Guest guest Posted February 27, 2011 Report Share Posted February 27, 2011 2.%% Oph vol118,2 Feb 2011 Ten-Year Change in Vision-Related Quality of Life in T1DM:[1210 pts with T1] Conclusions - Change in visual acuity was the most important factor associated with changes in vision-related quality of life scores in individuals with T1 during a 10-year period. Our findings support the necessity of close follow- up of individuals with T1 to avoid development of long-term complications and vision loss to improve quality of life. 3.%% Oph vol118,2 Feb 2011 Foveal Cystoid Spaces Are Associated with Enlarged Foveal Avascular Zone and Microaneurysms in Diabetic Macular Edema Objective - To study the association between pathomorphology at the foveal center delineated by spectral domain optical coherence tomography (SD-OCT) & vascular changes around the fovea in fluorescein angiography (FA) in patients with diabetic macular edema (DME). [86 eyes] Conclusions - The eyes with cystoid spaces at the foveal center [seen on] OCT had more Microaneurysms in the capillary network and larger foveal avascular zone in FA images. [fovea=center of macula] 4.%% M Triamcinolone Aids Laser Treatment of Diabetic Macular Edema (Reuters Health) Feb 02 - Pretreatment with intravitreal triamcinolone acetonide (IVTA) improves laser therapy of diabetic macular edema, Australian researchers report..However, possible side effects call for close follow-up. [84 eyes in 54 DM pts] At two years, 36% of the eyes treated with the combination approach [combo] showed an improvement of 10 letters or more in best corrected visual acuity compared to 17% of the laser-only eyes. (61%) phakic eyes in the combo group required cataract removal, compared to none in the laser-only group. In addition, 64% of combo eyes required treatment of elevated intraocular pressure compared to 24% of eyes in the laser only group. Further research is needed to determine whether the beneficial effects of steroids on macular edema expose the recipient to an increased risk of requiring ongoing intervention, say the investigators. 5.%% M HbA1c May Miss Diabetes in Adolescents (Reuters Health) Jan 25 - In comparison with results in adults with DM, hemoglobin A1c (HbA1c) testing in younger pts doesn't have the same level of discrimination, researchers report. [1400 pts age 12 -18; 8200 age 19-78] " Use of HbA1c for diagnosis of DM & pre-diabetes in adolescents may be premature until information from more definitive studies is available. " they conclude. 6.%% M Could New Diabetes Device Cut Low Blood Sugar Risk? (Reuters Health) Jan 24 - A handheld tool that provides diabetics with automated feedback -- from average blood sugar levels to early signs of a treatment's side effects -- may help certain pts better manage the disease. The biofeedback system could make it easier to walk the fine line between controlling blood sugar levels in order to minimize chronic complications & risking hypoglycemia.[Hypo] [120 adults with T1]. All received 3 different levels of feedback: Level 1 - basic blood sugar monitoring. Lev 2 & 3 added long-term averages & measures of variability, plus estimated risks for Hypo based on blood sugar values & patient's symptoms. . level 1's blood sugar monitoring was generally enough to keep average levels from rising too high. The more sophisticated feedback offered no additional benefit in preventing hyperglycemia. . however-- the estimated cases of severe Hypo dropped significantly, from more than 2 per patient/yr to fewer than 1 in 4 patients having an episode every year. " This technology is intended for implementation in any contemporary meter out there, " team leader said. " It would make for a very smart meter. " .. 7.%% M Aspirin for Primary Prevention in Diabetes State of the Evidence 1/21/11 Previous guidelines recommended low-dose aspirin therapy for the primary prevention of stroke in patients with T1 or T2 who were at increased CV risk - including age older than 40, family history of CVD, hypertension, smoking, or dyslipidemia. The current meta-analysis [10,117 pts]- reported that evidence demonstrating that low-dose aspirin is beneficial was lacking .. the benefits were not found to exceed the risk for major bleeding.. The (ADA) Standard of Medical Care in Diabetes--2010 guidelines now recommend the consideration of aspirin therapy 75-162 mg daily as a primary prevention strategy for pts with T1 or T2 who are at increased CV risk. Aspirin should not be recommended for patients at low CV risk, including women younger than 60 & men younger than 50 because the low benefit is offset by the risk for significant bleeding.. it remains questionable how much benefit or risk aspirin confers for primary prevention in patients with DM. Currently, 2 trials are under way to answer key questions about the risk/benefit ratio. 