Tag Archives: diabetes treatment

Fibro Warrior of the Week

This entry is part of a series, my fibro»

Recently I was asked to be interviewed for the Fibro Warrior of the week feature on http://fibrodaily.com/ ‘s website. I was honored to do it, Although I do not consider myself to be anything but an everyday person who just happens to have Fibromyalgia, but if any of my words can help another to live a little normally then I think I might have accomplished something. So here is the interview as printed..enjoy!

Fibro Warrior of the Week (#43)


Location: Hanson, Massachusetts, USA

Twitter: Fibro News
@Fibromen

Mantra: Being Irish, I have an abiding sense of tragedy which sustains me through temporary periods of joy.—
W.B. Yeats

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Ground-breaking study to cap the growing trend of type 2 diabetes in overweight adolescents

Researchers at The Children’s Hospital at Westmead are embarking on a ground-breaking new study to investigate whether a different dietary approach to insulin resistance in overweight adolescents can put the brakes on its progression to type 2 diabetes.

Type 2 diabetes affects 85 to 90 per cent of all people with diabetes. While it usually affects mature adults, younger people and children are increasingly being diagnosed. Often people with type 2 diabetes also have high blood pressure, high cholesterol and are overweight or obese.

The MBF Foundation funded the three-year $400,000 project recognising increased medical and community concern about the growing number of overweight children being diagnosed with insulin resistance.

Currently adolescents with insulin resistance are managed through a combination of exercise, diet in line with the Australian Dietary Guidelines and medication, with the aim of preventing or delaying the onset of type 2 diabetes.

Clinicians at The Children’s Hospital at Westmead are evaluating two diets, combined with an exercise program, for their effectiveness in turning the risk of this condition around. As a result of a growing body of evidence that amongst adults higher protein diets can more effectively reduce body fat and help control insulin levels, dietitians will investigate whether young people can similarly benefit from a high protein diet.

Dr Christine Bennett, MBF Foundation Steering Committee Chair and Chief Medical Officer of Bupa Australia*, says that one in four young Australians are now overweight or obese** and some of these will go on to develop type 2 diabetes if urgent action is not taken to manage this increasing problem.

“Type 2 diabetes can be difficult to control and needs to be managed effectively. Complications are often present at diagnosis and can lead to heart and kidney disease appear later in life. We can potentially save thousands of adolescents from this serious long term chronic condition,” she said.

“We want to give our young people the best possible start to life and find the best way to help them deal with a difficult problem. With early intervention insulin resistance is potentially reversible, or at least the progression to type 2 diabetes can be delayed.”

The program will see 108 adolescents aged between 10 and 18 take part in a diet and exercise regime.

Participants will follow one of two diets. The first will be based on the currently recommended Australian Guide to Healthy Eating, which is high in carbohydrates and low in fat. The second will follow a lower carbohydrate and increased protein diet.

“Teen-friendly diet models will be used to enhance compliance with the aim of reducing insulin levels and helping young participants lose weight,” said Dr Sarah Garnett Principal Researcher from the Westmead Children’s Hospital.

“We believe the project is the first of its kind. There is little evidence currently available to establish the best diet to control insulin resistance in adolescents and the role of protein in the diet,’ said Dr Garnett. “This will tell us the advice we can give these kids that will actually work.”

The program involves an intensive three month dietary intervention and a three month intensive gym and home based exercise program. The participants will be followed up for six months to measure the program’s effectiveness.

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Recruitment for the three year-study is already underway, with the first participants having started their exercise session at Fitness First in Parramatta. There is no cost to families in participating in the fitness program at Fitness First.

About the MBF Foundation

The MBF Foundation is a charitable institution set up by MBF to support and manage important health initiatives for the community using a portion of MBF Group’s investment income each year. The Foundation is focussing on three key areas – wellness and obesity, supporting healthy ageing and keeping healthcare affordable.

