Diabetes warning to men over 50

Men over the age of 50 are almost twice as likely as women to have diabetes without knowing it, it was claimed.

A study of more than 6,700 UK adults aged 52 to 79 found that 502 had type 2 diabetes, the most common form of the disease.

Of the affected men, 22% did not previously realise they had the condition compared with 12% of the women.

Type 2 diabetes is linked to lifestyle and associated with having a large waist or being overweight.

Study leader Dr Mary Pierce, from University College London, said: "The higher numbers of men with undiagnosed diabetes in this study may be explained by the fact that women go to their GP more often and are therefore screened more often.

"There needs to be much greater testing of overweight and obese people as well as those with other risk factors for diabetes."

Around two million people in the UK have type 2 diabetes. A further 750,000 are believed to have the disease without knowing it.

The new research was reported in the journal Diabetic Medicine.

It found that people had a greater risk of having undiagnosed diabetes if they had a high Body Mass Index (BMI), a measurement of weight related to height, a large waist, high blood pressure and high cholesterol.

Wealth, education, social class, ethnicity, age and smoking status were not significantly associated with increased risk.

Lifestyle changes may be the best way to delay diabetes

Lifestyle changes are the best way to stave off development of Type 2 diabetes, according to a 10-year followup of an innovative trial to prevent the disease in high-risk groups. The results are important because diabetes is a rapidly spreading epidemic in the United States. About 24 million Americans -- 1 in every 9 -- have diabetes, the vast majority of them Type 2, which develops during adulthood. An additional 57 million people have blood glucose levels that are higher than normal but that are not yet in the diabetic range, and it is this group that could benefit the most from interventions.

The original Diabetes Prevention Program trial involved 3,234 overweight or obese men and women, most of them from ethnic groups with an above-normal risk for diabetes. They were divided into three groups: one received intensive training on altering their lifestyle, the second received the diabetes medication metformin, and the third received a placebo. The lifestyle intervention involved reducing the amount of fat in their diet, exercising daily and losing 5% to 7% of their body weight. On average, those in this group exercised about 30 minutes per day and lost about 15 pounds, although they subsequently regained 10 pounds. Those in the metformin group lost 5 pounds, and those in the placebo group lost less than 2.

The study was halted prematurely in 2001 when it became clear that lifestyle intervention was most effective. Those in the lifestyle arm of the trial reduced their risk of diabetes by 58% compared with the placebo group, and those in the metformin group reduced risk by 31%.

The original group was offered the chance to participate in followup studies and 1,766 did, roughly a third from each of the trial arms. All were given training in lifestyle changes.

The study team, led by Dr. David M. Nathan of Massachusetts General Hospital, reported on the 10-year results this week in the journal Lancet. In the 10 years, participants in the original lifestyle-change group delayed the onset of diabetes by an average of four years compared with the placebo group, and those in the metformin group delayed it by an average of two years. "The benefits of intensive lifestyle changes were especially pronounced in the elderly," Nathan said. "People age 60 and older lowered their rate of developing diabetes in the next 10 years by about half."

About 5% to 6% of those in the lifestyle intervention group developed diabetes every year during the initial trial, a rate that remained constant over the follow-up period. About 8% of those in the metformin group and 11% of those in the placebo group developed diabetes each year during the original trial. Over the rest of the period, however -- apparently because of the added lifestyle training -- the latter two groups reduced their annual rate to the same range as those in the original lifestyle group.

In an editorial accompanying the report, Dr. Anoop Misra of Fortis Hospitals in New Delhi wrote that, "Prevention of diabetes is a long and winding road. There seems to be no shortcut, and a persistent and prolonged lifestyle intervention seems to be the most effective mode to travel on it."

Red Grape Compound Showing Promise Against Diabetes

Heart specialists may advise you to drink a glass or two of red wine to keep your heart healthy but emerging research may be shedding a new light on the same theory involving diabetes health. Next time you are planning a road trip, ski trip, or just a quiet dinner at home, you may want to reach for the red grapes and put a bushel (or bottle) in your cart to ward off the danger of diabetes. Type 2 diabetes is the most common form of the disease affecting 90 to 95 percent of the diabetic population, and is the type that occurs later in life, and differs from type 1 which is usually called juvenile diabetes because the majority of people get it during childhood. Whereas type 1 is caused by a disorder that crushes the insulin-producing cells, type 2 usually develops later in life because the body is still creating insulin, but there are not enough cells or the body is using more insulin hormones than it can create. Researchers at the University of Texas Southwestern Medical Center in Dallas are using the compound resveratrol—found in red grapes—to find out if it can stave off type 2 diabetes in humans. While the research has primarily been done on mice, author Roberto Coppari has hope because the findings have shown his team how the compound affects the brain. Coppari, an assistant professor of internal medicine at the University of Texas, says that once the brain has been labeled a "major player" in the fight against diabetes, drug companies will then work on a solution to “focus on a drug that will penetrate the brain.” Resveratrol is a compound found not only in red grapes and, consequently, red wine but also in pomegranates and other similar foods. When given to mice—even ones with a high-fat diet—resveratrol has been found to increase the life span of the tiny rodents by copying the practice of restricting the amount of food the mice eat. Coppari continues that weight loss and longer life can almost always be attributed to eating less which is information that is not new, “You can take the spider, fish, and almost every animal in the planet, and give 70 percent of what the animal would normally eat, and you'll see beneficial effects," he also acknowledges how hard it is to stick to a restricted diet, "Of course, calorie restriction is very difficult to impose on people. You will feel hungry all the time.” Once these mice were injected into the brain with resveratrol, the scientists followed a placebo group and a group of diabetic or limited-diet mice to track their progress. The team looked at the effects against diabetes solely because they were led to believe from previous studies that resveratrol can fend off the disease. After an observation period of at least five weeks, the mice that were on high-fat diets showed that healthy insulin levels came back in half of the group due to triggers of what the team at University of Texas thinks are brain proteins called sirtuins also called Silent Information Regulator Two (Sir2) proteins, which are thought to influence aging and stress resistance. Some of the other mice had elevated insulin levels which was conclusive depending on their diets. Even if the foundation for a solution is here, research is not yet closer to a plausible way to administer resveratrol to humans because injection into the brain is not an option. Coppari also rejects the idea that wine can solve your pre-diabetic problems as there is not enough of the compound in each serving, unfortunately. The study will be published in the December edition of the journal Endocrinology and is supported by the American Heart Association, National Institutes of Health, and the American Diabetes Association. Even though it seems that buying a bunch of grapes at the supermarket could keep the diabetes bug away, for now research will have to catch up, but in the meantime eating grapes can never be bad for you.