8.%% M Diabetes, Metformin and Lactic Acidosis 1/24/11; Metformin has long been thought to cause lactic acidosis (LA) --We assessed the relationship of metformin prescription and other factors to the incidence of LA. Results - The incidence of LA was greater in DM than in the non-DM population but with no further increase in patients taking metformin. 9.%% M Impact of Electronic Health Record Clinical Decision Support on Diabetes Care: A Randomized Trial We wanted to assess the impact of an electronic health record– based DM clinical decision support system on control of hemoglobin A1c, BP, and low-density lipoprotein (LDL) cholesterol levels in adults with DM [2556 pts] Conclusions EHR-based diabetes clinical decision support significantly improved glucose control and some aspects of BP control in adults with T2. 10..%% M Artificial Pancreas Could Help Pregnant Diabetic Women 2/1/11 — research has successfully demonstrated the potential benefits of an artificial pancreas in pregnant women with T1. Pregnancy poses additional risks for women with DM as hormonal changes make it very difficult to keep blood glucose levels within a safe range, especially at night. As a result of high blood glucose levels, babies of women with DM are 5 times as likely to be stillborn, 3 times as likely to die in their first months of life, and twice as likely to have a major deformity. Hypoglycemia (low blood sugar) in pregnancy is a major cause of maternal mortality. Strict glycemic control is more readily achievable by pregnant women with T2. However there has been a disappointing lack of progress in managing T1 in pregnancy. For this study the performance of an artificial pancreas or " closed- loop insulin delivery system " was evaluated in 10 pregnant women with T1. . the device was able to automatically provide the right amount of insulin at the right time, maintain near-normal blood glucose levels & , prevent nocturnal hypoglycemia in both early and late pregnancy. The artificial pancreas was created by combining a continuous glucose monitor with an insulin pump. If all goes well & funding is in place, Diabetes UK says the artificial pancreas for pregnant women could be available within 5-10 years. 11.%% M Trans-palmitoleic acid, metabolic risk factors, and new- onset diabetes in U.S. adults: Palmitoleic acid which is produced by endogenous [within body] fat synthesis, has been linked to both beneficial and harmful metabolic effects.. [3736 adults ] Conclusion: Circulating trans-palmitoleate is assoc with lower insulin resistance, presence of atherogenic dyslipidemia, & incident DM. Our findings may explain previously observed metabolic benefits of dairy con-sumption & support the need for detailed further investigation. NIH 12.%% WebMD:Cold Virus May Trigger T1DM 2/3/11 - A common cold virus could trigger T1 in at-risk children. The finding could help explain a dramatic rise in DM incidence among very young children, The new analysis of 26 studies revealed that children with T1 are almost 10 times more likely to show signs of enterovirus infection than children without T1. Enteroviruses are the 2nd leading viral cause of cold-like symptoms in children, after rhinoviruses. Researchers have long believed that genetic predisposition, the immune system, & environmental triggers interact to cause T1.This new analysis combined results from molecular enterovirus-diabetes studies, & the findings were clear, says lead researcher. The next step is identifying the specific enterovirus or viruses associated with T1, with the goal of developing a vaccine to prevent it. “There are more than 100 strains of enteroviruses, but probably only a handful are associated with T1,” she says. Very early exposure to cow’s milk & early exposure to gluten have also been linked to T1. 13.%% M Use of twice-daily exenatide in basal insulin-treated pts with T2: randomized, controlled trial. Insulin replacement in DM often requires prandial intervention [meal time insulin] to reach HbA(1c) targets. Objective: To test whether twice-daily exenatide injections reduce HbA(1c) levels more than placebo in pts on glargine. 