Many articles

[Guest guest]

1.%% M (Reuters) 5/24/11 Declining Coronary Heart Disease (CHD) Risk Among

Diabetics The estimated 10-year risk for CHD among adults with DM has

declined significantly in the past decade, using the Framingham Heart

Study(from 18.6% to14.6%) [1,977 pts;10yr] author saw declining trends in

hemoglobin (Hb)A1c, mean systolic BP, total cholesterol & ratio of total to

HDL cholesterol. " Because lifestyle behaviors profoundly influence many of

the risk factors for CV disease, physicians who are successful in assisting

pts to improve their key lifestyle behaviors - smoking, diet, physical

activity - will make important contributions to the CV health of their pts. "

2.%% ADA 6/27/11 Diabetes Patients Are Twice as Likely to Suffer Hearing

Loss Analysis of 11 studies showed Diabetics were twice as likely as those

without the illness to lose their hearing [this] should prompt doctors to

screen DM pts for the condition as routinely as they screen for eye & kidney

problems. It’s unknown why hearing loss is more common among diabetics,

though some researchers believe that nerve or blood vessel damage may be the

cause..

3.%% ADA 5/31/11 Lipid Genes Signal Diabetes, Heart Disease Genes that

control lipid levels may be an early predictor of DM as well as

atherosclerosis & heart disease.. In one study, the lipid component

dihydroceramide appeared to be a DM risk factor independent of glucose &

insulin levels. In another, a risk score pooling small effects of common

genetic variants predicted carotid plaque & arterial wall thickness as well

as CHD. [10,212 pts] studies were published as an abstract & presented at a

conference - data & conclusions should be considered to be preliminary until

pub in a peer- reviewed journal.

4.%% Oph 118,6 June 2011 A Phase 2/3, Multicenter, Randomized,

Double-Masked, 2-Yr Trial of Pegaptanib Sodium [macugen] for the Treatment

of Diabetic Macular Edema [DME] [abt 260 pts]Conclusions - Patients with DME

derive benefit from Rx with the selective vascular endothelial growth factor

antagonist pegaptanib. study data, support a positive safety profile in this

population.

5.%% M 5/31/11-- Although many older diabetics have good bone density

scores, they are as prone to fractures [FX] as people with osteoporosis.

" People with T2 have a strange combination, " said the team leader. " They

have a higher FX risk & a higher bone density.” They looked at 2 tests of

bone strength: bone mineral density-T score & the World Health

Organization's FRAX score. " A T score of minus 2.5 or lower is generally

considered osteoporotic -at high risk of FX, But if you have someone with T2

who has a T score of minus 2, they have about the same FX risk as a non-

diabetic with a T score of minus 2.5, " [9,449 women; 7,436 men]

6.%% JH 6/2/11 Diabetic Hepatopathy - The effects of DM on kidneys, eyes,

heart & nerves are well known, but adults with T2 may need to be concerned

about the liver as well. Advanced liver disease - DM hepatopathy with

cirrhosis, liver failure or the need for a liver transplant-- is the reason.

[400000 pts;6yr fup] After adjusting for [includes] age, income, urban

residence, & pre-existing conditions, the DM group was 77% more likely to

have serious liver disease..it is unclear whether this is due to direct

injury to the liver from elevated glucose levels or to nonalcoholic fatty

liver disease.

7.%% moved to #12

8.%% ADA 5/30/11 .. stem cell implant envelope - T1 Rx. ViaCyte Inc.

proposes to slip an envelope filled with pancreatic cells under the skin.

These cells would turn into beta islet cells [which produce insulin]. The

company has cured DM in hundreds of mice & hopes to begin human trials of

its implants - made from embryonic stem cells, by 2013. T1 is a particularly

appealing target for stem cell Rx since only one cell type needs to be

replaced. The issue is trickier for T2 but this Rx may have potential for T2

pts who use extra insulin to control their blood sugar.