For more information, or to arrange an interview or images, please contact:

Jackie Crossman or Renea Murphy
Crossman Communications
02 9361 0519 or 0402 218 662

Health benefits of Cinnamon

When you think of cinnamon, you might conjure up images of hot apple pie or warm-from-the-oven oatmeal cookies. And of course, there wouldn ?t be cinnamon toast without it. You?d probably never imagine, though, that cinnamon has health benefits. In fact, researchers recently discovered that this warming spice can actually help lower your blood sugar. Some of the natural compounds in cinnamon have the ability to mimic insulin, helping glucose get into cells, where it can be used for energy, and significantly lowering blood sugar in the process.

One study involving 60 men and women found that taking as little as 1/4 to 1/2 teaspoon of cinnamon a day lowered blood sugar by 18 to 29 percent. It also reduced bad LDL cholesterol by 7 to 27 percent in people with diabetes.

You probably also wouldn ?t guess that cinnamon is a good source of fiber (although actually, it?s not so surprising when you consider that it comes from the bark of the cinnamon tree). Two teaspoons provides 2.5 grams of fiber?more than 1/2 cup of raw cabbage or bell peppers or two dried apricot halves.

Cinnamon also contains the mineral manganese, which may help improve the way your body uses blood sugar. Just 2 teaspoons can set you up with more than one-third of the manganese you need for the day.

Health Bonus

The natural chemicals in cinnamon can help prevent blood platelets from clumping together and forming dangerous clots that can trigger a heart attack. And studies show that a mere whiff of cinnamon can boost brain activity and improve concentration.

There are more ways than you can imagine to sprinkle cinnamon into your diet.

Add cinnamon to apple sauce as the apples are cooking or use it to spice up baked apples.

Shake it on whole grain toast or whole grain English muffins.

Add a half teaspoon or so of cinnamon to ground coffee before starting the pot. You can also add it to tea or drink chai, which contains cinnamon and other spices.


Mix it into hot cereals, especially oatmeal.

Sprinkle a little cinnamon on top of ice cream or frozen yogurt or add it to plain yogurt along with a little honey.

Mix some with low-fat cream cheese for a tasty bread spread.

Flavor winter squash or sweet potatoes with cinnamon.

Perfect Portion: 1/2 teaspoon
Just 1/2 teaspoon a day can benefit your health. If you like cinnamon, go ahead and eat a couple of teaspoons a day, but don?t go overboard. Cinnamon contains natural compounds that can be toxic in high doses.

Diabetes drug shows promise against multiple sclerosis

A drug currently FDA-approved for use in diabetes shows some protective effects in the brains of patients with relapsing remitting multiple sclerosis, researchers at the University of Illinois at Chicago College of Medicine report in a study currently available online in the Journal of Neuroimmunology.

In a small, double-blinded clinical trial, patients with relapsing remitting multiple sclerosis were assigned to take pioglitazone (a drug commercially known as Actos used to treat type-2 diabetes) or a placebo. Patients continued their normal course of therapy during the trial.

Standard neurological tests were done initially, as were MRI scans to provide baseline values for lesions typically seen in MS patients. The patients were evaluated every two months, and blood samples were taken. Repeat MRI scans were done after five months and again after one year.

Patients taking pioglitazone showed significantly less loss of gray matter over the course of the one-year trial than patients taking placebo. Of the 21 patients who finished the study, patients taking pioglitazone had no adverse reactions and, further, found taking pioglitazone, which is administered in an oral tablet, easy.

“This is very encouraging,” said Douglas Feinstein, research professor of anesthesiology at UIC. “Gray matter in the brain is the part that is rich in neurons. These preliminary results suggest that the drug has important effects on neuronal survival.”

Feinstein’s lab has been interested in the class of drugs called thiazolidinediones, or TZDs. Several TZDs have been approved for use in the treatment of type-2 diabetes because of the drugs’ effect on the body’s response to insulin.


The researchers focused on pioglitazone because of its known anti-inflammatory effects, Feinstein said. They used primary cultures of brain cells to show that pioglitazone reduced the production of toxic chemicals called cytokines and reactive oxygen species. These molecules are believed to be important in the development of symptoms in MS.

Feinstein’s lab proceeded to test pioglitazone in an animal model of MS. They and others showed that pioglitazone and other TZDs “can significantly reduce the clinical signs in mice with an MS-type disease,” said Feinstein.

