develop earlier in women than men

As a kid, I knew more diabetic girls than boys. Maybe this is why...

Feb 20, 2007 - The 'diabetes clock' may start ticking in women years in advance of a medical diagnosis of the disease, according to a new research.

Epidemiologists at the University at Buffalo in New York have found that newly identified risk factors for diabetes found in the blood, such as markers of endothelial dysfunction, chronic sub-acute inflammation and blood clotting factors, are present early on in women who eventually progress from normal glucose status to the pre-diabetic condition. Pre-diabetes is diagnosed when blood sugar levels are higher than normal, but not high enough to indicate full-blown diabetes. The markers weren't associated with progression from normal to pre-diabetic status in men, said the study that appeared in the February issue of Diabetes Care.

'This is one of the first reports to show that otherwise healthy women are more likely than men to show elevated levels of endothelial factors and other markers of progression to pre-diabetes,' said lead author Richard Donahue. 'Because these pre-diabetic markers are not routinely assessed, and because diabetes is strongly linked with coronary heart disease, the study may help explain why the decline in death rates for heart disease in diabetic women lags behind that of diabetic men,' he said.

'Previous research had shown that hypertension and cholesterol were elevated among women who later developed diabetes. However, current findings that these novel risk factors are elevated among women even earlier than previously recognised does suggest that the 'diabetes clock' starts ticking sooner for women than for men.' The study involved 1,455 healthy participants originally enrolled in the Western New York Study, a case-control investigation of patterns of alcohol consumption and risk of cardiovascular disease conducted from 1996-2001. In the current study all participants were free of pre-diabetes, type 2 diabetes and known cardiovascular disease. They received a physical examination when they entered the study and again for this six-year follow-up.

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The costs and hope for diabetes suffers...

Diabetes problems hiking U.S. health costs
10 Apr. 2007 - Type 2 diabetics spend three times as much on care

Poorly managed type 2 diabetes costs the U.S. health system an extra $22.9 billion a year in direct medical costs to treat heart, eye, kidney and other serious health problems associated with the disease, diabetes groups reported on Tuesday. Annual health costs for a type 2 diabetic are three times that of the average American without diagnosed diabetes, according to a new report called State of Diabetes Complications in America.

"It is a pretty significant wake-up call for people, or should be. It really points out the importance of managing the disease," said Willard Manning, a health economist at the University of Chicago who worked on the report. About 20.8 million Americans have diabetes, which causes about 5 percent of all deaths globally each year.

Most have type 2, or adult-onset diabetes, in which the body loses its ability to use insulin. Obesity and lack of exercise are linked with type 2 diabetes, which can cause blindness, heart disease, stroke, chronic kidney disease and foot problems that can require amputations.

More http://www.msnbc.msn.com/id/18040557/

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Study shows promise for stem cell treatment for diabetes
10 Apr. 2007 -- Treating patients with stem cells made from their own blood showed promise as a treatment for 15 patients in Brazil newly diagnosed with Type 1 diabetes.

Preliminary results of the treatment, which were detailed in the April 11 Journal of the American Medical Association, showed 13 of the patients have so far been able to able to stop using insulin to treat their disease. The first patient has been followed for three years with the last patient treated and then followed for seven months. Type 1 diabetes, or juvenile diabetes, is an autoimmune disorder that's usually diagnosed in children or young adults and it destroys insulin-producing cells in the pancreas known as beta cells. Insulin is needed to help the body regulate blood sugar, which if not controlled can cause organ damage and death.

Researchers involved in the study says it's the first time the stem-cell treatment has been shown to work in a small group of newly diagnosed diabetes patients. One of the study authors, Richard K. Burt, who is the chief of the immunotherapy division at Northwestern University in Chicago, said it's way too early to call the treatment a cure and said additional and larger studies would be needed.

The stem-cell treatment regimen is risky. In an interview, Burt explained that blood was first withdrawn from patients who ranged in age from 14 to 31, and then frozen. Patients were then given four days of chemotherapy in order to destroy their immune systems and were also given strong antibiotics to fight infection. The stem cells in the patients' blood were then put back into the body. Patients were hospitalized for about three weeks. Burt said the idea was to "reset" the immune system by shutting down the immune system and then injecting the stem cells in order to help the body rebuild the system and stop the destruction of insulin-producing cells in the pancreas.

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Sounds like a witch's brew to me...

Diabetes drug comes from poison lizard
May 9, 2007 - A new drug released in Britain to treat a number of diabetes-related ailments -- including heart disease -- was developed from the spit of a poisonous lizard.

The drug, exenatide, was found by scientists to relieve heart disease, kidney failure and blindness in diabetes patients, The (London) Telegraph reported Wednesday. It was launched in Britain last week under the brand name Byetta.