9.%% ADA Vit D levels, microvascular complications & mortality in T1 .. [227

pts] followed from onset of DM. Plasma vitD [25(OH)D3] levels were tested

before pts developed microalbuminuria. Conclusions - In pts with T1, severe

vit D deficiency independently predicts all- cause mortality but not

development of microvascular complications in the eye & kidney. Whether vit

D substitution in T1 patients can improve the prognosis remains to be

investigated. Diab Care 2011;34(5)

10.%% MTD 6/1/11 Eye Examination May Provide Clues To Diabetic Nerve Damage

(DPN). Affecting about half of DM pts, DPN causes symptoms such as numbness,

tingling, or pain in the arms & legs. Using " high-tech " techniques such as

corneal confocal microscopy, the team found DPN is linked to degradation of

corneal nerves, thinning of retinal nerve fibers, & peripheral visual field

loss. They hope to combine these 4 factors into a simple eye scan that can

detect DM nerve damage in its early stages.

11.%% MP 6/6/11 Omega-3 fats linked to lower DM risk ..the study looked at

people's actual blood levels of omega-3 fatty acids & their later risk of

T2. That type of study generally offers stronger evidence than those which

ask people about their eating habits. [3,088 pts] of the one- quarter of pts

with the highest level 5% developed DM vs 6.5% of the one-quarter with

lowest level. The team cautions that their findings do not prove that

omega-3 fats, themselves, fight DM. The fats may be markers for some other

aspect of the pt’s diet or lifestyle . They advise that people focus on

getting plenty of healthy " whole foods " - ie fruits, vegetables, fiber- rich

grains, legumes, veg oils & fish -- instead of any single nutrient.

12.%% [3 reports re Dapagliflozin] Nat Med June 2011 New DM drugs go beyond

insulin to flush out excess sugar. All existing DM drugs lower BS by

modulating the activity of insulin. These drugs are quite effective in the

short term, but tend to lose their potency over time. Drug companies have

been racing to develop new meds that act on a pathway that doesn't involve

insulin. Dapagliflozin could be the first such agent to gain market

approval. [it] reduces blood glucose levels by preventing a protein called

sodium- dependent glucose cotrans-porter 2 (SGLT2) from reabsorbing glucose

in the kidney. As such, the sugar gets excreted through the urine instead of

reentering the blood stream & raising BS.. [# 7] ADA 6/1/11 Dapagliflozin

[dap] improves glycemic control in pts with T2 “Dap. significantly reduced

HbA1c in all studies,” team wrote. . & was well tolerated among

treatment-naïve pts with T2 & those unresponsive to prior Rx with

glimepiride or metformin. [ 3 randomized clinical trials;1500pts] “There

were symptoms suggestive of genital infection in all dap.. groups in all 3

studies & urinary tract infections in one [#45] ADA 6/25/11 ..dapagli-

flozin was effective but In all studies so far completed [5,478pts] 1.4% of

pts treated with dap developed some type of cancer, vs 1.3 % of control

group FDA is set to review the application on July 19.

13.%% ADA 6/8/11 DNA-based diets could prevent obesity, illness

... within a few years, a simple cheek swab could allow health experts to

create individualized diet plans for people based on their DNA.

Nutrigenomics, a new field that studies how food affects the way genes

function, holds promise for curbing diseases such as DM, cancer & heart

disease. Author said " Certain foods can impact how our genes work & are

expressed... They can be " turned up or down " through diet & lifestyle

choices. Nutrigenomics would allow people to know specifically which fruits

or vegetables would benefit them the most. .. team found that women who ate

high amounts of cruciferous veg (broccoli, cauliflower,..) & who had a

certain genetic profile were 50% less likely than other women to develop

breast cancer. These vegetables contain chemicals, which may help kill

cancer cells..He said it will be at least 5yrs before DNA-based diet plans

will be available to the public.

14.%% MP 6/6/11 Exercise Helps Men Battling DM & Sleep Apnea -- Men who have

T2 in addition to obstructive sleep apnea [OSA] seem to benefit from regular

EX. [567 men] fitness levels were based on the number of peak metabolic

equivalents (METs) they achieved during a stress test. After taking other

risk factors into account, such as race, smoking & medication use, the risk

of death among the men was 13% lower for every 1-MET increase in fitness

level. Men in the low-fitness category had a 75% higher risk of death than

those considered high fitness.. conclusions should be viewed as preliminary

until published in a peer-reviewed journal.

