Daily Health and Medicine News

Diabetes Prevention News

Program striving to avert diabetes

Participants of the local New York State YMCA Diabetes Prevention Program have learned healthier lifestyles and have lowered their chances of becoming diabetic.

The physician-referral-based program reviewed 16 weekly tips — among them healthy eating, being physically active, managing stress and staying motivated — that participants can use to prevent hearing bad news from their doctor. All participants are considered prediabetic, when blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes.

According to the American Diabetes Association, normal fasting blood glucose is below 100 milligrams per deciliter. A person with prediabetes has a fasting blood glucose level from 100 mg/dl to 125 mg/dl. If the blood glucose level rises to 126 mg/dl or above, a person has diabetes.

“You have to make yourself and your health a priority,” said Michelle L. Graham, Watertown Family YMCA wellness director and coordinator of the Diabetes Prevention Program. “You make yourself a priority, and it’ll pay off.”

That was her message earlier this month during the last class in the course, which is held at the agency’s downtown branch, 119 Washington St. The program encourages participants to lose 5 percent to 7 percent of their weight, maintain that level and participate in regular physical activity.

Each participant has agreed to help with research for the national Diabetes Prevention Program. The local program will gather data in an effort to have diabetes prevention reimbursable through insurance, Mrs. Graham said.

“This is the way health care needs to go,” she said.

Patricia A. Davis, Watertown, said that during the last week of the program, she reached her 7 percent weight loss goal. She returns to her physician next week to find out how her blood glucose level has changed. It was 109 mg/dl about 18 weeks ago.

The 73-year-old said she has scaled back her candy consumption and instead satisfies that craving with fruits and vegetables. Exercising at the Y a few days a week also has helped her shed pounds.

Since some family members found out they had Type-2 diabetes when they were in their 70s, Mrs. Davis said, she wanted to be proactive and stop the disease before it became a diagnosis.

“It scares me, because I tried to lose weight on my own,” she said. “I knew that was a part of getting diabetes, being overweight, although I wasn’t extremely overweight.”

Mrs. Davis and many other program participants said that to help decrease glucose levels, they have paid more attention to what kinds of food they’re eating as well as the amount of fat in the food.

With that, Mrs. Graham said, participants walked away with exactly what she wanted them to have: a heightened sense of awareness. Now, the group will meet once a month at the Y for the next 12 months to make sure members are sticking to their diabetes-prevention plans.

Hundreds of Diabetes Advocates Arrive in Washington, DC to Urge Congress to Stop Diabetes®

More than 200 volunteer advocates from the American Diabetes Association will meet with their Members of Congress this week, to urge them to support federal funding for diabetes research and prevention programs at the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC). Federal funding in Fiscal Year (FY) 2012 for diabetes is critical in our nation’s response to this epidemic. The diabetes advocates will also ask their Members of Congress to join the Congressional Diabetes Caucus, which acts to educate Members about diabetes and to support legislation that improves diabetes research, education and treatment.

Advocates are coming to Washington, DC for Call to Congress, the Association’s premier national advocacy effort. This year’s Call to Congress is being held March 9 – March 11, 2011. Attendees will include children and adults with type 1 and type 2 diabetes, family members of individuals with diabetes, researchers and other health care professionals. All are committed to advocacy efforts at the local, state and national levels.

“Call to Congress brings diabetes advocates from across the country together in the movement to Stop Diabetes and provides them with the opportunity to tell our federal government how important it is to fight this deadly epidemic,” said John Griffin, Jr., Chair of the Board, American Diabetes Association. “The Centers for Disease Control and Prevention projects that one in three children born in the year 2000 will develop diabetes in their lifetime unless our country changes its course. Congress must provide the funding and leadership necessary to invest in research and ultimately save lives.”

Specifically, Association advocates will meet with Members on March 10th to urge Congress to provide $2.209 billion in FY 2012 funding for diabetes research through the National Institute of Diabetes and Digestive and Kidney Diseases at NIH. Advocates will also ask Congress to support and prioritize vital diabetes prevention activities at the CDC through the efforts of the agency’s Division of Diabetes Translation in next year’s budget. Additionally, advocates will call on Congress to provide $80 million in funding from the Prevention and Public Health Fund that was included in the health care reform statute to scale up the proven, community-based National Diabetes Prevention Program.

Diabetes is a growing epidemic and is taking a devastating physical, emotional and financial toll on our country. Nearly 26 million Americans are living with diabetes and an additional 79 million are estimated to have prediabetes. The national price tag for diabetes is at an astounding $174 billion per year and that cost is estimated to almost triple in the next 25 years. Factoring in the additional costs of undiagnosed diabetes, prediabetes and gestational diabetes brings the total cost of diabetes to $218 billion.

Wyoming Health Department program supports primary prevention programs aimed at prediabetes

The Wyoming Department of Health’s Diabetes Prevention and Control Program is now supporting primary prevention programs aimed at prediabetes.

Prediabetes is a condition where individuals have elevated blood sugar levels due to insulin resistance, but not high enough to be diagnosed as diabetes. If the condition is left untreated, people with prediabetes will likely develop Type 2 diabetes.

People with prediabetes have an increased risk of cardiovascular diseases such as heart disease and stroke.

Nearly 13 percent of Wyoming adults report having diabetes or prediabetes.

For the department’s new prevention effort, hospitals at Sheridan, Casper and Laramie are serving as pilot sites for an intensive lifestyle balance program aimed at patients with prediabetes.

Family Goes to Capitol Hill to Support Funding for Diabetes Research, Prevention

One Potomac family is helping to make sure diabetes has a voice and is taking to Capitol Hill to spread the message.