Walk to raise money for juvenile diabetes, honor child's memory

Students, teachers and community members will walk Friday to raise funds for juvenile diabetes research and to honor the memory of a lost classmate.

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Breanne Tidmore was 8 years old when she died from undiagnosed Type 1 diabetes in 2005.
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SPECIAL TO THE TIMES

Breanne Tidmore was 8 years old when she died from undiagnosed Type 1 diabetes in 2005.

Friday would have been Breanne’s13th birthday. Members of the Gadsden community will mark the date with a walk at Southside Elementary School throughout the day, culminating in a balloon release at Breanne’s grave site at 3:30 p.m.

This is the fourth walk her mother, Brooke Tidmore, has sponsored to raise awareness and funds for juvenile diabetes research.

When Breanne got sick, Tidmore thought she had a virus. But her doctor knew almost immediately what was wrong. A test showed her blood sugar level was 600. A virus attacked her pancreas, halting insulin production. She went into a diabetic coma and was rushed to Children’s Hospital, where she died.

“We’re doing the best we can to raise money for this,” said Breanne’s great-grandmother, Mary Phillips. “We do it every year in her memory, and I understand it’s helped a lot of kids find out they have juvenile diabetes.”

In previous years, Tidmore said the Gadsden community has raised about $65,000 per year to donate to the diabetes research center at the University of Alabama at Birmingham.

This year has been more difficult than most for raising money and finding sponsors, she said.

The walk this year will be held at Breanne’s former school, which Tidmore said has remained supportive of her efforts despite the troubled economy. Any who wishes to contribute to this year’s cause may call Southside Elementary School at 442-1090 for information.

More than 15,000 children in the U.S. are diagnosed each year with Type 1 diabetes, according to the Juvenile Diabetes Research Foundation.

“Type 1 diabetes is an autoimmune disease in which the body’s immune system attacks and destroys the insulin-producing cells of the pancreas,” the JDRF Web site states.

Although it often strikes children suddenly and with many serious complications, Type 1 diabetes also can occur in adults. Those diagnosed with it must give it constant attention, with multiple daily insulin injections, according to JDRF.

Symptoms of Type 1 diabetes include extreme thirst, frequent urination, drowsiness or lethargy, increased appetite, sudden inexplicable weight loss, sudden vision changes, sugar in urine, fruity odor on breath, heavy or labored breathing, stupor or unconsciousness.

The balloon release is open to the public and will take place at Williams Southside Chapel-Memorial on Alabama Highway 77..0

A Solution For Diabetes: A Vegan Diet

I've been researching the most common and devastating diseases Americans are dealing with, with the aim of finding a common thread running throughout both cause and reversal. As it is now, one out of every two of us will get cancer or heart disease, and one out of every three children born after the year 2000 will be diagnosed with type 2 diabetes. These are devastating diseases, certainly to those who are burdened by them, but also to a health care system that is struggling to keep up.

The extraordinary doctors and nutritional scientists I've spoken with seem to be saying - and saying fervently - the same thing:a diet high in animal protein is disastrous to our health, while a plant-based (vegan) diet prevents disease and is restorative to our health. And they say this with peer-reviewed (the gold standard of studies) science to back them up. Even the very conservative ADA (American Dietetic Association) says: "Vegetarian diets are often associated with a number of health advantages, including lower blood cholesterol levels, lower risk of heart disease, lower blood pressure levels, and lower risk of hypertension and type 2 diabetes. Vegetarians tend to have a lower body mass index (BMI) and lower overall cancer rates."

Diabetes does not just mean you take a pill or injection every day. It means you can lose a decade of life. And you while you inch toward that uncomfortable end, you deal with an increased risk of heart attack, blindness, amputation, and loss of kidney function. It's a very serious disease. The good news is that diabetes can be halted and reversed in a very short time through some diet modifications.

To understand diabetes better, and to learn how to reverse it, I've talked with Dr. Neal Barnard, president of The Physician's Committee for Responsible Medicine. He is an adjunct associate professor of medicine at the George Washington University School of Medicine, and the author of numerous scientific articles in leading peer-reviewed journals, and a frequent lecturer at the American Diabetes Association's scientific sessions. His diabetes research was funded by the National Institutes of Health, the U.S. Government's research branch. He is also the author of Dr. Neal Barnard's Program for Reversing Diabetes.

KF: Why is type 2 diabetes suddenly so prevalent?

NB: Diets are changing, not just in the U.S., but worldwide. Diabetes seems to follow the spread of meaty, high-fat, high-calorie diets. In Japan, for example, the traditional rice-based diet kept the population generally healthy and thin for many centuries. Up until 1980, only 1-5% of Japanese adults over age 40 had diabetes. Starting around that time, however, the rapid westernization of the diet meant that meat, milk, cheese, and sodas became fashionable. Waistlines expanded, and, by 1990, diabetes prevalence in Japan had climbed to 11-12%.