15.%% M 6/23/11 Sleepiness, Not Sleep Apnea, Linked to Poor Glycemic Control

The interaction of sleep disturbance & glycemic control just got more

complex, data presented at SLEEP 2011 showed no association between glycemic

control & " the usual metrics of sleep- disordered breathing, " in T2 & OSA

[531 pts] However, pts who had a higher level of sleepiness on the ESS scale

had a higher HbA1c level compared with those who had a lower level, after

controlling for factors such as age, race, & waist. " ..if we could just ask

about sleepiness in DM pts we may be able to identify those with poor

glycemic control. " ..

16.%% M 6/2/11 Anti-inflammatory Therapy for Diabetic Retinopathy

DR has many features of inflammation, such as increases in inflam.

molecules, leukocyte recruitment & activation of local immune cells.

Inflammation plays a critical role in the development of DR by causing

vessel leakage & closure, pathological neovascularization [growth of

abnormal new cells] & nerve death. DM induces inflam reactions by many

mechanisms [includes] oxidative stress, high BP dyslipidemia & impaired

anti-inflammatory pathways. Better under-standing of anti- inflammatory

mechanisms may lead to better therapies in the future.

17.%% M 5/31/11 Diabetes May Shorten Working Life Complications such as

vision loss & nerve damage can make it difficult or impossible for people to

do their jobs. The French study found that obesity seemed to explain much of

the higher risk of work disability among people with DM. [506 pts;18yrfup]

By age 55, 52% of workers with DM were still on the job, vs 66% of those

without DM. by age 60, about 5% of diabetics were on disability, compared to

roughly 1% of non-diabetics. Author noted that France has a ..young

retirement age & a universal healthcare system. The impact of DM on

retirement & disability could be greater in the US where people typically

work longer & lack universal healthcare.

18.%% ADA 6/6/11 Hypoglycemic events can disrupt work productivity for

diabetics. A new survey which polled T1 & T2 pts found that about 1-in-5

respondents regularly are unable to do a full day of work due to disruption

caused by episodes of dangerously low blood sugar -hypoglycemia. [1404 pts]

Hypoglycemic symptoms often include pounding heart, trembling, hunger,

sweating, difficulty concentrating or confusion. Diabetics who are treated

with insulin can experience 1 to 3 events per month.

19.%% M 6/7/11 DM-Related Amputations Benefit From Combined Imaging

Dual-isotope single-photon emission computed tomography (SPECT) & computed

tomography (CT) show high sensitivity in distinguishing between soft tissue

infections & osteomyelitis. They can be used to eliminate unnecessary limb

amputation [227 scans] amputations resulting from DM are associated with a

5-yr mortality rate of 39- 60%, said author. The scan-guided management

resulted in conservative Rx, such as antibiotics & local tissue debridement,

for as many as 72% of 207 pts. " One study, [52,000 pts] found up to 9% of DM

foot infections resulted in major amputation & 23% led to minor amputation.

‘Our results showed rates that were less than half that level. Rx of DM foot

infection usually starts with a plain x-ray which has limited sensitivity &

specificity for early detection of osteomyelitis in diabetic foot,’

20.%% M 6/7/11 T2 Treatment liraglutide- Victoza Also Helps T 1— People with

well-controlled T1 had even better sugar control, used less insulin, & lost

an average of 10 lb in 6 m when taking Victoza in a small clinical study.

[14pts] Adding Victoza to insulin Rx quickly eliminated peaks & dips in

BS..Victoza is a GLP-1 receptor agonist taken by injection once daily.

Byetta, the other FDA-approved GLP-1 agonist, requires twice-daily

injections. [ #34] M 6/13/11 FDA Warns of Serious Risks Associated With

Liraglutide. [it] causes .. thyroid C-cell tumors in rats & mice. It is not

known whether (Victoza) causes [these] tumors in humans.. Also, in clinical

trials there were more cases of pancreatitis in pts treated with liraglutide

than in those given comparable meds. FDA recommends that pts be referred to

an endocrinologist If thyroid nodules are found or if serum calcitonin is

measured & found to be elevated. . signs & symptoms of pancreatitis

(includes persistent severe abdominal pain, sometimes radiating to the back,

which may or may not be accompanied by vomiting).

21.%% Eye (2011) 25, Long-term visual & retinopathy outcomes in a

predominately T2 pt group undergoing early vitrectomy & endolaser for severe

vitreous haemorrhage (VH)[88 eyes (69 T2) Conclusion - T2 pts can have

improvement in visual acuity & stabilisation of their

proliferative retinopathy after early vitrectomy & endolaser for VH .