59 centers in 5 countries Conclusion: Adding twice- daily exenatide injections improved glycemic control without increased hypoglycemia or weight gain in [these subjects] Adverse events of exenatide included nausea, diarrhea, vomiting, headache & constipation. Primary Funding Source: Alliance of Eli Lilly Co & Amylin Pharm. 14.%% MedWatch - FDA Safety Info & Adverse Event Reporting Prog Avandia (Rosiglitazone):[updated 2/04/11] FDA notified healthcare professionals & patients that information on the cardiovascular risks (including heart attack) of rosiglitazone has been added to the physician labeling & pt Medication Guide. Rosiglitazone is sold as under the brand name Avandia & as a combination product - brand name Avandamet the drug labels have also been revised to state that rosiglitazone should only be used: In pts already being treated with these medicines In pts whose blood sugar cannot be controlled with other anti-DMc medicines & who, after consulting with their healthcare professional, do not wish to use pioglitazone-(Actos).. 15.%% Nat Med 17 2011 NLRP3 inflammasome instigates obesity- induced inflammation & insulin resistance. The emergence of chronic inflammation during obesity in the absence of overt infection or well- defined autoimmune processes is a puzzling phenomenon. The Nod-like receptor (NLR) family of innate immune cell sensors, inflammasome are implicated in recognizing certain .. 'danger signals' leading to.. subsequent interleukin-1ß and IL-18 secretion. We show that calorie restriction & exercise-mediated weight loss in obese individuals with T2 is associated with a reduction in [fat] tissue expression of Nlrp3 as well as with decreased inflammation & improved insulin sensitivity... Collectively, these data establish that the Nlrp3 inflammasome senses obesity-associated danger signals & contributes to obesity-induced inflammation and insulin resistance. 16.%% Nat Med 17 2011 Hyperglycemia-induced cerebral hematoma [brain bleeding] expansion is mediated by plasma kallikrein..Hyper- glycemia is associated with poor clinical outcomes after intra-cerebral hemorrhage. We show that [this process] ..is greater in DM rats & mice compared to nondiabetic controls & that this expansion is ameliorated by plasma kallikrein (PK) inhibition or deficiency.. These findings suggest that hyperglycemia [allows] cerebral hematoma expansion by PK-mediated osmotic-sensitive inhibition of [clotting] .. 17.%% M Caffeine May Ward Off T2DM in Postmenopausal Women 2/4/11 Increases in caffeinated coffee consumption are associated with lower T2 risk among postmenopausal women, and sex hormone –binding globulin (SHBG) may be responsible for the relationship. Coffee may raise glucose tolerance by activating energy metabolism & boosting insulin sensitivity & ß-cell function. [10yr fup; 359 pts T2; 359 controls] " Our results suggest that SHBG levels may account for the potential protective effect of habitual coffee consumption against T2 risk among postmenopausal women. A better understanding of the underlying mechanisms requires further investigation... " NIH & Burroughs Wellcome Fund support. 18.%% MTD The Root Cause Of Blood Vessel Damage In Diabetes Discovered 1/31/11 Blood vessel problems are a common DM complication. Many of the nearly 26 mil Americans with DM face the prospect of amputations, heart attack, stroke & vision loss because of damaged vessels. .studies in mice show that the damage appears to involve 2 enzymes, fatty acid synthase (FAS) & nitric oxide synthase (NOS), that interact in the cells that line blood vessel walls. " We already knew that in DM there's a defect in the endothelial cells that line the blood vessels, " says first author " People with DM also have depressed levels of fatty acid synthase - The team studied mice that had been genetically engineered to make FAS in all of their tissues except the cells that line blood vessels. " .. there are strong parallels between the absence of FAS & the deficiencies in FAS induced by lack of insulin & insulin resistance, " [these].mice could not make the substance that anchors nitric oxide synthase to the endothelial cells in blood vessels - their blood vessels were leaky & when a vessel was injured, they were unable to generate new blood vessel growth. They were also more susceptible to.. infection. “Our findings strongly suggest that if we can use a drug or another enzyme to promote FAS activity, specifically in blood vessels, it might be helpful to pts with DM, " .it shouldn't matter whether a person has T1 or T2: both are associated with defects in FAS. " support by NIH AM Heart Ass & ADA 19.