The same sort of trend has occurred in the U.S. Over the last century, per capita meat consumption increased from about 150 pounds per year (which was already very high, compared with other countries) in the early 1900s to over 200 pounds today. In other words, the average American now eats 50 pounds more meat every year, compared with a century ago. In the same interval, cheese intake soared from less than 4 pounds per person per year to about 32 pounds today. Sugar intake has gone up, too, by about 30 pounds per person per year. Where are we putting all that extra meat, cheese, and sugar? It contributes to body fat, of course, and diabetes follows. Today, about 13% of the U.S. adult population has type 2 diabetes, although many of them are not yet aware they have it.

KF: What causes diabetes?

NB: Normally, the cells of the body use the simple sugar glucoseas fuel, the way a car uses gasoline. Glucose comes from starchy or sweet foods we eat, and the hormone insulin escorts it into the muscle cells to power our movements. Glucose also passes into our brain cells to power our thoughts. In type 2 diabetes, the cells resist insulin's action, so glucose has trouble getting into the cells.

KF: What happens to the body when one develops diabetes? What's the fallout?

NB: If glucose can't get into the cells, it builds up in the blood. It is as if gasoline coming out of a gas pump somehow can't get into your gas tank, and it ends up spilling over the side of your car, coming in through your car windows, and dribbling all over the pavement. It is a dangerous situation. The abnormally high levels of glucose circulating in the bloodstream are toxic to the blood vessels, especially the tiny blood vessels of the eyes, the kidneys, the extremities, and the heart.

KF: Is it really that serious, or can we just take a drug for it?

NB: A person with diabetes loses more than a decade of life, on average; about three-quarters will die prematurely of a heart attack. It is also a leading cause of blindness, amputations, and loss of kidney function. Many drugs are available, from insulin to oral medications and an ever-increasing variety of other medications. In order to protect the heart, many patients are also put on medications to lower cholesterol and blood pressure. A person with diabetes who walks into my office is typically using $3,000 to $5,000 worth of medications each year. And yet these medications only slow the progression of the disease; many people have serious complications despite being on medications.

Treating diabetes can benefit baby, mom

NEW YORK (AP) — Treating even mild diabetes that develops during pregnancy helps keep moms and babies from gaining too much weight and makes for easier deliveries, new research shows.

Pregnant women in the U.S. are routinely tested and treated for high blood sugar levels, although it hasn’t been clear whether treating the mildest cases really benefited them and their infants.

In a study of 950 women, those with mild gestational diabetes who were treated had fewer overly large babies, fewer cesarean sections and fewer pregnancy complications, compared to women who didn’t have their diabetes treated.

“There is every reason to fully treat women with even the mildest (gestational diabetes) based on our results,” said the study’s leader, Dr. Mark Landon of Ohio State University Medical Center in Columbus.

Gestational diabetes begins during pregnancy and usually goes away after childbirth. It affects as many as one in seven pregnant women, depending on the population. The mother’s elevated blood sugar can cause the fetus to grow too large, sometimes requiring a C-section and can bring on other health problems for the mother and baby.

Risk factors include being over 25, being obese and a family history of diabetes.

Medical groups support testing pregnant women for the condition and treatment, although the U.S. Preventive Services Task Force, a government health panel, said last year there wasn’t enough evidence to recommend screening.

For the government-funded study, 958 women with mild gestational diabetes were recruited at 15 medical centers. They got diabetes treatment or standard prenatal care. Treatment included diet counseling and insulin if it was needed to control their blood sugar.

In the treatment group, there were fewer babies of unusually large size (7 percent vs. 15 percent in the untreated group) and fewer babies weighed more than about 9 pounds (6 percent vs. 14 percent). On average, the treated women gained 5 fewer pounds after their diagnosis than the untreated ones.

There were also fewer C-sections and cases of preeclampsia, a serious pregnancy complication. There were no deaths in either group, and no difference in other birth-related complications.

Landon noted that a “remarkable” 93 percent of the women in the treatment group kept their blood sugar under control with diet alone; only 7 percent needed insulin.

The findings are reported in Thursday’s New England Journal of Medicine.

Dr. David A. Sacks of Kaiser Foundation Hospital in Bellflower, Calif., said switching to a healthier diet could help other pregnant women limit weight gain, too. More large babies are born to overweight or obese women who don’t have diabetes, he said.

“This is a real easy therapy to apply to every single pregnant lady,” said Sacks, who wrote an editorial about the study in the journal.

Even before she got pregnant, Lorenda Donaugh knew all about gestational diabetes. She works with Landon at Ohio State, doing ultrasounds for his patients, and ended up becoming one after she was diagnosed at 28 weeks with a mild case.

“I knew it was going to be hard work. It takes a lot of time and planning,” said the 27-year-old, who lives in the Columbus suburb of Westerville.

Donaugh, who was not part of the study, monitored her blood sugar several times a day, modified her diet and took extra walks. She eventually took a diabetes medication.

Planning meals and cutting back on sugar was the hardest part, she said. Whenever she was tempted, she thought of her baby. “Being pregnant, you have all those cravings, but you still have to limit that food,” she said.

The work paid off. She delivered a healthy daughter on Sept. 14. Adelynn weighed 6 pounds, 4 ounces and her mom had only gained a modest 22 pounds.

McLeod Medical Center Darlington offering diabetes education classes

McLeod Medical Center Darlington is offering a series of diabetes education classes to the public during the month of October.