22.%% M 6/21/11 FDA Issues Draft Guidance for Artificial Pancreas System

[APS] It is hoped The draft guidance will advance the development & approval

of an APS to treat T1 in the US. An APS is an automated, closed-loop system

that combines a continuous glucose monitor, an insulin infusion pump, & a

glucose meter for calibrating the monitor. The devices are designed to work

together, monitoring the body's glucose levels & automatically pumping

appropriate doses of insulin as determined by a computer algorithm. This

draft guidance provides recommendations for those planning to develop &

submit an application for a low-glucose suspend system intended for single-

patient use at home. FDA currently is working on a second draft guidance

that will help manu facturers & researchers develop more autonomous APSs.

23.%% ADA 6/16/11 FDA Says DM Drug Might Raise Cancer Risk -The use of

Takeda Pharm. Co.'s DM drug Actos for more than 1year might increase the

risk of bladder cancer. FDA said the product label would be updated to

include information about the risk of bladder cancer along with a so-called

medication guide that is meant for patients.

24.%% M 6/3/11 Diacerein May Improve Glycemic Control of T2 - In a Mexican

study, 2months of treatment with the anti-inflammatory agent diacerein

improved insulin secretion & A1C levels in T2. Diacerein, which reduces

levels of TNF-alpha & interleukin (IL)-1-beta, is widely used for [arthritic

diseases] although not in the US [40pt;randomized placebo or drug;60days]

" Further studies are needed to test long-term administration as well as to

explore its use in combination with other [drug treatments]. "

25.%% M 6/14/11 Recurrent Stroke Risk Higher in T2 - Pts with T2, but

without frank cardiovascular disease, are at higher risk for recurrent

stroke & CV events than those without DM or metabolic syndrome. However,

statin Rx appears to cut the risk in both groups, the author, Vanderbilt U

said. " This increased risk is attenuated by intensive lipid lowering not

only in diabetics but also those with met syndrome as well as those without

[either condition] [4731 pts] randomly assigned to atorvastatin (Lipitor) or

placebo. study sponsored by Pfizer

26.%% ADA 6/14/11 Diabetes vaccine moves a step closer Scientists

are a step nearer to developing a vaccine for T1, after showing that a nasal

spray can stop the body's immune system from attacking insulin-producing

cells. [52 new T1pts] The spray is not intended as a treatment for people

who already have DM.. The team is testing the nasal spray in young people

with a family history of T1 who have developed antibodies for DM.

27.%% ADA 6/10/11 Scientists have developed a promising new strategy for

treating T2- blocking the breakdown of insulin, after it is secreted from

the pancreas. In T2, the body stops responding efficiently to insulin, a

hormone that controls blood sugar. To compensate for the insensitivity to

insulin, many DM drugs work by boosting insulin levels -injecting more

insulin or by increasing the amount of insulin secreted from the pancreas.

" Insulin levels in the blood reflect the balance between how much is

secreted & how fast it is broken down, " team leader M. Leissring, Mayo

Clinic said. The team studied mice in which insulin-degrading enzyme (IDE)

was " knocked out, " or deleted genetically. The findings suggest that drugs

that inhibit IDE could be useful in treating DM.

28.%% A question from Santa re talking glucometers..’ In your research

have you come across a system that provides both the talking meter & some

way of handling that little drop?’ [of blood] Response: Raskin, M.A.

Sup of Rehab..Services Vista Center for the Blind & Visually Impaired - ‘for

many of our clients this is the greatest challenge. This is especially true

for those with neuropathy of the fingers, issues with muscle coordination,

or problems getting enough blood. We can increase our chances of success by

getting a generous blood sample. We teach our clients to warm their hands &

arms with a heating pad or in warm water for 5 min prior to the finger

stick. We also encourage our clients to shake the blood toward the fingers

as though they were shaking the mercury down in an old- fashioned fever

thermometer. We use the deepest setting on their automatic lancet & ask them

to firmly hold their lancet against the finger before pushing the trigger. I

encourage our clients to use their thumb on the hand being lanced to help

mark the location on the finger where the finger was pricked. By holding the

thumb near the location of the blood drop, it is easier to match the blood

with the end of the strip. Sharon Hudson, Associate Dir. Vista Center, has

been having clients place small rubber bands on the fingertips to help guide

the strip to the spot of blood. It is important to teach clients to place

the end of the strip well in front of the blood drop & then move the strip

toward the blood drop until it captures the blood. It is typical for a

client to try to place the strip on top of the blood drop. This is more

likely to smear the blood & render it useless. Some clients find it easier

to hold the strip stationary & move the blood drop on the finger toward the

strip, rather than the other way around. By holding the meter firmly at the

edge of a table, positioned either horizontally or vertically, some clients

find it easier to move their finger along the strip until the blood sample

is captured. It is easier to use a firm strip, rather than a strip that

easily bends.