Barbara Weckstein Kaplowitz — a Potomac resident who has been a diabetic for 44 years — is joining more than 200 other volunteer advocates from the American Diabetes Association to encourage Congress to support federal funding in Fiscal Year 2012 for diabetes research and prevention programs. Kaplowitz, her husband, Brett— who sits on the Washginton, D.C., metro leadership council for American diabetes—and their two children, Scott, 16, and Molly, 17, are participating in the American Diabetes Association Call to Congress, which began on Wednesday and continue until Friday.

“What this means to me personally is that I can do my part to make sure the government will continue funding research,” Kaplowitz said. “Diabetes impacts me every day, so I’d love to see it go away in my lifetime and, if not in my lifetime, I’d like to see a cure in my children’s lifetime.”

Almost 26 million Americans are living with diabetes and an additional 79 million are estimated to have prediabetes, according to the American Diabetes Association.

Kaplowitz and other advocates will meet with members of Congress on Thursday to ask them to provide more than $2.2 billion in Fiscal Year 2012 funding for diabetes research through the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health, according to a release from the American Diabetes Association.

Also, the American Diabetes Association advocates will request that Congress give $80 million of funding to help with the National Diabetes Prevention Program.

This isn’t the Kaplowitz’s first time helping raise awareness about diabetes. The family has raised about $150,000 through local fundraisers in an effort to help find a cure for diabetes, Kaplowitz said.

For the past six years, the family has hosted a fundraiser at California Tortilla where a portion of the proceeds go to help find a cure for diabetes. Also, over the last eight years the family has participated in the Step Out: Walk to Stop Diabetes.

Support from other local families and the community at Walt Whitman High School — where both her children are students — have helped make events a success, Kaplowitz said.

“For me, it’s important to have my children see what an impact an individual can make no only in the community, but also when they make a call to Congress,” she said.

Diabetes Treatment News

HEALTH: Poor struggle to access diabetes care, says study

BANGKOK, 2 March 2011 (IRIN) – Ineffective or insufficient diabetes treatment can be fatal for millions worldwide, according to a new study by the US-based Institute for Health Metrics and Evaluation.

Of the areas evaluated – the United States, Iran, Mexico, Scotland, England, Colombia and Thailand – only in Thailand did the poorest have more trouble accessing diabetes care than the general population.

Thai chronic disease specialists say screenings, high-quality labs and treatment for the risk factors that can lead to diabetes – high blood sugar, blood pressure and cholesterol – are lacking outside big cities.

Lack of awareness

Using data from 2004, the study found more than eight out of 10 Thai men and women were not adequately treated for these risk factors. Some had never been screened: of 3.2 million people nationwide with diabetes in 2004, 1.8 million people were unaware of their condition.

“This is an insidious disease that can be asymptomatic,” said the study’s Thailand-based researcher, Wichai Aekplakorn, at Ramathibodi Hospital.

Diabetes, which the UN World Health Organization (WHO) says causes about 6 percent of deaths worldwide (mostly in developing countries) every year, is a chronic condition that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces.

But since 2009, Aekplakorn said, things have been improving. Of the 3.5 million estimated to have the disease that year, 2.4 million people knew. Of those seeking treatment, 28.5 percent were considered to be under “good control” versus 12.2 percent five years earlier.

Universal health coverage, launched in 2002, has slowly extended care to more people, now reaching some 48 million, he added.

The still-low numbers being screened for diabetes may be concentrated in groups that do not have national identity cards – needed to obtain subsidized medical care – or those who migrate frequently, said Jureephon Congprasert, deputy director of the Health Ministry’s Bureau of Non-communicable Diseases.

Poor diabetes management is in part due to the shortage of trained medical staff (such as ophthalmologists, nephrologists, dieticians) to deal with disease complications, she added.

Diabetes is the main cause of partial vision loss and blindness in adults in developed countries and accounts for most limb amputations that are not caused by accidents, according to WHO.

Catching up

While Thailand has been lauded for its performance in HIV care, reaching near universal coverage, chronic disease care lags behind.

“Having a system in place for one condition does not necessarily translate into good care for other conditions,” said Stephen Lim, a former research fellow in Thailand’s Ministry of Health from 2004 to 2007 and one of the authors of the new diabetes management study.

“For HIV, awareness and advocacy for treatment… has been very high, ie. there is a very public face to the disease. In general there is not the same movement behind combating chronic diseases like diabetes.”

Unlike infectious diseases, which have a culprit “agent”, chronic diseases have multiple causes, which make them harder to find, treat and wipe out, said Aekplakorn.

“Most NCDs [non-communicable diseases] have several factors – urbanization, [health] behaviours, global consumer trends. It is more complicated and we cannot end them by tackling only one issue.”

Improving The Diagnosis, Classification And Coding Of Diabetes, UK

A new report, launched by the Royal College of General Practitioners and NHS Diabetes, aims to improve the diagnosis, classification and coding of diabetes. It provides advice and support to all clinicians involved in this often complex diagnostic challenge as well as providing free, downloadable practice audit tools to aid accurate diagnosis.

It outlines:

– The results of a systematic review examining existing evidence on misdiagnosis, misclassification and miscoding

– The results of an analysis of two primary care databases of nearly one million patients establishing the extent of misdiagnosis, misclassification and miscoding

– Pragmatic Guidelines for diagnosis and classification

– Audit tools to improve diagnosis, classification and coding in clinical practice and the results of a pilot using them

A pilot of the audit tools across five practices with 1600 people on diabetes registers found 2.2% of people diagnosed with diabetes did not have it, 2.1% of people were classified with the wrong type of diabetes and 0.9% of people had their type of diabetes coded as indeterminable.

Dr Clare Gerada, Chair of the RCGP and a practising GP in London, said: “Diabetes is a growing concern for GPs and their teams and it is crucial that patients receive the correct diagnosis so that they can start to receive the appropriate treatment and care.