The free diabetes self-management program will be taught by a Certified Diabetes Educator from the McLeod Diabetes Center and will teach participants diabetes self-management skills as recommended by the American Diabetes Association.

The four-course series includes Overview of Diabetes and Stress Management, Friday; Monitoring and Prevention of Diabetes Complications, Oct. 9; Diabetes Medications and Exercise Guidelines, Oct. 16; and Diabetes Meal Planning, Oct. 23.

Each class will be from 9 to 11 a.m. in the McLeod Medical Center Darlington Resource Center, located behind McLeod Medical Center Darlington at 701 Cashua Ferry Road, Darlington. Participants should plan to attend all four classes.

Martha Lee of Hartsville went through the series in April. She has been living with diabetes for more than 20 years, but was amazed that she learned new tips to help her manage her diabetes with more ease.

“I learned a lot not only from the McLeod Diabetes Center educators, but from the other participants as well,” she said in a McLeod Health press release.

Lee said the educators taught the material in a way that was easy to understand and remember. She still is following the guidelines and recommendations today, nearly six months later.

Lee said she wanted to take education classes at the McLeod Diabetes Center in Florence, and when she heard about the Darlington series, she signed up immediately because of the convenience of the location and the proximity to her home.

The McLeod Diabetes Center has been recognized by the American Association of Diabetes Educators, the American Diabetes Association and the Diabetes Initiative of South Carolina for meeting national and state standards of diabetes education.

Call McLeod Reservations and Scheduling at (843) 777-2095 to register. Space is limited.

Four tips to prevent diabetes

While one in 13 Americans have it, type 2 diabetes may be one of the most preventable diseases afflicting the country.

A vigorous exercise program and controlling weight can prevent or even cure it.

But the kinds of things a person eats also may play a role, according to a report from the Harvard Medical School.

The tips include:

*Eating lots of fiber. A diet rich in whole grains can reduce the risk of developing type 2 diabetes by 40%, compared with eating a low amount of fiber.

*Drinking coffee, decaf or regular. One cup a day lowers the risk by 13% and two to three cups by 43%, compared with drinking no coffee.

*Moderate alcohol. Men who consumed two to four drinks a week lowered their risk by 26%; five to six drinks by 33%; and one or more drinks a day by 43%.

*Get nutty. Women who ate nuts or peanut buttter at least five times a week lowered their risk by 20% to 30%, compared with women who rarely ate nuts.

Diabetes Signs – How to Decide If You Have Diabetes Symptoms

Medical has always been and always will be an important concern for every of us. Taking correct treatment for our bodies enables us to live longer, happier, plus fulfilled lives. We take in vitamins, minerals plus many other supplements that lead us to such goal. However, certain diseases enter our bodies without us even having a clue. Before we identify it, we’re suffering from such nasty plus sometimes incurable infection. Thus it is fundamental to be aware of the signs plus symptoms that come from the various viruses out here, including the infamous diabetes. Looking out for diabetes signs might come in totally handy and possibly will as healthy save your life.
Diabetes has been one of the diseases of the human body that has certain peculiar characteristics. One of which is its capability to develop symptoms showing out from our bodies in a quick and utterly rapid way. These diabetes signs possibly will show up in merely a course of weeks or days usually in children and adolescents.
One of the most conventional signs of diabetes would be the urge to urinate constantly. Somehow it is totally simple to spot this kind of sign. You only require to ask yourself, “Am I visiting the bathroom to urinate additional continually?” If the answer is yes, then you ought to be in the look out for a quantity of other symptoms of having diabetes. Frequent urination is caused due to increased levels of glucose in your blood. In short, having lesser glucose in the blood would likely lead to let your bladder think full plus thus keeps you having the urge to urinate often.
Diverse sign to look out for is having that unquenchable thirst. If you are feeling like you cannot get sufficient of drinking water and still feel that you are thirst, then this can healthy be special sign of diabetes. Your body has been getting more water out of your blood plus you have been urinating often. Such will lead you to dehydration. Thus explains the require to quench your thirst by drinking additional water.
Feeling weak may well explain the require of insulin from our body. Insulin helps the glucose to reach out to our cells so that we will be replenished including energy. If such important element is gone, then it clearly elucidates our being tired plus weak.
These are only a quantity of of the diabetes signs that we all should be alert of. If you happen to notice a few, don’t hesitate to be checked by your physician. It’s improved to be safe than sorry.

New Sign of Diabetes Risk

SHBG Level -- And Genes That Control It -- Mark Type 2 Diabetes Risk

Sept. 16, 2009 - A new blood test strongly predicts risk of type 2 diabetes.

The test looks at sex hormone-binding globulin or SHBG. Once considered merely a way for the body to store extra sex hormone, SHBG now appears to be a player in a number of body functions.

Protection against type 2 diabetes -- or susceptibility to it -- appears to be one of them.

People with the lowest SHBG levels have a tenfold higher risk of type 2 diabetes than those with the highest SHBG levels.

"Sex hormone-binding globulin may have a causal role in the risk of type 2 diabetes," conclude Eric L. Ding, ScD, of the Harvard School of Public Health, and colleagues.

Ding and colleagues looked at data collected during the Women's Health Study from healthy, postmenopausal female health professionals who did not receive hormone therapy. Over the course of the study, 359 of these women developed type 2 diabetes. They were compared to 359 study participants who did not develop diabetes.

After accounting for diabetes risk factors -- including weight and waist size -- Ding's team found that SHBG levels were strongly linked to diabetes risk. Women with the lowest SHBG levels were much more likely to have diabetes than those with higher SHBG levels.

To validate the finding, the researchers repeated the study in men enrolled in the Physicians' Health Study, comparing 170 men who developed diabetes during the study to 170 matched men who did not.