%% Effects of Insulin on Brain Glucose Metabolism in Impaired Glucose Tolerance 2/3/11; Diabetes. 2011;60(2) We studied effects of insulin on brain glucose metabolism & cerebral blood flow in 13 pts ts with impaired glucose tolerance & 9 healthy subjects using positron emission tomography (PET)... These results suggest that insulin regulation of brain glucose metabolism is disturbed in metabolic syndrome. 20.%% MTD Evolution Led To Genetic Variation That May Affect DM , 2/8/11 The root causes of complex diseases such as T2DM & obesity have been difficult to identify because the diseases are complex. They occur at the dicey biological intersection of genes & environment, & because they arose in our relatively recent past, it's not easy to simply compare DNA sequences from " then " & " now " to pinpoint likely genetic culprits. Now Stanford researchers have identified genetic variations in a hormone involved in the secretion of insulin - a molecule that regulates blood sugar levels - that occur more frequently in some human populations than others. People with the " new " variants, which are thought to have first occurred 2,000 to 12,000 years ago, have higher fasting levels of blood glucose than those with the more traditional, or ancestral, form of the gene. High blood glucose levels are associated with the development of DM, which occurs when the body is unable to produce or respond properly to insulin. The finding may help scientists better understand subtle changes in human metabolism, or " energy balance regulation, " that occurred as our species shifted from being primarily hunter- gatherers to a more agriculturally based society. It may also help clinicians identify individuals likely to develop DM, and direct the development of new therapies for DM & obesity. 21.%% ADA Omega-3 May Keep Blindness at Bay 2/11/11 Omega-3 fatty acids may help prevent the eye disease retinopathy, which can lead to blindness in some individuals, such as those with diabetes. More than 50% of people who have DM for 25 years will develop retinopathy. Previous research has indicated that eye diseases may be slower to develop in people who eat a lot of fish. And now new research [Harvard] suggests that an enzyme called 5-lipoxygenase, or 5-LOX, may convert omega-3 into an acid called 4-HDHA, which slows abnormal blood vessel growth. The team is working with the NEI to conduct a trial of omega-3 supplements in patients with advanced macular degeneration. 22.%% ADA Trial Will Test Whether Surgery Is the Best Option for T2DM 2/11/11 Scientists in NY will be among the first to test bariatric surgery specifically for treatment of T2, seeking to determine how well surgery can control DM compared to currently approved treat- ments. The study is the first of its kind to include patients who are only overweight or mildly obese. Previous research has indicated that gastric bypass surgery in severely obese individuals can improve or normalize blood glucose levels, reduce the need for medication, & lower the risk of DM-related death. The new study will include 50 pts with T2 who will be randomized to receive either Roux-en-Y Gastric Bypass or traditional medical Rx & lifestyle modification. All pts will receive counseling on lifestyle modification techniques such as diet & physical activity. The researchers hope the study results will help establish better criteria for selecting surgical candidates rather than BMI alone. 23.%% UCSB Chemists Make Discovery that May Lead to Drug Treatment Possibilities for Alzheimer's, Diabetes, and other Diseases 2/10/11 scientists have made a discovery that has the potential for use in the early diagnosis and eventual treatment of plaque- related diseases such as Alzheimer's disease & T2 The amyloid diseases are characterized by plaque that aggregates into toxic agents that interact with cellular machinery, explained the lead author Amyloid plaques are protein fibrils that, in the case of Alzheimer's disease, develop prior to the appearance of symptoms. He says that his research provides the first examples of the conversion of randomly assembled small peptides into ordered sheets that comprise fibrils. He describes how understanding the fundamental forces that relate..shape, and biochemistry of peptide aggregates is central to developing diagnostic & therapeutic strategies for amyloid diseases. 