“The report found that the overwhelming majority of people are correctly diagnosed with what is increasingly recognised as a very complex condition. However in a few cases people have been misdiagnosed, misclassified or miscoded with diabetes. The new guidelines and audit tools will be of great benefit to doctors and patients and we will be working very closely with our members and other primary care colleagues to introduce them into widespread clinical practice.”

Dr Rowan Hillson, National Clinical Director for Diabetes, said: “It is reassuring that the vast majority of people with diabetes are correctly diagnosed. In a few complex cases people may have been misdiagnosed with diabetes or the type of diabetes misclassified, but this shouldn’t significantly affect their treatment. However, with 2 million people diagnosed with diabetes in England and the numbers predicted to go much higher, the classification algorithm and audit tools provided today make a valuable contribution to help GPs with diagnosis, classification and coding of diabetes.”

Anna Morton, Director of NHS Diabetes, said: “I am delighted that we worked with the RCGP and colleagues from across the diabetes community to produce this report. The key aim of NHS Diabetes is to work with frontline staff to improve diabetes care and we will be using all our efforts to see its recommendations translated into clinical practice across England.”

Avril Surridge, who has diabetes, said: “From talking to friends and colleagues I know how hard diagnosis hits people. To be told later that you do not have diabetes can be wonderful news but also distressing to realise they have lived under an unnecessary shadow sometimes for some time. Similarly, to be diagnosed with one type of diabetes and then later to have that changed to diagnosis of another type is both alarming and confusing and raises queries about the treatment they have had. I really hope that the recommendations in this report are taken up very quickly so that the accuracy of a diagnosis of diabetes improves.”

Turn-key to diabetes uncovered

Australian scientists appear to have discovered a major turn-key for type 1 diabetes while looking for a new way to safely transplant insulin-producing cells.

A solitary molecule – Interleukin 21 (IL-21) – has emerged as critical to the way these diabetics have an immune system which wrongly kills off their insulin-producing cells.

Researchers at Sydney’s Garvan Institute of Medical Research developed an experimental drug which neutralised this IL-21 in diabetic mice, to uncover a rapid and “unprecedented” effect.
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The mice were not only seen to readily accept a batch of donated insulin-producing cells without using conventional drugs to suppress their immune system.

After just two weeks of treatment, they also showed signs of returning to healthy pancreas function over and above the strength of these donated cells.

“This is unprecedented in a sense, and I can’t think of one other example where neutralising one molecule would have such a huge effect, said Dr Cecile King who undertook the research along with Dr Helen McGuire.

“… And what we noticed when we looked at the pancreas of the transplant recipients, they were beginning to regain function and many of those mice could be fine without the transplant after a period of time.”

Dr King said the study showed the importance of a steady supply of IL-21 to the immune system’s killer T-cells – which patrol the body looking for foreign invaders and, incorrectly in the case of type 1 diabetics, insulin-producing cells.

Without access to IL-21, the T-cells did not target or reject donor insulin-producing cells when transplanted into the mice.

Doing was also seen to put their pancreas on a path towards sustained healthy insulin-producing function, as though they no longer had type 1 diabetes.

“Perhaps what we see in the pancreas is such a chronic inflammation … and once we halt that process we actually see a lot of new growth, and a lot of the (insulin-producing) islets that are there regain functionality,” she said.

Further studies in diabetic mice – including whether the drug could have a positive effect on its own without a transplant – would follow, Dr King said, and the next major step would be a trial in people.

Despite the positive signs, she also cautioned the research had taken seven years to reach this point and it would take more time to prove the same technique was safe and effective in people.

“This study is very encouraging and it does offer hope for people with type 1 diabetes but, realistically, we’re a decade away from seeing this (treatment) in humans,” Dr King said.

The research is published in the international journal Diabetes.

Diabetes Prevention News

A Short Group Immune to Diabetes and Cancer

Scientists are learning a lot about cancer and diabetes prevention from a group of short Ecuadorians who suffer from Laron syndrome, a rare disease that results in stunted growth. MSNBC reports that the Ecuadorians suffering from Laron syndrome have a mutation in a gene that regulates cell growth and division. Scientists have discovered that this mutation also leads to resistance to diabetes and cancer. The secret is in how the mutation affects a growth-signaling pathway in the body. In the Ecuadorians, a deficient growth hormone receptor caused lowered levels of insulin-like growth factor 1 (IGF1), which is associated with resistance to cancer and diabetes.

As Diabetes Explodes, Big Pharma Is Gearing Up

Diabetes is a growing global scourge, but for Big Pharma it’s more of a lifesaver. In the U.S. alone, a whopping 105 million people have diabetes or prediabetes, according to new estimates from the Centers for Disease Control and Prevention. Nearly 26 million Americans have diabetes, a 10% increase from 2008. And an estimated 79 million adults have prediabetes, a staggering 39% increase from 2008. No wonder pharmaceuticals companies are eager to tap the market.

Characterized by high blood-sugar levels, diabetes results from the body’s difficulty to produce and/or use insulin — a hormone that helps the body use blood sugar for energy. Type 1 diabetes develops when the body can no longer make insulin. In Type 2 diabetes, which accounts for 90% to 95% of cases, the body gradually loses its ability to use and produce insulin.

In prediabetes, which affects 35% of the adult population, blood sugar levels are higher than normal, but not high enough to be diagnosed as diabetes. Prediabetes, though, raises a person’s risk of Type 2 diabetes.

Hefty Price Tag

Despite its growing prevalence, the disease can’t be taken lightly. Diabetes is the seventh-leading cause of death in the U.S. and is a major cause of heart disease, stroke and high blood pressure. Diabetes is also the leading cause of kidney failure, nontraumatic feet and leg amputations, nervous system damage and new cases of blindness among adults in the U.S.