The results in men were virtually the same as those in women.

Moreover, Ding and colleagues found that men and women with a gene variant called rs6259 had 10% higher SHBG levels than those without it. And those with a gene variant called rs6257 had 10% lower SHBG levels.

People with the SHBG-raising gene were less likely to have diabetes; people with the SHBG-lowering gene were more likely to have diabetes.

The researchers suggest that a person's SHBG level may be an important factor in determining type 2 diabetes risk and the need for early treatment.

Early Warning for a Deadly Kidney Disease

Carol Johnson, an otherwise healthy woman in her 60s, was at her wits’ end. Despite a good diet and regular exercise, she was gaining weight — 20-plus pounds. Her blood pressure was too high, even though she was taking three drugs for it. And she didn’t feel well.




This week Dr. Leslie Spry of the National Kidney Foundation joins the Consults blog to answer readers’ questions about kidney disease.
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Since 2005, two doctors had told her she had a high blood level of creatinine, a product of muscle breakdown that can suggest abnormal kidney function. Yet neither doctor could figure out why. Even repeated kidney infections failed to alert her current doctor to the real problem.

Then, in March 2008, Mrs. Johnson, a retired special-education teacher living in Independence, Mo., noticed an advertisement for a free screening test offered by the National Kidney Foundation.

The test, part of a nationwide program called KEEP (for Kidney Early Evaluation Program), can serve as an early warning sign for a disease that often shows no symptoms until patients are on the verge of kidney failure. It uses a formula to convert the creatinine reading to a better measure of how well the kidneys are filtering wastes from the blood — the EGFR, or estimated glomerular filtration rate. (The precise rate, called the GFR, is measured by a much more involved test.)

Mrs. Johnson’s EGFR was 49, well below the normal reading of 90 or above and a sign that she had chronic kidney disease. Suspecting that she was taking more medication than her kidneys could handle, her doctor stopped two of them.

And using information she found on the Web, Mrs. Johnson made some changes on her own. She cut out red meat, colas and sweets. She started eating still more vegetables and whole grains. And she kept to her daily exercise program, alternating among a gym workout, water aerobics and brisk walking.

Within six months Mrs. Johnson, now 67, had lost the extra weight, and her blood pressure and EGFR were normal. “If not for going to KEEP and finding out what was really wrong,” she said in an interview, “I would have accepted the fact that nothing more could be done.”
Multibillion-Dollar Problem

Like many other Americans with chronic kidney disease, Mrs. Johnson might have ended up with a heart attack or stroke, bone disease or kidney failure. Once kidneys fail, patients must undergo regular dialysis or have a kidney transplant, procedures that add billions of dollars to the nation’s health care costs.

The kidney foundation undertook the KEEP program nine years ago because family doctors and internists often fail to order an EGFR when performing routine blood tests on patients at risk for kidney disease — even, as happened to Mrs. Johnson, when there are hints of kidney malfunction.

Fully half of the first 11,000 people whose blood and urine were tested in the KEEP program had evidence of kidney disease, but only 3 percent of them knew that before being screened.

Belgian nephrologists writing in The Mayo Clinic Proceedings in 2006 reported that physicians were often unaware of the severity of kidney malfunction because they relied solely on a creatinine measure. They noted that as many as four out of five patients with chronic kidney disease were referred to a specialist for treatment late in the disease, within six months of needing dialysis or a transplant.

According to the latest national surveys, 26 million Americans have chronic kidney disease, and the numbers rise daily as more people become overweight and develop diabetes or high blood pressure, the two leading causes of kidney malfunction.

The KEEP program, which has so far examined more than 130,000 participants, screens adults with the most common risk factors for chronic kidney disease — diabetes, high blood pressure or a family history of kidney disease.

To find nearby upcoming screenings, go to www.kidney.org and click on the “Get Tested” box, or call the foundation at (800) 622-9010.

Follow-up surveys of 72,000 people who have taken advantage of the free community-based screenings indicate that the test has prompted many to take action, like seeing a physician, adjusting their diets and doing more to control their blood pressure and diabetes.

Constellation of Risks

Chronic kidney disease is a life-threatening condition even for the young and middle-aged. Men under 55 and women under 65 identified through the KEEP program as having chronic kidney disease had twice the risk of heart attack or stroke, and four times the risk of dying, as those free of the disease, according to a study led by Dr. Peter A. McCullough of the William Beaumont Hospital in Royal Oak, Mich.

Dr. McCullough explained that kidney damage caused biological changes that accelerated injury to blood vessels throughout the body. He urged that all adults at risk for kidney disease, including smokers, be routinely checked for protein in their urine and reduced kidney function. Those found to have a kidney problem should also be tested for abnormalities that can result in bone disease or calcium deposits in blood vessels, he said.

Dr. Joseph A. Vassalotti, chief medical officer of the kidney foundation, said that in addition to the leading risk factors, many other conditions could increase the risk for chronic kidney disease. Among them are heart disease, lupus, amyloidosis (a buildup of amyloid proteins in the body), chronic kidney infection, polycystic kidney disease, hepatitis B or C, and multiple myeloma.

In addition, kidney damage can result from overuse of corticosteroids or of nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen, from excessive cola consumption and from exposure to certain environmental toxins and radiological materials like barium.

The risk of developing kidney failure is also higher among Hispanics, African-Americans and American Indians than other ethnic groups, partly because of higher rates of high blood pressure and diabetes and poorer access to medical care.

As with Mrs. Johnson, if kidney problems are caught early and their underlying cause is corrected or properly treated, kidney damage and other complications can be slowed or halted, and sometimes even reversed.