24.%% M New Insulin Degludec Reduces Hypoglycemia (Reuters Health) Feb 03 - In T1DM insulin degludec, an ultra-long-acting basal insulin, controlled blood sugar levels as well as insulin glargine but with less hypoglycemia - confirmatory results from two phase III trials have set the stage for a launch of degludec & DegludecPlus in 2013. The ultra-long effect of degludec results from the slow release of insulin monomers that form after subcutaneous injection which produces a long half-life & a smooth, stable pharmacokinetic profile at steady state. [178 pts] 25.%% Nonalcoholic Fatty Liver Disease (NAFLD Increases Risk of Death among Patients With Diabetes:2/6/11 [337 pts] (NAFLD) is a common diagnosis - In the US 1 in 3 adults suffer from [it]. Similarly, the prevalence of DM has reached proportions observed never before, with 8% of people in the US affected with it. Concomitant DM in pts with NAFLD is associated with more severe inflammation and fibrosis & increases the risk for liver-related death and overall death. 26.%% JH The Calcium Connection 2/17/11 More than 20 years ago, the Framingham Heart & Eye Study uncovered an association between diabetic retinopathy [DR] & cardiovascular diseases, such as coronary heart disease & stroke.. some studies also found that as DR worsens, risk of CVD mounts. Researchers recently reported a strong assoc between DR & the amount of calcium [CA] in the coronary arteries. CA levels are a reliable marker for atherosclerosis, which can lead to stroke, heart attack & yes, eye problems. Atherosclerosis is the hardening & narrowing of arteries from plaque, a buildup on blood vessel walls of cholesterol, CA & other substances. [204 pts with T2] those with proliferative DR (the dangerous growth of new blood vessels on the back of the vitreous humor) were 6 times more likely to have coronary artery calcium (CAC) levels over 400 -- a score that places them at risk for heart disease -- than people who didn't have the condition. The median CAC score among those with proliferative DR was 981. When the team accounted for other risk factors for heart disease,( age, smoking etc) the assoc persisted. This suggests that increased CAC levels are an independent risk factor for DR & that both may be caused by the same underlying pathology. Pathologies implicated in the development of DR include damage to cells by free radicals, accumulation of sugars, bonding of sugar with protein molecules & increased levels of certain growth factors -- all of which have been associated with the development of atherosclerosis. 27.%% MTD Study Identifies Blood Glucose Levels That Predict 10yr Risk Of Retinopathy 2/14/11 people who have higher blood glucose levels & poorer control of those levels over time appear more likely to develop eye-related complications 10 yrs later, .. " It is now well established that the non-DMc population also has retinopathy, albeit at a lower frequency than pts with DM & in a milder form, indicating that there may be factors other than fasting plasma glucose levels that increase the risk. [700 pts] Compared with those without retinopathy, those with the condition had higher average levels of fasting plasma glucose 10 yrs prior & higher HbA1c (6.4 vs. 5.7%). " We propose that thresholds of 108 mg/dl for fasting plasma glucose concentration & 6.0 % for HbA1c level could be used to define those who are at risk of retinopathy;..Factors other than glucose measures play only a minor role in retinopathy, " they conclude. 28.%% MTD Study Reveals How Omega 3's Work In Preventing Several Forms Of Blindness 2/10/11 Omega-3 fatty acids [O3A]- fats commonly found in fish oil - were shown several years ago to prevent retinopathy, in a mouse model of the disease. A follow-up study, reveals exactly how O3A's provide protection & also suggest that they may be beneficial in DM. Retinopathy - an eye disease caused by the proliferation of tortuous, leaky blood vessels in the retina occurs in DM, in the " wet " form of AMD & other eye conditions. The ability to prevent these " neovascular " eye diseases with O3A could provide tremendous cost savings " The cost of OA3 supplementation is about $10 a month, vs up to $4,000 a month for anti-VEGF therapy, " referring to drugs such as Lucentis used in AMD & DM retinopathy. O3A highly concentrated in the retina, are often lacking in Western diets, which tend to be higher in omega-6 fatty acids. In the previous