“More importantly, when mice who are already ill are treated with pioglitazone, the clinical signs of the disease go away,” he said. “We were able to induce almost complete remissions in a number of mice.”

“We are now working to determine the mechanisms to explain the protective effect on neurons that we see in our studies,” said Feinstein. “We hope to expand into a larger trial to confirm these preliminary results.”

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Claudia C. Kaiser, who was a post-doctoral student at UIC, is first author on the paper. Other authors are Dinesh Shukla and Demetrios Shias of UIC; Glen Stebbins, Dusan Stefoski and George Katsamakis of Rush University Medical Center; and Douglas Jeffrey of Wake Forest University School of Medicine. Takeda Pharmaceuticals funded the study and provided the drug but had no other involvement in the study.

For more information about UIC, visit www.uic.edu.

[Editors Note: An MP3 podcast on this topic is available https://blackboard.uic.edu/bbcswebdav/institution/web/news/podcasts/PdCst61-May26%2709-Feinstein.mp3 ]

Is vitamin D deficiency linked to Alzheimer’s disease and vascular dementia?

Hypothesis explored in the current issue of the Journal of Alzheimer’s Disease

Amsterdam, The Netherlands, May 26, 2009 – There are several risk factors for the development of Alzheimer’s disease and vascular dementia. Based on an increasing number of studies linking these risk factors with Vitamin D deficiency, an article in the current issue of the Journal of Alzheimer’s Disease (May 2009) by William B. Grant, PhD of the Sunlight, Nutrition, and Health Research Center (SUNARC) suggests that further investigation of possible direct or indirect linkages between Vitamin D and these dementias is needed.

Low serum levels of 25-hydroxyvitamin D [25(OH)D] have been associated with increased risk for cardiovascular diseases, diabetes mellitus, depression, dental caries, osteoporosis, and periodontal disease, all of which are either considered risk factors for dementia or have preceded incidence of dementia. In 2008, a number of studies reported that those with higher serum 25(OH)D levels had greatly reduced risk of incidence or death from cardiovascular diseases.

Several studies have correlated tooth loss with development of cognitive impairment and Alzheimer’s disease or vascular dementia. There are two primary ways that people lose teeth: dental caries and periodontal disease. Both conditions are linked to low vitamin D levels, with induction of human cathelicidin by 1,25-dihydroxyvitamin D being the mechanism.

There is also laboratory evidence for the role of vitamin D in neuroprotection and reducing inflammation, and ample biological evidence to suggest an important role for vitamin D in brain development and function.

Given these supportive lines of evidence, Dr. Grant suggests that studies of incidence of dementia with respect to prediagnostic serum 25(OH)D or vitamin D supplementation are warranted. In addition, since the elderly are generally vitamin D deficient and since vitamin D has so many health benefits, those over the age of 60 years should consider having their serum 25(OH)D tested, looking for a level of at least 30 ng/mL but preferably over 40 ng/mL, and supplementing with 1000-2000 IU/day of vitamin D3 or increased time in the sun spring, summer, and fall if below those values.

Writing in the article, Dr. Grant states, “There are established criteria for causality in a biological system. The important criteria include strength of association, consistency of findings, determination of the dose-response relation, an understanding of the mechanisms, and experimental verification. To date, the evidence includes observational studies supporting a beneficial role of vitamin D in reducing the risk of diseases linked to dementia such as vascular and metabolic diseases, as well as an understanding of the role of vitamin D in reducing the risk of several mechanisms that lead to dementia.”

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The article is “Does Vitamin D Reduce the Risk of Dementia?” by William B. Grant, Ph.D. It is published in the Journal of Alzheimer’s Disease 17:1 (May 2009).

Diabetics’ heart attack risk can be reduced, research finds

People with diabetes who maintain intensive, low blood sugar levels are significantly less likely to suffer heart attacks and coronary heart disease, new research published today in The Lancet has shown.

By undertaking a meta-analysis which pooled information from five large trials, researchers at the University of Cambridge were for the first time able to provide reliable evidence linking intensive blood sugar level (or glucose) control with fewer heart attacks.