29.%% NIH News New Videos, Website Offer Important Resources for People

Affected by DM. NIH & CDC DM education program (NDEP) offers resources to

support lifestyle change. 3-5-min videos, which can be found at

www.YourDiabetesInfo.org/HealthSense address topics such as setting goals to

improve health, living with T2, finding support, as well as segments on T2

prevention & physical activity. Resources included in Diabetes HealthSense

have been reviewed by a team of leading independent experts on psychosocial

issues with specific expertise in the science of behavior change. visitors

can choose what they'd like help with, such as how to cope with stress, etc

They can also utilize tracking tools for calories or physical activity, or

online programs to help them manage their weight or stop smoking.

30.%% ADA 6/21/111 potential genetic link behind higher rates of T2 among

African Americans [Afr-Amer] A team (Wake Forest U & s Hopkins U) report

that Afr-Amer more efficiently convert omega-6 polyunsaturated acids (PUFA)

into long-chain PUFAs. long-chain PUFAs which are often then converted into

inflammatory messengers. Higher levels of these substances have been

observed to be associated with more inflammation which often leads to

insulin resistance & T2. Still, the findings do not mean that all Afr-Amer

are doomed to develop T2. If a person excludes omega-6 PUFAs from their

diet, the inflam process will never get started.., the team leader pointed

out that these fats now make up about 8% of the av person’s daily caloric

intake. However, several decades ago, they only accounted for about 2%. As

red meat & processed foods became more available, intake of these unhealthy

fats increased at alarming rates.. Understanding which nutrients may be

healthy for one population, but not for another will be essential to

optimizing public health. AfrAmers develop T2 about 1.5 times the rate of

Caucs, according to ADA.

31.%% M 6/14/11 Death, Diabetes, CV Disease Risk From Prolonged TV Watching

Confirmation that sitting in front of television for prolonged lengths of

time has long-term adverse effects has come from a new review of studies

showing a direct relation between the amount of TV viewing and risk of T2,

cardiovascular disease, & all-cause mortality. The review, showed that for

every 2hrs of TV watched daily, the risk of DM increased by 20%, the risk of

CVD increased by 15%, & the risk of all-cause mortality increased by 13%.

Coauthor Dr. Hu (Harvard) said: " TV watching is worse than other

sedentary activities in that it is particularly passive. It has a lower

energy expenditure compared with driving, reading, working at a computer,

etc. People tend to eat when they are watching TV, & they also tend to eat

junk food and sugary beverages rather than healthier food. This might be

related to the large amount of commercials for junk food, which increase the

appetite, or it may just be due to boredom...the paper reports that TV

watching is the most commonly reported daily activity apart from working &

sleeping in many populations around the world, occupying an average of 40%

to 50% of free time. Grøntved A & Hu F B. Television viewing and risk of

type 2 diabetes, cardiovascular disease, & all-cause mortality. A

meta-analysis. JAMA 2011; 305:.

32.%% ADA 6/16/11 Teen depression linked to poor glycaemic control

the team found teens who started off with good blood- glucose monitoring

were resistant to the effect of depression on glucose control. [145 pts] On

average, HbA1c would change half a percentage point if an adolescent’s

depression increased by 5points on the Children’s Depression Inventory.

HbA1c levels changed more for children who started off with worse

blood-glucose monitoring. “This suggests that targeting sustained adherence

to [blood-glucose monitoring] would be the primary tool to prevent worsening

glycaemic control for those already achieving optimal glycaemic control,

followed closely by maintaining a low level of depressive symptoms,” the

authors wrote.