study, mice fed diets rich in O3A had nearly 50% less pathologic vessel growth in the retina than mice fed omega-6-rich diets & that the O3A diet decreased inflammatory messaging in the eye. In the new study, they document another protective mechanism: a direct effect on blood vessel growth (angiogenesis) that selectively promotes the growth of healthy blood vessels & inhibits the growth of abnormal vessels...In addition, the team isolated the specific compound from O3A that has these beneficial effects in mice & the enzyme that produces it ( 5-LOX). Finally, they showed that 5-LOX acts by activating the the same receptor targeted by " glitazone " drugs such as Avandia, Since these drugs also increase the risk for heart disease, boosting O3A intake through diet or supplements might be a safer way to improve insulin sensitivity in patients with DM. " There needs to be a good clinical study in diabetes, " 29.%% M Hypertriglyceridemia Tied to Amputations in Diabetics (Reuters Health) Feb 16 - Triglyceride levels are associated with the risk of lower-extremity amputation. [28,000 pts] Triglycerides at a level of 150-199 mg/dL carried a hazard ratio of 1.10 compared to that below 150 mg/dL. .beyond 500 mg/dL, it rose to 1.65. " This previously unrecognized clinical risk needs to be further investigated to determine if treatment of triglycerides can reduce amputation risk, " the researchers conclude. 28.%% Medline Abstract Repeated episodes of hypoglycemia [H] as a potential aggravating factor for preclinical atherosclerosis in subjects with T1 [25 pts T1 +repeated H] Conclusions: In addition to the induction of H unawareness & an increased risk for severe hypo- glycemia, repeated H could be related to.. preclinical atherosclerosis in T1. The precise mechanisms explaining this association remain to be clarified. 29.%% Medine Retinal and gingival [gums] hemorrhaging & chronic hyperglycemia. Conclusions: Gingival hemorrhaging reflected on retinal hemorrhaging, & both shared chronic hyperglycemia as an explanatory marker. These findings support the hypothesis that retinopathies are reflective of systemic microvascular injury. 30.%% M Does Renin-angiotensin System Blockade have a Role in Preventing Diabetic Retinopathy? [DR] 2/13/11; The recent DIRECT program assessed use of the angiotensin receptor blocker (ARB) candesartan in T1 & T2... at present the evidence does not justify routine use of an RAS blocker in a metabolically well-controlled normotensive, normo-albuminuric patient with T1...Conclusion - Microvascular complications remain important causes of morbidity.. There is an unmet need in retinopathy prevention & the new data on RAS blockade are encouraging. It is not yet clear whether RAS blockade has direct effects on the eye or whether the effect on retinopathy is largely explained by BP lowering, but this is of little consequence for clinical practice. BP targets in DM are getting lower & the [new] data add weight to existing evidence to consider use of an RAS blocker as antihypertensive agent in pts with DM. 31.%% Nat R Endo 7, (March 2011) | Prevention of T1DM: feeding the ultimate goal Rabina Kochar & Kevan C. Herold Abstract Treatment of (T1DM) has focused on maintenance of normoglycemia through insulin therapy, diet and exercise. Additional efforts have involved immune interventions, introduced at diagnosis to limit or prevent the autoimmune attack on the pancreatic islets. To read this article in full .. US$18 © 2011 Nature Publishing Group, 32.%% Nat Rev Immunology 11, (Feb 2011) Immunometabolism: an emerging frontier Diane Mathis & E. Shoelson Abstract - Immunometabolism is an emerging field of investigation at the interface between the distinct disciplines of immunology and metabolism. Accelerating interest in this area is being fuelled by the obesity epidemic & the relatively recent realization that obesity affects the immune system and promotes inflammation, and that obesity- induced inflammation potentially promotes a variety of chronic conditions and diseases. The multilevel interactions between the metabolic and immune systems suggest pathogenic mechanisms that may underlie many of the downstream complications of obesity and offer substantial therapeutic promise. [example of this area of research : Abstract The inflammasome-mediated caspase-1 activation controls adipocyte [fat cells] differentiation & insulin sensitivity Stienstra, R.et al. Cell Metab. 12, (2010)] 34.