As Sally Burrows-Hudson, a registered nurse in Sunnyvale, Calif., and a specialist in kidney disease, wrote in The American Journal of Nursing, “When patients at risk for chronic kidney disease are identified early and treated aggressively, the disease progression can be slowed or stopped, complications can be prevented or controlled, and clinical outcomes can be favorable.”

Biocon, US firm to jointly make drug for diabetes

Bangalore, Sep 11 (IANS) India’s biotech major Biocon Friday entered into a strategic tie-up with the US-based Amylin Pharmaceuticals to jointly produce a peptide hybrid molecule for treating diabetes.

As part of the tie-up, the two firms will collaborate to develop the therapeutic compound and share the development costs, Biocon said in a statement here.

The research will centre on Amylin’s “phybrid” technology that combines two peptide hormones into a single molecule entity.

Biocon will utilise its expertise in recombinant microbial expression to produce the compound and leverage its experience in pre-clinical and clinical development of diabetes products.

According to Biocon chairman and managing director Kiran Mazumdar-Shaw, the agreement leverages the synergistic capabilities of the two companies.

“Amylin’s knowledge of peptide therapeutics and its leadership in the diabetes market, paired with our capabilities in process development, manufacturing and clinical development, provides ample scope to bring a novel therapy to diabetics,” Shaw said in the statement.

Amylin chief executive Daniel M. Bradbury said the tie-up would lead to cutting-edge peptide science to provide relief diabetic patients.

Based in San Diego, California, the 22-year-old Amylin is engaged in the discovery, development and commercialisation of drugs for treating diabetes, obesity and other diseases.

Par Pharma Gets FDA Approval To Market Diabetes Drug Nateglinide

Par Pharmaceutical Companies, Inc. (PRX: News ) said it received a final approval from the U.S. Food and Drug Administration to market nateglinide tablets, a drug indicated in the treatment of type II diabetes.

Nateglinide tablets are indicated as an adjunct to diet and exercise to improve glycemic control in adults with Type II diabetes mellitus. Nateglinide is a generic version of Novartis' Starlix. It is estimated that Starlix has annual U.S. sales of approximately $124 million, according to IMS Health data.

Par will begin shipping the 60mg and 120mg strengths of nateglinide immediately.

Nateglinide lowers blood glucose by stimulating the release of insulin from the pancreas. It achieves this by closing ATP-dependent potassium channels in the membrane of the beta cells. This depolarizes the beta cells and causes voltage-gated calcium channels to open. The resulting calcium influx induces fusion of insulin-containing vesicles with the cell membrane, and insulin secretion occurs.

Nateglinide tablets are contraindicated in patients with known hypersensitivity to the drug or its inactive ingredients.

PRX is currently trading at $21.58, up $0.39 or 1.84%, on a volume of 0.737 million shares on the NYSE.

Teaching teachers about diabetes

New school year means new teachers to train about your child's diabetic condition

CORPUS CHRISTI — A new school year is beginning. But for parents of diabetic students, it may mean a new teacher or school nurse to train about their child’s diabetes.

Proper diabetes management at school is one of the top concerns of any parent. Multiple insulin injection therapies, frequent blood sugar checks and insulin pumps place a greater demand on the diabetes knowledge and skills of school personnel.

The parent of the diabetic student must be patient with new teachers and nurses and not expect them to be experts in diabetes care. A calm and methodical approach by parents is the best strategy.

Each diabetic student should have an individual care plan that is written down by the parents and signed off by the student’s diabetes doctor. Parents should get school order forms from their diabetes doctor before school starts.

Federal and state laws protect the rights of diabetic students today. There is a school bill of rights for the student with diabetes that every parent should know. The school is obligated to respect and support these rights. Most schools strive to do the best job possible.

I suggest parents meet with the school staff to open a positive line of communication. I always suggest a face-to-face meeting early in the school year to answer questions from both sides.

Good diabetes care requires the student to perform certain duties and tasks daily. This includes having the right to perform blood sugar monitoring in the school whenever it’s necessary, even in the classroom. The student must be allowed to take bathroom breaks and have access to drinking water whenever needed. If extra insulin is needed, the student should be allowed the ability to administer the insulin without delay and should not be restricted to a designated area.

If a diabetic student’s blood sugar is low, he or she should not be sent to the nurse’s office unattended. The sugar level could worsen and result in a loss of consciousness or seizure. Teachers should keep fast acting sugar in their desk as an emergency treatment.

The school lunchroom must provide adequate time for the student to eat their designated meal plan. Morning or afternoon snacks also should never be denied if they are part of the student’s care plan. Food or snacks should never be denied based on high blood sugars.

Coaches may not realize that the diabetic student can participate in any activity he or she is physically fit and able to qualify for. Every professional sport from baseball to soccer can boast of diabetics with significant accomplishments.

Field trips are also not to be withheld simply because of diabetes. Snacks and other medical supplies will be needed, plus a knowledgeable school staff member (or parent) should be in attendance.

One common problem I still see is sending a student home for a low or high blood sugar reading in the absence of an illness. Swings in blood sugar are part of the condition. School staff must know proper management of these events and avoid overreacting.

Dr. Stephen Ponder, who has type 1 diabetes, has been a pediatric endocrinologist for 20 years. He is director of the Children’s Diabetes and Endocrine Center of South Texas at Driscoll Children’s Hospital. Contact him at 694-4864 or stephen.ponder@dchstx.org or follow him on Twitter at twitter.com/dr_steve_ponder

Insulin stolen in U.S. linked to health problems

The FDA has received reports of patients who suffered unsafe blood-sugar levels after using a vial from one of the stolen lots of Levemir insulin.(Courtesy FDA)

People with diabetes should avoid using certain vials of insulin made by Novo Nordisk that were stolen earlier this year and have been linked to unsafe blood-sugar levels, U.S. regulators said Wednesday.