Scientists designed the drug after analyzing a chemical found in the saliva of the Gila monster. The chemical was found to be similar to a human hormone that assists in the regulation of blood sugar. The hormone is weakened or missing in Type 2 diabetes patients, which can lead to a number of complications. The drug is purported to compensate for the weak or missing hormone to keep insulin levels at a normal level.

During a trial, 46 percent of human subjects given exenatide along with the current treatment drug metformin were able to control their blood-sugar levels adequately, compared to only 13 percent who received placebos.

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New way to make insulin with tobacco...

Scientists grow insulin in tobacco plants
July 30, 2007 -- U.S. researchers have discovered insulin grown in plants can resolve diabetes in mice -- a finding holding promise for humans afflicted with the disease.

University of Central Florida biomedical scientists led by Professor Henry Daniell found insulin might someday be grown in genetically modified plants and then be used to prevent diabetes before symptoms appear or to treat the disease in its later stages

Daniell's research team genetically engineered tobacco plants with the insulin gene and then administered freeze-dried plant cells to five-week-old diabetic mice as a powder for eight weeks. By the end of the study, the scientists found the diabetic mice had normal blood and urine sugar levels, and their cells were producing normal levels of insulin.

Daniell has since proposed using lettuce instead of tobacco since lettuce can be produced cheaply and avoids the stigma associated with tobacco. The National Institutes of Health provided $2 million to fund the UCF study, which is reported in the July issue of the Plant Biotechnology Journal.

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New diabetes treatment...

Tiny Cells Figure Big in Diabetes Treatment
Nov. 14, 2007 - Islets Could Be a Key to Diabetes Cure

At 43, she is trim, fit and energetic. She camps, hikes and runs marathons on Maui, where she lives and is a nurse. But she was here at the University of Minnesota Medical Center last month to receive an infusion of cells taken from the pancreas of a deceased donor. The experimental procedure, which has been tried in about 1,000 patients worldwide, aims to restore Rohde's ability to produce insulin.

In recent years, scientific understanding of diabetes has expanded markedly. Studies have shown keeping blood sugar levels as close to normal as possible can help prevent or delay many of the complications of the disease. At the same time, scientists have been working on ways to go beyond just treating the disease, all the way to prevention and a cure.

"We've had a tremendous amount of progress in diabetes in recent years," says Jay Skyler of the Diabetes Research Institute at the University of Miami. And more is coming. "We're at a stage now where we can sense that we can lick this thing," he says. "We're going to get there."

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New diabetes drug...

Promising new drugs for type 2 diabetes
November 28, 2007 - About this time last year, we reported on new research regarding the effects of resveratrol, a molecule present in red wine that showed some interesting effects on longevity in mice.

This week's Nature contains a paper, from some of the same authors, detailing the effects of some synthetic molecules that also activate SIRT1, and their potential as therapeutics for type 2 diabetes.

Type 2 diabetes is a growing health concern. It is the insulin-resistant form of the disease, and is closely related to obesity and a number of other conditions that make up what's known as metabolic syndrome. The study, from scientists at Sirtis Pharmaceuticals, UCSD, and Harvard Medical School, found that these synthetic SIRT1 activators showed beneficial effects in both mouse and rat models of obesity, improving insulin sensitivity, lowering plasma glucose levels, and aiding glucose metabolism.

Promisingly, these compounds are active at doses much lower than resveratrol, which bodes well for their potential as novel treatments for type 2 diabetes. Although the paper did not address the topic of lifespan, it would be interesting to know whether these compounds showed the same effects on longevity as resveratrol. One thing's for sure though; SIRT1 is surely going to be the focus of a lot more research from here on out.

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Would it violate tenets of Jewish and Muslim faiths?...

Pig cells tested as diabetes treatment
Jan. 8, 2008 -- A California company is looking at the potential for treating diabetes with pig islet cells.

San Diego-based MicroIslet, Inc. said encapsulated islets from pigs have the potential for solving many of the problems associated with transplantation of insulin-producing islet cells from human donors or cadavers as a long-term diabetes treatment, the company said Tuesday in a release. MicroIslet said it has demonstrated proof of principal of this idea through multiple animal studies and is seeking approval to begin human clinical trials this year.

"Xenotransplantation (from one species to another) has the potential to solve many of the problems associated with the transplantation of islet cells from one human to another," company president Dr. Jonathan Lakey said at a recent conference. He said pig islets could one day emerge as a significant treatment for type 1 diabetes.

Islet cell transplantation involves harvesting insulin-producing islet cells from the pancreas of an organ donor and injecting them into the portal vein. Transplanted cells make insulin in response to ingestion of sugars and starches, similarly to how a normal pancreas operates, the company said.