%% N Rev Immunology 11, (Feb 2011) T2DM as an inflammatory disease Abstract - Components of the immune system are altered in obesity & T2, with the most apparent changes occurring in adipose tissue, liver, pancreatic islets, vasculature & circulating leukocytes. These immunological changes include altered levels of specific cytokines & chemokines, changes in the various leukocyte [blood cells that digest bacteria..] populations & increased apoptosis & tissue fibrosis. Together, these changes suggest that inflammation participates in the pathogenesis of T2. Preliminary results from clinical trials with salicylates & interleukin-1 antagonists support this notion & have opened the door for immunomodulatory strategies for the treatment of T2 that simultaneously lower blood glucose levels & potentially reduce the severity and prevalence of the associated complications of this disease. 35.%% M Glycosylated Hemoglobin Associated With Diabetes Risk 2/23/11 — A glycosylated hemoglobin (HbA1c) level equal to or more than 5.0% is associated with a progressively & increased risk for DM with greatest risk for those with an HbA1c level of 6.0% to 6.4%, according to the findings of an historical cohort study. Levels of HbA1c were also found to be an independent risk factor for T2, by a second study. [12000 nonDM pts; base-line HbA1c 6.5% ;med record data;8yr fup] incidence of diabetes progressively & significantly increased among pts with an HbA1c level above or equal to 5.0% & a significantly increased risk was evident for those with an HbA 1c of 6.0% to 6.4% (P = .0001). The team developed a risk calculator to estimate the 5-year risk for DM based on these and other clinical data. " The findings of the [2nd] study [919 subjects].. clearly document that subjects with high- normal HbA1c have a strong risk of developing T2..” the team concluded. 36.%% M Feb 25, 2011 Breastfeeding by Diabetic Moms Cuts Babies’ Obesity Risk - Also Benefits Moms by Helping Them Recover From Gestational Diabetes [GD] Breastfeeding for 6months or more may reduce the risk that babies born to DM mothers become obese later in life, a new study shows. Other experts hailed the study, as well- designed and important. “They thought they might see a big difference between babies whose mothers did not have DM & those babies whose mothers did in terms of obesity protection down the road, depending on how much breast milk they got,” said one expert not involved in the study. “And if they got more than 6 months of breast milk, they didn’t.. that’s a good thing, because it shows that you can sort of wipe out that negative potential effect on the baby, if you breastfeed long enough.” & experts say the metabolic benefits of breastfeeding extend to mom, too, helping her recover from GD & protecting her against developing DM again later in life. In the womb, babies of mothers who have diabetes are exposed to more glucose & free fatty acids than babies whose mothers don’t have DM “So these fetuses are overnourished, even before the babies are born, so that makes them more heavy at birth, but also they have a higher percent of fat mass.. why do these effects persist over the life course? one of the proposed mechanisms is that.. this hypernutrition changes their satiety point so they only feel full when they’re overfed. . they tend to eat increased amounts of food throughout their life because their satiety point has been altered, permanently,” the study leader said.. Abbreviations: fup-follow up; pt - patients; DM - diabetes Mellitus; T1DM - type 1 diabetes mellitus T2DM - type 2; DME - diabetic macular edema;DR - diabetic retinopathy; alleles -one of 2 or more alternate forms of a gene; FPG - fasting plasma glucose; BP - blood pressure; CVD - cardiovascular disease; MI -myocardial infarction/ heart attack ; OCT - optical coherence tomography; BCVA - best corrected visual acuity ;ADA - Am Diab Ass & ADA Professional; JH- s Hopkins Alerts ; M- Medscape Web MD; NEI - Nat Eye Institute ; MTD- Medical News Today; Definitions via online Medical dictionaries. Disclaimer, I am a BSN RN but not a diabetic or diabetic educator. Reports are excerpted unless otherwise noted. [translations, explanations by thl] This project is done as a courtesy to the blind/visually impaired and diabetic communities. Dawn Wilcox RN BSN Coordinator The Health Library at Vista Center; an affiliate of the Stanford Hospital Health Library. contact above e-mail or thl@... 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