The U.S. Food and Drug Administration said in June that three lots of Novo Nordisk's Levemir insulin were stolen in North Carolina. Since then, the FDA has received three reports of patients who suffered unsafe blood-sugar levels after using a vial from one of the stolen lots.

Health Canada also advised consumers in June not to use lot numbers:

• XZF0036.
• XZF0037.
• XZF0038.

"Evidence gathered to date suggests that the stolen insulin was not stored and handled properly, and may be dangerous for people to use," the FDA said in a release.

Only about two per cent of the 129,000 affected vials have been returned, the FDA said.

Not authorized for sale in Canada

Levemir insulin is used to treat Type 1 diabetes in adults and children, and Type 2 diabetes in adults who need long-acting insulin to control high blood sugar. It is given by injection and comes in 10-ml vials.

The products are not authorized for sale in Canada and have not been found for sale in the Canadian marketplace, but travellers may have bought them in the U.S. or over the internet, Health Canada said.

Canadians with the product are advised not to use it, and check with their health-care professional if they have any concerns.

A spokesperson for Health Canada said Wednesday no additional information was available, and that the department will provide an update if required.

The FDA advised patients to replace vials from the three lots with a vial of Levemir from another lot. The lot numbers are found on the side of the box of insulin and also on the side of the vial.

"If you must switch to another brand of insulin for any reason, first contact your health care provider because another insulin product may require adjustments in dosing," the FDA said Wednesday.

People should always look at their insulin carefully before using it, the FDA said, noting levemir is a clear and colorless solution.

The FDA continues to investigate the theft.

A spokesperson from Novo Nordisk's U.S. headquarters in Princeton, N.J., said the company is cooperating with the FDA. The company is based in Denmark.

With files from The Associated Press

Causes of Diabetes

Diabetes mellitus occurs when the pancreas doesn't make enough or any of the hormone insulin, or when the insulin produced doesn't work effectively. In diabetes, this causes the level of glucose in the blood to be too high.

In Type 1 diabetes the cells in the pancreas that make insulin are destroyed, causing a severe lack of insulin. This is thought to be the result of the body attacking and destroying its own cells in the pancreas - known as an autoimmune reaction.

It's not clear why this happens, but a number of explanations and possible triggers of this reaction have been proposed. These include:

• infection with a specific virus or bacteria;
• exposure to food-borne chemical toxins; and
• exposure as a very young infant to cow's milk, where an as yet unidentified component of this triggers the autoimmune reaction in the body.

However, these are only hypotheses and are by no means proven causes.

Type 2 diabetes is believed to develop when:

• the receptors on cells in the body that normally respond to the action of insulin fail to be stimulated by it - this is known as insulin resistance. In response to this more insulin may be produced, and this over-production exhausts the insulin-manufacturing cells in the pancreas;
• there is simply insufficient insulin available; and
• the insulin that is available may be abnormal and therefore doesn't work properly.

The following risk factors increase the chances of someone developing Type 2 diabetes:

• Increasing age;
• obesity; and
• physical inactivity.

Rarer causes of diabetes include:

• Certain medicines;
• pregnancy (gestational diabetes); and
• any illness or disease that damages the pancreas and affects its ability to produce insulin e.g. pancreatitis.

What doesn't cause diabetes

It's important to also be aware of the different myths that over the years have arisen about the causes of diabetes.

Eating sweets or the wrong kind of food does not cause diabetes. However, it may cause obesity and this is associated with people developing Type 2 diabetes.

Stress does not cause diabetes, although it may be a trigger for the body turning on itself as in the case of Type 1 diabetes. It does, however, make the symptoms worse for those who already have diabetes.

Diabetes is not contagious. Someone with diabetes cannot pass it on to anyone else.

(by Dr. Rob Hicks)

Diabetes News: Finding the Causes of Diabetes, Medicinal Herbs Used in China Are Shown to Lower Glucose Levels. Please also read Yu Xiao San 8805 on Type I and Type II Diabetes and Hypoglycemic Effects of Selected Ingredients

Causes of Diabetes

Drugs such as steroids, Dilantin, and others may elevate the blood sugar through a variety of mechanisms. Certain other drugs, such as alloxan, streptozocin, and thiazide diuretics, are toxic to the beta cells of the pancreas and can cause diabetes. Certain syndromes (for example, Prader-Willi, Down's, Progeria, and Turner's) may result in a hyperglycemic state; if this state is prolonged, the result can be permanent diabetes.

Diabetes resulting in an insulin-dependent state is classified as Type 1 diabetes. While Type 1 diabetes affects only between 5 to10 percent of the diabetic population, its effects on the body can be worse than other forms of diabetes. In the past, Type 1 has been known as juvenile or juvenile-onset diabetes (because it is usually diagnosed in those under thirty), brittle diabetes, unstable diabetes, and ketosis-prone diabetes. People in this classification more frequently exhibit the classic symptoms, usually with ketones present in blood and urine. A blood-sugar level of 800 mg/dl (44 mmol) or more, especially if ketones are not present, indicates a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome (a state in which the body is extremely dry (dehydrated), the chemicals in the body are concentrated, and the blood sugar is high).

As stated before, diabetes is a syndrome or group of diseases (rather than one disease), leading to the prolonged hyperglycemic state. Type 1 is most associated with the killing of the beta cells, most likely by the body's own immune system. Either the immune system cannot kill an infecting agent, which then kills the beta cells, or the immune system itself goes "wild," attacking the body's own tissue and destroying the beta cells. The cells of the islets of Langerhans are inflamed, resulting from an infectious-disease process (for example, mumps) or, more commonly, from an autoimmune (allergic to self) response.