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Something I've always suspected...

Obesity 'may be largely genetic'
Thursday, 7 February 2008, Becoming overweight as a child is more likely to be the result of your genes than your lifestyle, claims a study.

University College London researchers examined more than 5,000 pairs of identical and non-identical twins. Their American Journal of Clinical Nutrition study found that differences in body mass index and waist size were 77% governed by genes.

An anti-obesity group said regardless of genes, a balanced diet and exercise were vital to good health. "It is wrong to place all the blame for a child's excessive weight gain on the parents - it is more likely to be due to the child's genetic susceptibility" - Professor Jane Wardle, University College London

Children who are overweight are likely to be overweight or obese in adulthood, raising the risk of certain cancers, heart disease, stroke and diabetes later in life.

However, despite the emergence of some possible genes that contribute to obesity, there is still debate as to the extent to which we are pre-programmed to be overweight by our genetic makeup. The study, from the Cancer Research UK Health Behaviour Research Centre at UCL, goes some way to answering that question.

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Results of diabetes study published...

Patients getting aggressive diabetes treatment had higher death risk
February 6, 2008 - Lowering blood sugar to near-normal levels is a proven treatment for Type 1 diabetics, but it may not be the best treatment for those with Type 2 diabetes, particularly those with heart disease or multiple risk factors for heart disease, government scientists said today.

Researchers had to curtail a major clinical trial of intensive treatment for such patients after concluding that patients with the lowest blood sugar levels had an increased risk of dying compared to those with a more modest reduction of sugar levels. The findings were a surprise to researchers, who expected to see a clear benefit from the lower sugar levels, and their source remains a mystery. Analysis has been unable to link the increased death rate to episodes of hypoglycemia -- low blood sugar -- or to any drug or combination of drugs used in the study.

In particular, they did not find any link to the diabetes drug rosiglitazone, trade-named Avandia, which has previously been linked to deaths from heart disease among those taking it. Dr. William T. Friedewald of Columbia University, who led the study, cautioned that most diabetes patients are not aiming to achieve such low blood sugar levels, "so this is not relevant for them." A statement issued by the American Diabetes Assn. cautioned diabetics not to alter or abandon their treatments without consulting their physicians.

An estimated 20 million Americans have Type 2 diabetes, in which tissues throughout the body become resistant to the effects of insulin. About 284,000 people die from it each year, with 65% of the deaths linked to cardiovascular disease. Type 2 diabetics have two to four times the normal risk of heart disease. The clinical trial, called Action to Control Cardiovascular Risk in Diabetes, or ACCORD, represents an attempt to lower the risk of cardiovascular complications in older patients at high risk. The study at 77 sites in the United States and Canada enrolled 10,251 people between the ages of 40 and 82 who had had Type 2 diabetes for at least 10 years and either already had cardiovascular disease or had at least two risk factors for it, such as high blood pressure and high cholesterol levels.

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Factors other than blood sugar...

Diabetes Health Goes Beyond Blood Sugar
February 8, 2008 - The startling findings of a major federal study on the effects of lowering blood sugar are unlikely to change the way most people with Type 2 diabetes manage their illness, doctors said Thursday.

The study, announced Wednesday, showed that an intensive program to lower blood sugar actually increased risk of death. The findings were so surprising that the study was stopped early, and they seemed to undercut the accepted wisdom that people with diabetes should do everything possible to get their blood sugar down to normal. But the methods used in the study, called Accord (for Action to Control Cardiovascular Risk in Diabetes), bear little resemblance to the techniques most doctors and patients use to manage blood sugar levels. And the patients in the study were typically far sicker than many people with diabetes today.

“The intensity of what we did is done virtually nowhere on the planet,” said Dr. John Buse, vice chairman of the study’s steering committee and the president of medicine and science at the American Diabetes Association. “It’s far beyond what’s common in clinical practice.” Dr. Buse called the study’s regimen to lower blood sugar a “brutal program.” Still, doctors are likely to reconsider their emphasis on lowering blood sugar at all costs, because it is becoming clear that other factors influence the overall health of patients with diabetes.

The New England Journal of Medicine published a study this week showing that a three-pronged approach of managing sugar, blood pressure and cholesterol — combined with low doses of aspirin — prolonged the lives of people with diabetes. The patients who did best in that study did not reach the nearly normal sugar levels that were the aim of the Accord study. Instead, their levels were just slightly higher than normal.

In the Accord study, the group of patients who were randomly assigned to lower their blood sugar levels to nearly normal had 54 more deaths than the group whose levels were less rigidly controlled. The patients were in the study for an average of four years when investigators stopped the intense regimen and put all of them on the less intense one.

More http://www.nytimes.com/2008/02/08/he...abetes.html?hp