All that adds up to a hefty price tag. Diabetes, the CDC says, costs $174 billion annually. In November, health insurer UnitedHealth Group (UNH) released a study projecting that the disease will cost the nation $3.35 trillion over the next decade, with diabetes and prediabetes costing almost $500 billion annually. A 2007 study by the American Diabetes Association estimated that 1 in every 10 health care dollars is attributed to diabetes.

The CDC is working with the National Institute of Health on the National Diabetes Prevention Program, as provided for in the landmark Affordable Care Act. It estimates that if current trends continue, as many as 1 in 3 U.S. adults could have diabetes by 2050. Just in 2010, 1.9 million new cases were diagnosed in adult Americans. The CDC estimates that 84% of adults diagnosed with diabetes take insulin and/or oral medication.

The Top-Selling Drugs

In 2009, the U.S. diabetes market grew 17% from 2008, reaching $14.9 billion, according to data from health care information company IMS Health. Worldwide, the market generated sales of over $25 billion, according to independent business information provider Visionagain. By 2019, Morningstar projects the worldwide diabetes market, excluding insulin, will grow to over $55 billion.

That’s why pharmaceutical companies, in search for more revenue in light of the many high-price drugs that are coming off patent, are focusing much of their efforts on this growth market. According to IMS Health, the top-selling diabetes drugs in the U.S. now are Takeda’s oral drug Actos, with nearly $1.8 billion in sales in the first half on 2010; Sanofi-Aventis’s (SNY) Lantus products, with nearly $1.5 billion in sales, and Merck’s (MRK) Januvia, with $854 million in sales. The total diabetes market in the first half of 2010 was $8.7 billion, nearly as much as full-year 2005’s market of $9.3 billion.

Rounding out the top five diabetes drugs in the U.S. are Novo-Nordisk’s (NVO) Novolog and Eli-Lilly’s (LLY) Humalog, both of which are analog insulin drugs. Other players include Lilly and Amylin’s (AMLN) Byetta, which had fourth-quarter 2010 sales of $174.6 million, and Novo-Nordisk’s Victoza, which had sales of roughly $127 million in the third quarter. Both are antidiabetes hormone analog drugs. And then there’s the controversial oral pill Avandia from GlaxoSmithKline (GSK), whose sales declined to roughly $112 million in the third quarter.

Drugs that are analogs of human insulin, such as Lantus, held 42% of the U.S. market, followed by so-called glitazones, such as Actos and Avandia, with 28% of the market, and DPP-4 Inhibitors, such as Januvia and Bristol-Myers Squibb’s (BMY) and AstraZeneca’s (AZN) Onglyza, with 14% of the market, according to IMS Health data.

An Epidemic in China and India

Big Pharma continues to push ahead. In January alone, Lilly and Boehringer Ingelheim announced an agreement to jointly develop diabetes compounds. And a new class of drugs, SGLT-2 inhibitors, holds the promise of becoming blockbusters, according to Morningstar, with Bristol and Astra further along in development of these compounds.

But diabetes research isn’t necessarily easy. MannKind’s (MNKD) inhaled insulin, for one, was rejected last week by the Food and Drug Administration. And when Roche faced setbacks with its once-weekly insulin, it resorted to massive job cuts.

Diabetes is also becoming a global problem, and in some countries, such as China and India, an epidemic. Pharmaceutical companies are paying attention. Lilly recently announced plans to open a research center focused on diabetes in China.

As long as diabetes cases keep expanding, this market will become increasingly important to Big Pharma.

Diabetes Prevention: Four Steps for Diabetes Prevention

Almost 26 million people in the United States now suffer from diabetes, according to data released by the U.S. Centers for Disease Control and Prevention (CDC) on Feb. 11.

The report shows that one in three Americans has a high risk of developing type 2 diabetes in his or her lifetime.

Type 2 diabetes is a metabolic disorder that affects blood sugar levels and has serious complications, including eye problems, nerve damage in extremities, heart or kidney disease, and even death. Sufferers who have developed the disease are often not diagnosed until several years later, leading them to have higher chances of complications. Early diagnosis is vital to successfully treat the disease and to prevent or at least delay associated complications.

According to the CDC’s 2011 national fact sheet, 26 million Americans, or 8.3 percent of the U.S. population, are affected by diabetes, yet seven million of them remain undiagnosed.

Dr. Robert Henry, president of the American Diabetes Association’s Medicine and Science, said that the new CDC data are a “real wake-up call” and highlight the importance “for Americans to know if they are at risk and take action, if needed.”

“Let’s use these devastating new numbers as inspiration to work harder and stop diabetes in its tracks,” he said, according to the American Diabetes Association.

The CDC diabetes factsheet shows results of a prevention study, the Diabetes Prevention Program, which showed that lifestyle changes like weight loss and increased exercise lowered development of type 2 diabetes by 58 percent over three years and by as much as 71 percent in older people over 60 years old.

Here are some tips from the ADA to help you prevent or delay the onset of type 2 diabetes:

1. Understand your risks
Inherent risk factors are a family history of diabetes, being over 45 years old, and ethnicity, with African Americans, American Indians, Hispanics, Asian Americans, and Pacific Islanders being more at risk.

Negative factors that can be controlled include being overweight, inactivity, having an unhealthy diet, smoking, and having above-average blood sugar, blood pressure, or cholesterol levels.

2. Get a check-up

Regular health checks for blood glucose, blood pressure, and blood lipid levels are very important. Measuring blood glucose shows whether someone has prediabetes or diabetes. For optimal health, maintain a healthy blood pressure, and have normal lipid levels.

3. Exercise
According to experts, 30 minutes of exercise almost daily is beneficial. People not used to this can begin with 10 minutes most days and increase activity levels through habits like taking the stairs or parking further away from destinations.

4. Diet
Make small diet changes, one at a time, for a healthier diet. Have a salad and one vegetable with dinner. Opt for low-calorie snacks, and take a salad and veggies with dinner.