The research, funded by the British Heart Foundation, pointed to a 17 % reduction in heart attacks and a 15 % reduction in coronary heart disease. However, the study found a more modest trend towards reduction in strokes with intensive control of glucose levels compared to standard care. Importantly, in contrast to smaller studies which had suggested possible harm from better blood sugar control, there were no adverse effects on deaths from any cause.

It is well documented that diabetics are at increased risk of heart disease. Even though patients can reduce their risk by maintaining healthy blood pressure levels and cholesterol reduction, the risk remains high.

Dr Kausik Ray of the University of Cambridge, lead author of the study, said: “Previous studies have been inconclusive, leaving diabetics and their doctors unsure as to whether maintaining lower blood sugar levels actually benefitted the patients. Although additional research needs to be conducted, our findings provide insight into the importance of improving glucose levels which should include lifestyle changes as well as medication.”


The five trials involved more than 33,000 individuals, including 1497 heart attack cases, 2,318 cases of coronary heart disease, and 1227 strokes. In order to assess the possible risk of various heart conditions, Dr Ray and his team analyzed the data collected on the glucose levels in blood, specifically a long-term marker of glucose control called HbA1c. In healthy individuals, HbA1c levels average between 4-5%. However, diabetics often have levels above 6.5%.

In the present study, those taking a standard treatment maintained a HbA1c level of 7.5%. Individuals who underwent intensive treatment to lower their blood sugar level were 0.9% lower than those who underwent standard treatment (average 6.6%), thereby dramatically reducing their risk of disease in large blood vessels.

Professor Peter Weissberg, Medical Director at the British Heart Foundation said: “It is well established that carefully controlling blood sugar in people with diabetes can help prevent disease in small blood vessels that leads to kidney failure and blindness. This collective analysis of several large clinical trials suggests that careful blood sugar control also protects against heart attacks and strokes, the major causes of death in people with diabetes.

“These findings emphasise the importance of detecting and treating diabetes as early as possible, thus preventing the chances of developing heart and circulatory disease.”

Dr Ray concluded: “The present findings reinforce the need for diabetic patients to achieve and maintain better control of blood sugars long-term, as a means to reduce risk of heart disease.”

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For additional information please contact:
Genevieve Maul, Office of Communications, University of Cambridge
Tel: +44 (0) 1223 332300, +44 (0) 1223 765542
Mob: +44 (0) 7774 017464
Email: Genevieve.maul@admin.cam.ac.uk

Triglycerides implicated in diabetes nerve loss

To stall progress of neuropathy, doctors should monitor levels of an easily measured blood fat as closely as they do blood sugar, study suggests

ANN ARBOR, Mich.– A common blood test for triglycerides – a well-known cardiovascular disease risk factor – may also for the first time allow doctors to predict which patients with diabetes are more likely to develop the serious, common complication of neuropathy.

In a study now online in the journal Diabetes, University of Michigan and Wayne State University researchers analyzed data from 427 diabetes patients with neuropathy, a condition in which nerves are damaged or lost with resulting numbness, tingling and pain, often in the hands, arms, legs and feet. The data revealed that if a patient had elevated triglycerides, he or she was significantly more likely to experience worsening neuropathy over a period of one year. Other factors, such as higher levels of other fats in the blood or of blood glucose, did not turn out to be significant. The study will appear in print in the journal’s July issue.

“In our study, elevated serum triglycerides were the most accurate at predicting nerve fiber loss, compared to all other measures,” says Kelli A. Sullivan, Ph.D., co-first author of the study and an assistant research professor in neurology at the U-M Medical School.

“These results set the stage for clinicians to be able to address lowering lipid counts with their diabetes patients with neuropathy as vigilantly as they pursue glucose control,” says Eva L. Feldman, M.D., Ph.D., senior author of the study and the Russell N. DeJong Professor of Neurology at the U-M Medical School.

With a readily available predictor for nerve damage – triglycerides are measured as part of routine blood testing – doctors and patients can take pro-active steps when interventions can do some good, says Feldman.

“Aggressive treatment can be very beneficial to patients in terms of their neuropathy,” says Feldman, who is also director of the A. Alfred Taubman Medical Research Institute and director of the Juvenile Diabetes Research Foundation Center at U-M for the study of complications in diabetes.