33.%% ADA 6/16/11– Low-normal serum folate - between 2- 7ng/mL,

is associated with an increased risk of depression in DM pts which suggests

that, as with other depressed patients, folate supplement- ation might boost

responses to antidepressants. [58pts] Although folate levels have been

previously correlated with depression, the study seems to be the first to

find the connection in people with DM. .

34.%% moved

35.%% ADA 6/20/11 Non-invasive retinal measures may serve as risk markers

for DM retinopathy [DR] in young people with T1, .arteriolar length/diameter

ratio (LDRa) & tortuosity. Both ndependently predicted which pts developed

DR at about 4 years of follow-up [700pts]..After adjusting for [includes]

HbA1c, BP, total chol. & BMI, pts with the lowest LDRa had an 80% increased

risk of incident DR compared with those with the highest LDR. A higher

proportion of girls 42.1% developed R than boys 35.8% & lower LDR predicted

incident DR in both sexes.

36.%% ADA 6/20/11 a breakthrough in research on the benefits of cell

energy.. could bring new ways of treating T2. Energy production in cells

involves a crucial enzyme (AMP- activated protein kinase(AMPK) .. since the

activation of AMPK in muscle cells makes them more sensitive to insulin,

drugs that amplify [these] actions could help to improve sensitivity to

insulin & treat T2.

37.%% ADA 6/19/11 Endosphere Gets U.S. Patent on Implantable Devices to

Treat Obesity, T2. EndoSphere develops devices such as the SatiSphere

duodenal insert. [note from DRL April -another such device [ EndoBarrier

Gastroin-testinal Liner is placed in the GI tract (via the mouth) to create

a barrier between food & the wall of the intestine...preventing food from

coming into contact with the intestinal wall may alter the activation of

hormonal signals that originate in the intestine, thus mimicking the effects

of a Roux-en-Y gastric bypass procedure ..]

38.%% M 6/21/11 High-Dose Statin Therapy Increases the Risk of DM A

meta-analysis of some statin trials has revealed a significant 12% increase

in the risk of DM assoc with statin use in high doses vs moderate-dose

therapy Team leader said that while there might be consequences from the

raised blood glucose levels, researchers do not yet know what these long-

term effects mean. However, lowering LDL-cholesterol levels is probably more

important than the increase in BS levels. " Overall, high-dose statins

reduced the risk of CV events in the meta-analysis by 16% compared with low-

or moderate-dose statin Rx.. [5 randomized, controlled trials;32 752 pts] He

suggested that clinicians monitor HbA1c levels when treating patients with

high-dose statin therapy.

39.%%MP Environmental pollutants [EP] & T2: review of mechanisms that can

disrupt beta cell function. The prevalence of DM is currently at epidemic

proportions.. Although genetic predisposition & lifestyle choices are

commonly accepted reasons for the occurrence of T2, it has recently been

suggested that EP are additional risk factors for DM. ..because of the

crucial role of pancreatic beta cells in development & progression of

T2,.studies have shown how these compounds interfere with the insulin

secreting capacity of beta cells. Oestrogenic compounds, organophosphorus

compounds, persistent organic pollutants & heavy metals are discussed.. It

is clear that some EPs affect pancreatic beta cell function..This supports

the need to .. fully explore the DM-inducing potential of pollutants.

s TL ; et al;Diabetologia. 2011; 54(6)

40.%% NatRev Endo 7,July 2011 Anomalous role for dietary salt in DM-

Prevailing guidelines advocate a low-salt diet to decrease progression of

renal & CVD in pts with DM. However, 2 recent cohort studies in pts with T1

& T2 associate LOWER salt intake with increased rates of end- stage renal

disease, CV death & all-cause mortality. The “salt wars” pit those who view

dietary salt as a toxin & favor its restriction as a matter of public policy

vs those who are skeptical that lowering salt intake would improve public

health. [638pts T2; 2807 pts T1-;10yr]

41.%%NatRevEndo 7 July 2011 T2- current therapies & emergence of surgical

options Pts with T2 are usually treated with drugs in combo. with lifestyle

modification. The development of new anti-DM agents, such as insulin analogs

& incretin-based therapies, has led to Rx strategies that enable many pts

with T2 to achieve target HbA1c levels (7.0%). However, many factors - such

as drug inadequacies & adverse effects can interfere with the ability of

some pts to reach metabolic targets. Gastric bypass surgery in morbidly

obese people with T2 leads to remission of the DM in the majority of pts &

improvement in the rest. A major contributor to this improvement is an

alteration in gastrointestinal hormone secretions. Interventional surgery

might, therefore, be considered a reasonable therapeutic alternative for

overweight & obese pts with T2 who do not respond to medical Rx. H.Lebovitz

State U NY hlebovitz1@...