For more information, visit the American Diabetes Association’s website where you will find these three free resources:

* My Health Advisor calculates your risk of type 2 diabetes and heart disease, then shows simple lifestyle changes to help, like losing weight or stopping smoking.

* CheckUp America provides detailed information on risk factors and how to reduce your risk of diabetes.

* Call the Center for Information and Community Support at 1-800-DIABETES for advice and free information in English and Spanish, including the new booklet Top 5 Ways to Stop Diabetes and Get Healthy Right Now!

Diabetes Treatment and Diagnosing

Afe Babalola decries commercialisation of public health service

Pro-Chancellor, University of Lagos, Chief Afe Babalola, has criticised the commercialisation of public health service delivery, saying this has made government hospitals become more expensive than private ones.
Chief Babalola stated this at the opening of the first Strategies For Improving Diabetes Care In Nigeria (SIDCAIN) annual lecture entitled, “Health Scheme and National Development”.

According to the legal luminary,”it cannot be right that public health institutions, especially those set up by Federal Government with substantial subventions should become more expensive than their private counter parts.”

He stated: “there is abundant empirical evidence that commercialisation of public health service delivery exerts huge negative imparts on the attainment of the Millennium Development Goals in Nigeria.”

“I do not subscribe to making health care an avenue for profiteering. It is reported that, while an average private hospital in Ibadan where the UCH is located charges N500 for consultation, the UCH charges between N750 to N1, 250 for consultation alone.”

Chief Babalola declared further that, “these fees require urgent downward review, perhaps through a health scheme that would subsidise the costs.”

Earlier at the lecture, whose theme was “Diabetes mellitus in a developing country” Dr Sonny Kuku, Chairman, University College Hospital (UCH), declared that diabetes had reached an epidemic proportion.

He stated that currently the treatment and prevention of diabetes rely on education, diet and medications.

Evaluation of four novel genetic variants affecting hemoglobin A1c levels in a population-based type 2 diabetes cohort (the HUNT2 study)

Chronic hyperglycemia confers increased risk for long-term diabetes-associated complications and repeated hemoglobin A1c (HbA1c) measures are a widely used marker for glycemic control in diabetes treatment and follow-up. A recent genome-wide association study revealed four genetic loci, which were associated with HbA1c levels in adults with type 1 diabetes.

We aimed to evaluate the effect of these loci on glycemic control in type 2 diabetes.

Methods: We genotyped 1,486 subjects with type 2 diabetes from a Norwegian population-based cohort (HUNT2) for single-nucleotide polymorphisms (SNPs) located near the BNC2, SORCS1, GSC and WDR72 loci. Through regression models, we examined their effects on HbA1c and non-fasting glucose levels individually and in a combined genetic score model.

Results: No significant associations with HbA1c or glucose levels were found for the SORCS1, BNC2, GSC or WDR72 variants (all P-values >0.05).

Although the observed effects were non-significant and of much smaller magnitude than previously reported in type 1 diabetes, the SORCS1 risk variant showed a direction consistent with increased HbA1c and glucose levels, with an observed effect of 0.11% (P=0.13) and 0.13 mmol/l (P=0.43) increase per risk allele for HbA1c and glucose, respectively. In contrast, the WDR72 risk variant showed a borderline association with reduced HbA1c levels (beta=-0.21, P=0.06), and direction consistent with decreased glucose levels (beta=-0.29, P=0.29).

The allele count model gave no evidence for a relationship between increasing number of risk alleles and increasing HbA1c levels (beta=0.04, P=0.38).

Conclusions: The four recently reported SNPs affecting glycemic control in type 1 diabetes had no apparent effect on HbA1c in type 2 diabetes individually or by using a combined genetic score model. However, for the SORCS1 SNP, our findings do not rule out a possible relationship with HbA1c levels.

Hence, further studies in other populations are needed to elucidate whether these novel sequence variants, especially rs1358030 near the SORCS1 locus, affect glycemic control in type 2 diabetes.

Author: Jens HertelStefan JohanssonHelge RaederCarl PlatouKristian MidthjellKristian HveemAnders MolvenPal Njolstad
Credits/Source: BMC Medical Genetics 2011, 12:20

Hallmark Health to affiliate with Joslin Diabetes Center

The following was submitted by Hallmark Health:

According to the American Diabetes Association there are nearly 24 million children and adults in the United States living with diabetes and an additional 57 million Americans at risk for the disease.
In response to the epidemic of diabetes in men and women living in Massachusetts, Hallmark Health System, the leading provider of vital health services north of Boston, has joined forces with the Joslin Diabetes Center, the world’s preeminent diabetes research and clinical care organization.

The Joslin Diabetes Center Affiliate at Hallmark Health, which will be led by Sunita Schurgin, MD, Tara Hamilton, MD and Sybil Kramer, MD will offer some of the latest advances for treating diabetes and its complications as well as patient education and support services. Hallmark Health will be one of 40 national and two international Affiliate locations as well as the only Joslin Affiliate in Boston’s northern suburbs.

“We are honored to enter into this partnership with the Joslin Diabetes Center,” said Terry Giove, vice president of Ambulatory Services for Hallmark Health. “Our two organizations share the common goal of providing the very best in diabetes care. We look forward to working closely with Joslin to treat, educate and support diabetes patients throughout the Hallmark Health system.”

Joslin provides clinical, educational, operational and marketing support to its Affiliates to help assure that high quality, comprehensive and cost-effective diabetes care is available to each partner’s community — ensuring that these organizations and the patients they serve are in touch with some of the latest clinical trends and research breakthroughs.

“We are delighted to have Hallmark Health join us in the fight against diabetes,” said Janice Murphy, JD, director of National Affiliated Programs for the Joslin Diabetes Center. “We’ve got a huge problem with diabetes in the United States. Hallmark has shown its commitment to dealing with this chronic disease and we’re thrilled to partner with them.”