The autoimmune process results in the circulation of antibodies that may either cause or be caused by beta-cell death. If it is found that the antibodies cause beta-cell destruction (the body fighting what it now considers foreign to itself), the body's response to the Type 1 diabetes is much less severe (i.e., easier to control) with treatment. Until then, the outcome is a lack of available insulin. While the onset is said to be sudden, changes resulting in decreased insulin availability may have occurred over a longer period of time. In short, insulin-dependent diabetes mellitus is an inherited defect of the body's immune system, resulting in destruction of the insulin-producing beta cells of the pancreas.

Heredity is a major cause of diabetes. If both parents have Type 2 diabetes, there is a chance that nearly all of their children will have diabetes. If both parents have Type 1 diabetes, fewer than 20 percent of their children will develop Type 1 diabetes. In identical twins, if one twin develops Type 2 diabetes, the chance is nearly 100 percent that the other twin will also develop it. In Type 1 diabetes, however, only 40 to 50 percent of the second twins will develop the disease, indicating that while inheritance is important, environmental factors (for example, too much food, too much stress, viral infection, and so forth) are also involved in the development of Type 1 diabetes.

(by Diana W. Guthrie, R.N., Ph.D., and Richard A. Guthrie, M.D.)

See also

Diabetes Information
Diabetes Treatment Using Alternative Medicines

'Stress, wrong eating habits cause diabetes'

Allahabad: The quarterly programme of Diabetes Education Forum (DEF) was held here on Saturday. Renowned doctors from all over the country delivered lecture on diabetes.

The programme was inaugurated by MLN Medical College principal Dr P C Saxena. Chief guest and president of DEF Dr D K Hazra focussed on the prevention of diabetes. He said that stress, sleeplessness and wrong eating habits may cause diabetes. Mustard, olive and peanut oil are beneficial, he added.

Professor of physiology in CSMMU Lucknow, Dr N S Verma clarified the widely prevalent myths about diabetes. President of Kanpur Diabetes Forum Dr Brij Mohan said a diabetic patient has 3-4 per cent higher chances of suffering from heart ailments.

Secretary of UP Diabetes Association Dr Anuj Maheshwary discussed the various kidney related complications of diabetes. Consultant physician from Aligarh Dr Praveen Varshney spoke on management of diabetes with insulin. The programme was organised by endocrinologist, director professor and head of medicine, MLN Medical College and president of UP Diabetes Association Dr Sarita Bajaj. The programme was conducted by Dr Shanti Chaudhri.

Diabetes Drug Raises Heart Risk

This WisdomCard features top online resources on this topic

A recent study confirms that Avandia (rosiglitazone) is linked with an increased risk of heart failure and death. Avandia is used to control blood sugar levels in those withtype 2 diabetes. Researchers feel that there is no justification for using Avandia over another drug calledpioglitazone.¹

Fast Facts:

• For every 93 patients using rosiglitazone, it is estimated that there will be one extra cardiovascular death each year.²
• Data from around 40,000 patient records was used for this study.²
• This study is published in the August 2009 BMJ.

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The Top 10 Resources on Diabetes Drug Raises Heart Risk

Selected by our Guides and Physician Review Team

1. Medical News Today: A Drug Used To Treat Type 2 Diabetes Is Associated To Increased Risk Of Heart Failure (Aug. 19, 2009)
2. Bloomberg: Glaxo’s Avandia Has More Heart Risks Than Actos, Study Finds (Aug. 19, 2009)
3. Medpage Today: No Cardiovascular Class Effect with Thiazolidinediones (Aug. 19, 2009)
4. Press Association: Diabetes Drug Raises Heart Risk(Aug. 19, 2009)
5. Reuters: Glaxo's Avandia Riskier Than Takeda Drug(Aug. 19, 2009)
6. CTV: Actos Safer for Heart Than Avandia, Study Suggests (Aug. 18, 2009)
7. Vancouver Sun: Diabetes Drug Could Lead to Heart Failure (Aug. 18, 2009)

Exercise helps protect against type 2 diabetes - even in old age

Diabetes specialist Nicolas Musi, M.D., associate professor in the School of Medicine at The University of Texas Health Science Center at San Antonio, said that whether a person is 8 years old or 88, exercise helps protect against type 2 diabetes.

It does this, in part, by revving up the function of small structures called mitochondria, which are found inside cells.

Musi studied the effects of exercise on 100 muscle biopsy specimens and is documenting how exercise affects the mitochondria. Mitochondria function as "energy factories" by taking up different nutrients and converting them into energy.

"With age, there is a decline in the number and function of the mitochondria. We did an exercise intervention in older individuals and noticed that physical activity improves mitochondrial function substantially in people over 65," Musi said.

"While the benefits are related to the amount of exercise, in general, any amount of exercise is better than none.

"Even small amounts of exercise can confer benefits. However, it is important to design an exercise program that will not cause harm, particularly in older persons or those compromised by conditions such as heart disease. If an older person has not done regular exercise for several years, it is best to begin a new exercise program under the supervision of a physician or certified trainer," Musi added.

Age-related decline in the number of mitochondria contributes to type 2 diabetes, but exercise can reverse it.

"Older patients have a high incidence of diabetes and pre-diabetes, but respond very well to exercise. We are investigating how physical activity can prevent diabetes in people who have pre-diabetes," Musi said.

Musi said that with exercise, the muscle becomes more efficient at burning sugars and fats.

Scientists don’t know why, but one hypothesis is that exercise activates an enzyme called AMP kinase. This enzyme monitors energy levels and maintains normal levels of energy in cells. (ANI)