42.%% ADA 6/24/11 Weight loss surgery may cure diabetes in many cases - Most

obese people with DM will be cured of [it] after weight loss surgery, a new

review suggests. [9 studies;82,200pts;1yrfup; gastric bypass or banding] In

gastric bypass, food is diverted around the stomach into a small pouch,

reducing the amount of food a person can eat & hindering its absorption.

Gastric banding slips a ring over the top of the stomach to limit how much a

person eats. Among diabetics who had gastric bypass 83% wound up free of DM

meds vs 62% of those who had the gastric banding procedure. author Dr. R.

Meijer said those outcomes exceed what can be achieved with conventional

methods of therapy. It's unclear how long surgery's impact on DM lasts. One

study found that 10 yrs after surgery, just one third of people whose DM had

abated continued to have good BS control. Surgery does have the potential

for complications that wouldn't occur with drugs, 7% in one study - Most

were minor wound infections, but massive bleeding, kidney failure & other

serious complications occurred in more than 2%; Other side effects include

nausea & some food intolerance. Some pts also gain back weight over time.

43.%% MP 6/26/11 " Lean gene " ups risk of heart disease and diabetes

[75,000 subjects] The team found that a gene called IRS1 is linked with

having less body fat. When they investigated further, they found IRS1 also

leads to having unhealthy levels of cholesterol & blood glucose ..the gene

was only linked to lower levels of fat under the skin, but not to the more

harmful fat that surrounds the organs -visceral fat. Author said " People who

are lean are generally healthier than people who are overweight or obese,

But we all know some people who are lean & also may have high cholesterol or

have a heart attack before age 50 -- so maybe this gene is one factor in

looking healthy but still being at risk for CVD & T2.

44.%% ADA 6/25/11 Cure for Type 1 diabetes? -- Researchers at Mass General

Hospital say it may be possible to reverse T1 with an existing & inexpensive

tuberculosis vaccine - BCG which prevents the body's T cells from destroying

insulin- producing cells, allowing the pancreas to regenerate & start

producing insulin again -Tests in a small number of humans [ number not

stated] have shown promising increases in insulin production & researchers

will present their findings Sunday at a meeting of the ADA in San Diego.

45.%%ADA 6/28 Advances in Treating T1: Drugs Show Promise for Preserving

Body’s Ability to Produce Insulin - Not All Studies Had Positive Effect The

progression of T1 may be slowed in those newly diagnosed, through the use of

promising new medications currently under development,.8 studies of

therapies in various stages of clinical development look at the potential

for preventing the slow loss of insulin production that occurs within the

first several months following the diagnosis of T1. One example: The drug,

DiaPep277, a potential vaccine for T1, was developed with the goal of

preventing beta cell destruction. During the development of type 1 diabetes,

it is believed that an increase in a protein in the beta cell called “heat

shock” protein causes beta cell destruction through activation of

destructive T-cells. Researchers removed 24 of 500 amino acids from the

“heat shock” protein, In this phase two study, the altered “heat shock”

protein administered subcutaneously to 100 pts newly diagnosed with T1–

succeeded in protecting the beta cells, replicating in humans the findings

in laboratory mice. ..

CDC - Centers for Disease Control and Prevention.

Abbreviations: fup-follow up; pt - patients; DM - diabetes Mellitus; T1DM -

type 1 diabetes mellitus T2DM - type 2; DME - diabetic macular edema;DR -

diabetic retinopathy; FPG - fasting plasma glucose;BS - blood sugar or

glucose level; BP - blood pressure; NV- neovascular-ization; CVD -

cardiovascular disease; CHD -coronary heart disease; MI -myocardial

infarction/ heart attack ; OCT - optical coherence tomography; BCVA - best

corrected visual acuity ;ADA - Am Diab Ass & ADA Prof; M- Medscape Web MD;

MP- Medline Abstract, Medline Plus & HealthDay; MTD- Med News Today;NEI -

Nat Eye Institute; 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@...