The Center at Hallmark Health will offer advanced clinical care for the treatment of diabetes for patients ages 18 and older, as well as patient education and support services. This multi-disciplinary program will offer services for:

• Diabetes screening
• Comprehensive diabetes care and management
• Complication screening, prevention and treatment
• Weight management and nutritional counseling
• Medication management
• Insulin pump management
• Self-care and self-management
• Gestational diabetes management

Patients will be cared for by a dedicated, highly experienced team including a board-certified endocrinologist, registered dietitian, certified diabetes educator and other medical and support professionals. Along with expert diabetes care, these physicians will continue to provide treatment for a wide variety of other endocrinology diagnoses.

Ipsen suffers blow as Roche drops diabetes deal

(Reuters) – Swiss drugmaker Roche has dropped development of diabetes treatment taspoglutide, ending its partnership with French drugmaker Ipsen and pushing Ipsen’s shares as much as 4 percent lower.

Ipsen said on Wednesday it would thoroughly assess the available data on the drug to see if it can be developed with another partner as it would be too costly to develop the drug, once seen to have $2 billion sales potential, on its own.

The announcement came at Ipsen’s 2010 sales presentation. Fourth-quarter sales rose 1.1 percent to 258 million euros ($360 million), leaving full-year sales up 6.5 percent to 1.03 billion. They were up 5.1 percent in constant currency terms.

Quarterly sales missed forecasts of some analysts due to weak performance in primary care and in the United States.

“On a geographical basis, at the exception of France, Europe did relatively well. As far as the U.S. franchise, it is again disappointing,” Rodolphe Besserve, analyst at Societe Generale wrote in a research note.

Ipsen also said the group would present a new strategy in the second quarter of this year as U.S. healthcare reforms and price cuts in Europe are dampening growth prospects for the industry overall.

“The healthcare industry now faces new challenges and is currently undergoing important changes worldwide,” said Chairman and Chief Executive Marc de Garidel who replaced Jean-Luc Belingard over strategic differences in November. “I have decided to run a thorough strategic review to further define Ipsen’s mid-and-long term vision,” he said in a statement.

Taspoglutide was licensed to Roche in 2006, having shown promising end-stage clinical trials.

But then the drug suffered setbacks in its development, and Roche suspended dosing in a late-stage trial in September, leading many analysts to believe it would be halted due to adverse reactions among some patients.

Societe Generale’s Besserve said it was unlikely that Ipsen could find another partner for taspoglutide which belongs to the same glucagon-like peptide (GLP-1) drug class as Novo Nordisk’s Victoza and Amylin Pharmaceuticals Inc’s and Eli Lilly and Co’s Byetta.

Another GLP-1 product, Bydureon, suffered a setback when Amylin Pharmaceuticals Inc’s and Eli Lilly and Co, citing the need for further studies, including the drug’s effect on heart rate.

“Following the disappointing setbacks for … taspoglutide, we see few near-term catalysts for Ipsen’s stock, Jefferies Research analyst Tara Shivarattan wrote in a note, citing the slow ramp-up of Ipsen’s U.S. business and a challenging environment in Europe.

Ipsen shares fell 4.3 percent to 24.44 euros by 1011 GMT.

The company will release its full-year results on March 2.

Diabetes News and Treatment

Coffee Can Curb Diabetes Risks

UCLA — Researchers at UCLA have discovered that coffee’s protective effects against Type 2 diabetes may be attributed to a protein that regulates sex hormones.

Sex hormone-binding globulin, or SHBG, regulates and biologically activates male and female sex hormones, which are commonly thought to play a crucial role in the development of Type 2 diabetes. By increasing coffee consumption, SHBG levels increase, lowering the subject’s risk of developing diabetes.

In a press release, UCLA professor of epidemiology Simon Liu and doctoral student Atsushi Goto reported that women who consumed four cups of coffee each day were 56 percent less likely to develop Type 2 diabetes compared to nondrinkers. The coffee-drinkers were found to have higher concentrations of SHBG in their blood than those who abstained from the caffeinated beverage.

According to Goto, the study’s findings are not correlated to decaffeinated coffee.

“Consumption of decaffeinated coffee was not significantly associated with SHBG levels, nor diabetes risk, so you probably have to go for the octane!” Goto said in a press release.

Old Drug Helps Alcohol Addicts

UC San Francisco — A group of scientists at UC San Francisco recently published a study of an FDA-approved drug that could potentially treat alcoholism.

Chlorzoxazone, commonly prescribed as a muscle relaxant, has been confirmed to decrease alcohol consumption in heavy-drinking rats. According to lead author Woody Hopf, an assistant adjunct professor of neurology at UCSF, the drug could reduce neuronal excitability in a region of the brain’s reward system known as the nucleus accumbens, which perpetuates cravings for alcohol or other addictive substances.

In their current study, Hopf and his colleagues discovered that rats that drink heavily have fewer SK channels — ion channels that allow potassium to pass across a cell membrane — in their neurons than rats that do not drink heavily. Chlorzoxazone was found to activate those SK channels, resulting in a loss of excitability of the nucleus accumbens, which plays a large part in addiction and pleasure as well as the suppression of alcohol consumption in heavy-drinking rats.

“Chlorzoxazone might be exactly the kind of drug to take the edge off that craving, without side effects.” Hopf said in a press release.

According to Hopf, the next step is clinical trials, which he said can be expected to begin immediately, as the drug has already been approved by the FDA.

Geneticists Gaze Into Gut Genome

UC Berkeley — Scientists at UC Berkeley have sequenced the genomes of microbes that exist within the gut of prematurely born infants in order to achieve a better understanding of the intestinal problems that commonly plague the population.

Researchers are still unsure if the diseases, including deadly necrotizing enterocolitis, or NEC, are caused by bacterial pathogens or imbalances within the population of organisms that live within the gut of premature infants.