People can reduce blood triglyceride levels with the same measures that reduce cholesterol levels: by avoiding harmful fats in the diet and exercising regularly.


Context

Diabetic neuropathy affects around 60 percent of the 23 million people in the United States who have diabetes. It is a complication in both type 1 and type 2 diabetes.

Until now, doctors have lacked an effective way to predict which diabetes patients are at greatest risk of neuropathy. Most often, the condition becomes evident when irreversible nerve damage has already occurred. Neuropathy is the leading cause of diabetes-related hospital admissions and amputations that are not secondary to trauma.

Triglycerides are a type of lipid, or fat, that the body makes from calories it doesn’t need immediately. Triglycerides are stored in fat cells until they are needed to provide energy. When higher-than-normal amounts circulate in the blood, a person is at higher risk of cardiovascular disease.

Research implications

The new finding adds to an emerging picture of the close connections between cardiovascular disease and diabetes. Elevated triglycerides are one of the most common features of the lipid disorders found in patients with type 2 diabetes, by far the most common form of diabetes, says Rodica Pop-Busui, M.D., Ph.D., one of the study’s authors and an assistant professor in the metabolism, endocrinology and diabetes division of the Department of Internal Medicine at the U-M Medical School.

“Cardiovascular disease is the main cause of excess mortality among patients with diabetes. Research also has shown that the presence of neuropathy is an important predictor of these deaths,” says Pop-Busui.

“Our findings in this study reinforce the tight links between cardiovascular disease and peripheral neuropathy in patients with diabetes. We demonstrated that the same lipid particles that contribute to the progression of atherosclerosis are also very important players in peripheral nerve fiber loss.”

In addition, the study confirms a growing belief among some diabetes researchers that elevated blood levels of certain lipids, rather than solely elevated blood sugar, are key in the progression of diabetic neuropathy. The study pinpoints triglycerides as the critical indicator.

Research details

The researchers examined data from a previous clinical trial of a drug that showed promise for relieving neuropathy. They looked at data from 427 participants who had mild to moderate diabetic neuropathy at the beginning of the one-year trial. Among other factors, the trial measured myelinated fiber density in a peripheral nerve in the leg in participants over the course of the year. A decline in this density is a prime indicator that neuropathy is worsening.

The new findings from U-M are an example of how medical science often looks for one thing and doesn’t find it—the drug trial found that a promising agent turned out to be ineffective for treating neuropathy—but the data can yield unexpected, useful knowledge about something else.

Realizing the trial data held potential clues, the U-M team selected trial participants who had similar characteristics regarding nerve function at the beginning of the study but significantly lower myelinated fiber densities at the end. They used microarray technology not available 15 years ago, when the data was collected.

“We then compared all of the other data concerning lipids and blood glucose. We found that out of all the data collected on these patients, elevated triglycerides were the factor that differed the most, when we compared the patients who lost nerve fibers with those who didn’t,” says Sullivan.

Elevated triglycerides correlated with the nerve fiber loss independent of disease duration, age, diabetes control or other variables.

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Other U-M authors include Timothy D. Wiggin, M.S., co-first author; non U-M authors are Anders Sima, M.D., professor of pathology and neurology at Wayne State University Medical School, and Antonino Amato, M.D., from Sigma-Tau Research.

Funding: National Institutes of Health, Juvenile Diabetes Research Foundation Center for the Study of Complications in Diabetes, American Diabetes Association, Thomas Foundation, Sigma Tau Research, and the U-M Program for Neurology Research and Discovery.

Journal citation: Diabetes, http://diabetes.diabetesjournals.org/cgi/reprint/db08-1771v1

Resources: http://www.med.umich.edu/PNRD/

What Are The Symptoms Of Diabetes? by JohnJames

Ensure that you don’t eat foods that will increase your blood sugar level. That’s a very big mistake lots of diabetic patients make. They still think they are young, gay and without any problems. As soon as you get diagnosed with diabetes, it’s time to eat and drink responsibly and with a great deal of caution, least you worsen the condition. Continue reading