As infants mature, the populations of organisms that reside in their gut change dynamically as various microbes compete for biological dominance. Babies born prematurely may have eccentricities in their cycle that lead to the proliferation of disease-causing bacteria, possibly resulting in illness.

According to assistant professor of surgery at the University of Pittsburgh School of Medicine Michael J. Morowitz, in order to gain a better understanding of the microbe populations, an analysis of normal, healthy microbial population dynamics is needed before disease-causing factors can be found.

“It’s become very apparent that there are some fundamental unanswered questions just about the colonization process under normal circumstances,” Morowitz said in a press release. “It’s really important to get a handle on what the normal process is first, and then, eventually, we can look closely at babies with NEC and see if they deviate from what appears to be the normal colonization process.”

Jill Banfield, a professor of earth and planetary science and of environmental science, policy and management at UC Berkeley, said in a press release that a full genome sequence is needed due to the possibility of even a few genes having strong implications for the character of the bacteria.

“We already know that just a few genes can make one strain a pathogen and one beneficial or commensal,” Banfield said. “We expect that a lot of the issues with the colonization process in the gut that leads to disease may be tracked to subtle differences in strains.”

Glaxo Sets Aside Over £2bn to Cover Legal Fees

18 January 2011 – The global pharmaceutical group GlaxoSmithKline has set aside £2.2 billion during the fourth quarter of 2010 to cover possible legal fees related to its diabetes drug Avandia.

The European authorities banned Avandia during 2010 while its use has been restricted in the United States due to a suspected link to heart disease, according to news reports.

The drug giant said in a statement that the £2.2 billion charge primarily relates to “additional provisioning” which is related to a US state investigation into the group’s US sales, promotional activities and product liability cases related to Avandia.

Such legal fees are an occupational hazard for large drug groups operating in the complex pharmaceuticals market which has weathered the global economic downturn relatively well.

Outside the US, the Asia Pacific region is emerging as the fastest growing pharmaceutical industry in the global arena, according to a new report, entitled “Asia Pacific Pharma Sector Analysis”.

The region’s low labor and manufacturing costs have attracted huge investments from the global giants, including GlaxoSmithKline and Pfizer among other companies.

In combination with increasing disposable income of regional consumers and the increasing prevalence of lifestyle diseases, these factors will help the market to grow at double digit growth rate during the forecast years, according to the report which provides a comprehensive overview of the sector in the region.

Research and Markets: China Diabetes Management Devices Market Opportunity, Growth Trends & Forecasts Till 2016

The Market Intelligence report provides critical market data for China diabetes management devices market and its product categories. The data includes market size in terms of value and volume; average selling price for each product type, growth trends and market shares of companies at sector and category level. Its vital cross category comparison and cross sub-category comparison section makes analysis very handy for company professionals. The report helps professionals in mapping market size, competition, understanding historic and future growth trends. It covers important categories such as blood glucose monitoring systems and insulin delivery devices.
Market size in terms of value ($) and volume (units), for each level of segmentation from 2005 to 2010 and forecast till 2016.
Market growth in terms of value ($) and volume (units), for each level of segmentation from 2005 to 2010 and forecast till 2016.
Competitive Analysis: Market share (%) of companies is covered at sector and category level for 2010.
Pricing Analysis: Average selling price ($) for each product type from 2005 2010 and forecast till 2016.

Cross category comparison and cross sub-category comparison Forecast and historic market growth and market size comparison for various categories and sub-categories from 2005 to 2010 and 2010 to 2016.

We update this product from time to time in order to provide you with the most recent information. This process may take 24 to 36 hrs.

Key Topics Covered:

Introduction

Scope of the Report

Chinese Market for Diabetes Management Devices (2005-2016)
Definitions
Diabetes Management Devices
Blood Glucose Monitoring Systems
Insulin Delivery Devices
Diabetes Management Devices Overall Revenue ($ mn) by Category, (2005-2016)
Diabetes Management Devices Overall Company Shares, 2010

Chinese Market for Blood Glucose Monitoring Systems (2005-2016)
Definitions
Blood Glucose Monitoring Systems
Blood Glucose Meters
Blood Glucose Test Strips
Continuous Glucose Monitoring Systems
Blood Glucose Monitoring Systems Revenue ($ mn) by Sub-Category, (2005-2016)
Blood Glucose Monitoring Systems Volume (Units) by Sub-Category, (2005-2016)
Blood Glucose Monitoring Systems Average Price ($), (2005-2016)
Blood Glucose Monitoring Systems Company Share (%), 2010

Chinese Market for Insulin Delivery Devices (2005-2016)
Definitions
Insulin Delivery Devices
Insulin Pens
Reusable Insulin Pens
Disposable Insulin Pens
Insulin Syringes
Insulin Pumps
Insulin Delivery Devices Revenue ($ mn) by Sub-Category, (2005-2016)
Insulin Delivery Devices Volume (Units) by Sub-Category, (2005-2016)
Insulin Delivery Devices Average Price ($), (2005-2016)
Insulin Delivery Devices Company Shares (%), 2010

Appendix
Research Methodology
Contact us
Disclaimer

Companies Mentioned:
Abbott Laboratories
Animas Corporation
Apex Biotechnology Corp
ARKRAY, Inc.
AViTA Corporation
Bayer HealthCare AG
Becton, Dickinson and Company
BIONIME Corporation
Eli Lilly and Company
F. Hoffmann-La Roche Ltd
LifeScan, Inc.
Medtronic, Inc.
Novo Nordisk A/S
San Meditech(Huzhou)Co.,Ltd
Sanofi-Aventis
Smiths Medical
Terumo Corporation

Diabetes Treatment and Prevention News

How drinking milk could protect you from diabetes

Drinking milk may help prevent type 2 diabetes – the disease linked to obesity.

Contrary to the popular perception of dairy products as unhealthy, regular consumption could actually reduce the risk of developing the condition by up to 60 per cent, according to a study.

The ingredient responsible is trans-palmitoleic acid, a fatty acid found in the dairy fat of milk, cheese, yoghurt and butter.

Researchers at the Harvard School of Public Health in the United States say it can combat type 2 diabetes, which affects more than 2.3million Britons.

In the study, published in the Annals of Internal Medicine, more than 3,700 participants were followed for 20 years by researchers.

They took measurements including blood glucose, insulin and levels of fatty acids.
They found that higher levels of trans-palmitoleic acid were associated with healthier levels of blood cholesterol and insulin.

Overall, those with the highest levels of trans-palmitoleic acid had about a 60 per cent reduced risk of developing type 2 diabetes.

Lead researcher Dariush Mozaffarian said: ‘The magnitude of this association is striking.

‘This represents an almost three-fold difference in risk of developing diabetes among individuals with the highest blood levels of this fatty acid.’

The study also appears to confirm previous research showing that a diet rich in dairy foods is linked to lower risk of type 2 diabetes and related metabolic abnormalities.

A review of 324 studies of milk consumption and effects on health last year suggested the health benefits of milk outweigh any dangers that lie in its consumption, cutting deaths from common diseases by 15-20 per cent.

As little as one-third of a pint a day shows benefits in some studies while others involve regular consumption of almost a pint a day.

Dr Mozaffarian said: ‘There has been no clear biologic explanation for the lower risk of diabetes seen with higher dairy consumption in prior studies. This is the first time that the relationship of trans-palmitoleic acid with diabetes risk has been evaluated.

‘We wonder whether this naturally occurring trans fatty acid in dairy fats may partly mimic the normal biologic role of its cis counterpart, cis-palmitoleic acid, a fatty acid that is produced in the body.

‘In animal experiments, cis-palmitoleic acid protects against diabetes.’

Professor Gokhan Hotamisligil, senior author on the study, said this latest research had strong findings, but needed to be confirmed by a trial which set out to prove how it worked.

He said: ‘This is an extremely strong protective effect, stronger than other things we know can be beneficial against diabetes.

‘The next step is to move forward with an intervention trial to see if there is therapeutic value in people.’

Death Toll Estimate from French Diabetes Drug Climbs Over 2,000

The French Health Ministry has launched an investigation into the deaths of possibly more than 2,000 people who took the type 2 diabetes drug and appetite suppressant Mediator, and developed heart valve problems. When the French daily Le Figaro broke the story last month, 500 people were thought to have died. Mediator had been on the market since 1976, and was only pulled off in 2009. More than 5 million French people took the drug during that time. The privately-owned Servier, which makes it, is France’s second largest pharmaceutical company after Sanofi-aventis. It reported “consolidated” revenues of $5 billion in 2009-2010.

The case is reminiscent of GlaxoSmithKline’s diabetes drug Avandia. This past September, the FDA significantly restricted its use and the European Medicines Agency suspended it altogether, after cardiologist Steven Nissen of the Cleveland Clinic pointed the heightened risk of heart attack and stroke. From 1999 to 2009, more than 47,000 people on Avandia suffered heart attack, stroke, heart failure or death. The New York Times noted the often conflicting advice FDA staffers gave on its safety.

It is still unclear as to who knew what and when in Mediator’s case. But Le Figaro got hold of a letter which reveals that in 1998, three doctors with France’s Securite Sociale—which oversees health insurance, warned the French drug regulatory agency that Mediator could damage heart valves. Their warning was apparently ignored. They pointed that the medication was chemically similar to another Servier appetite suppressant that had been banned in 1997. Remember Fen Phen? In 1997, the FDA forced then American Home Products to withdraw its appetite suppressants Redux and Pondimin, after those drugs combined with another diet pill phentermine, cause heart valve lesions in overweight patients. Looks like those drugs might be related to Mediator, and if so, the health risks are well documented.

The French hope to find out what happened by January 15. Meanwhile Servier’s 88-year-old founder, Jacques Servier, told Le Monde that he is “shocked and stunned.” He would like to know “where these 500 dead people are”.

MOH clears way for pig cell diabetes research

Mon, 20 Dec 2010 6:37p.m.

By Rachel Morton

The Ministry of Health has cleared the way for more research to be done on how pig-cells affect type one diabetes sufferers.

Russia has just registered the New Zealand drug diabecell which was first tested on a patient here 14 years ago.

Researchers hope it won’t be long until it’s registered here too.

Fourteen years ago Michael Helyer put himself forward as a guinea pig for a treatment for type 1 diabetes; he was injected in the abdomen with pig cells.

Fourteen years on and he’s still experiencing the benefits.

The cells have mimicked his natural insulin production, meaning he doesn’t need to inject himself as often.

“This is a world first therapy and New Zealand is the first to have a product that has phased through trials and we’re certainly on the map around the world,” says Susanne Clay of Living Cell Technologies.

On the map because finally there have been two significant developments; the drug diabecell has been registered for use in Russia and the New Zealand phase of testing has progressed, the Ministry of Health has approved two more patients.

That means within a year the drug could be registered here too.

“The final trials that will allow us to apply for approval in New Zealand,” Susanne Clay says.

The drug is currently only being tested on people with unstable type 1 diabetes, meaning they have unexpected extreme highs and lows of blood sugar.

But if the drug successfully treats those patients, it could eventually become available for all sufferers of type 1 diabetes like Mr Helyer.

Mr Helyer says he is disappointed New Zealand wasn’t the first to register the drug, the testing was halted here for 10 years after fears pig viruses could be transmitted to people.

But Mr Helyer says the results speak for themselves and it will be a major medical breakthrough when diabecell is available for all type 1 diabetes sufferers here.