Sue Marshall blogs about diabetes for Desang

Texas Researcher Poised to Test Leptin as a Replacement for Insulin Among Type 1s

April 23, 2010
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After mice “thrived” on the insulin-free regimen the hormone leptin offered, researchers are now ready to test the response on humans…

A University of Texas researcher who genetically modified mice with type 1 diabetes to control their disease with leptin instead of insulin is now ready to extend his experiment to human test subjects. Dr. Roger Unger, a researcher at the UT Southwestern Medical School in Dallas, will begin the tests as soon as leptin manufacturers can assure him of a steady supply of the hormone.

While other studies have indicated that the hormone may help control blood sugar levels, Unger and his associates were the first to experiment with leptin as a monotherapy in diabetes.

In his paper, “Leptin monotherapy in insulin dependent type 1 diabetes,” just published in the Proceedings of the National Academy of Sciences, Unger details how his team initially genetically modified diabetic mice to produce extra quantities of leptin. The mice were then taken off insulin and left to rely solely on leptin to control their blood sugar levels.

Unger reports that the mice thrived on the insulin-free regimen. Because genetic manipulation is not an option in human test subjects, the next step was to treat diabetic mice that had not been genetically altered with pump-delivered injections of leptin. Unger reports that those mice, too, did well despite the absence of insulin.

One reason for Unger’s desire to see if leptin can be a viable alternative to insulin is concern about the side effects produced by the typically large doses of insulin that most people with type 1 diabetes have to take. Among them are large fluctuations in blood sugar levels and possible long-term ill effects on blood vessels. In his experiments with leptin, Unger found that only low doses of the hormone were needed to maintain stable blood sugar levels.

Even as he undertakes tests with human subjects, Unger agrees with other diabetes experts that there is still a long way to go before leptin could be recommended as an alternative diabetes therapy. One important question the research may help answer is why leptin mimics insulin’s ability to deliver sugar to muscles and fat cells.

In comments on his paper, Dr. Barbara Kahn, a diabetes expert at Harvard Medical School and chief of endocrinology at Beth Israel Deaconess Medical Center in Boston, said that Unger’s research will have to address several other crucial questions:

  • Mouse and human eating patterns are very different. Mice graze constantly on food that takes a long time to digest, while humans eat several meals a day. Can leptin, which can maintain constant blood sugar levels in animals whose eating patterns do not create wide swings in the first place, work in humans, whose eating patterns invite such swings?
  • Unger’s mice had to be genetically altered to produce leptin, whereas most people with type 1 diabetes already produce normal amounts of leptin. What side effects might be created if the amount of leptin in their systems is increased?
  • Will leptin make it harder for type 1s to tell if they are having a hypoglycemic episode?

Whatever answers Unger’s further research delivers, they probably won’t help people with type 2 diabetes, who are resistant to both insulin and leptin.

via: Texas Researcher Poised to Test Leptin as a Replacement for Insulin Among Type 1s

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China Takes Over as Diabetes Capital of the World

April 22, 2010
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The BBC recently reported China as the diebetes capital of the world…

One in 10 adults in China, or approximately 92 million people, has Type 2 diabetes, making the country the new diabetes capital of the world, according to a recent report. India was previously thought to have the highest number of diabetics in the population, according to a recent article from the BBC.

The majority of the cases in China remain undiagnosed. The report notes that there is an estimated additional 150 million with pre diabetes. A similar percentage of people in the U.S. have diabetes, but China has a much greater overall population, leading to the higher overall number of people with diabetes. A study last year notes that more than 60% of the global cases of diabetes would occur in Asia.

Researchers suggest that the urbanization and improvements in lifestyle in China have contributed the growing number of cases.

via: China Takes Over as Diabetes Capital of the World


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Weight Loss Surgery Can Lead To Psychological Distress

April 21, 2010
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Gastric banding is an extreme solution at best, but for some people with obesity and diabetes it’s available.

People who have gastric band surgery to lose weight are at risk of low self-esteem, relationship problems and being dissatisfied with their body image, according to new research being presented at the Diabetes UK Annual Professional Conference (APC) today.

Researchers from the University of the West of England and Southmead Hospital, Bristol, followed 25 patients, aged from 30 to 58 years, and recorded their experience 12 months after receiving a post-laparoscopic gastric banding operation. 64 per cent of the participants had Type 2 diabetes.

Although the people who took part in the study reported significant health benefits such as improved blood glucose levels and lower cholesterol and blood pressure levels, they also found that living with the gastric band had a strong, negative psychological impact on their daily lives. The majority reported that having a gastric band was as hard as having to diet and that losing the opportunity to eat as a coping strategy left them struggling to deal with distressing life events.

Lead researcher Dr Andrew Johnson from Southmead Hospital said: “Our findings show that having a gastric band fitted should not be seen as the easy option when it comes to losing weight. This operation has a strong psychological impact as well as a physical one and we found that regular psychological support is needed to help people cope with the realities of having the device fitted.”

Simon O’Neill, Director of Care, Information and Advocacy Services at leading health charity Diabetes UK, said: “Losing weight not only reduces your risk of developing Type 2 diabetes but also significantly improves management in those who have the condition. We always advise people wanting to lose weight to try to do so by following a healthy, balanced diet high in fruit and vegetables and low in fat, sugar and salt combined with physical activity. Weight loss surgery can be a way of losing significant amounts of weight for people who are obese. However, surgery does have serious associated risks and should only be considered if sustained attempts to lose weight through diet and lifestyle changes have been unsuccessful. This new research also shows that there might be psychological consequences to having the procedure and patients should be made aware of these when considering the surgery.”

The NHS Information Centre recently released figures showing a 55 per cent increase in the number of people having weight-loss surgery, such as stomach stapling or having a gastric band fitted, between 2006/07 and 2008/09, from 1,950 to 4,220.

via: Weight Loss Surgery Can Lead To Psychological Distress


Mutation That Affects Response to Smell and Taste Could Lead to Type 2 Diabetes

April 20, 2010
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Genetic mutation – doesn’t sound very mice does it?

According to Duke University researchers, a mutation that causes the lack of an insulin-controlling molecule may be a factor in the development of type 2 diabetes. The molecule, ankyrin B, is activated in response to the smell and taste of food and leads to the production of insulin in preparation for food intake.

Because ankyrin B is an important factor in the body’s insulin response, researchers at Duke University Medical Center experimented with genetically mutated lab mice to see how they were affected by a deficiency of the molecule. They found that a lack of ankyrin B impaired the mice’s ability to produce proper amounts of insulin in response to food smells and tastes. This led to higher blood glucose levels, which over time led to the onset of type 2 diabetes.

Based upon the sequence of events-ankyrin B deficiency, followed by long-term effects on blood sugar levels, followed by diabetes-the Duke researchers concluded that the disease gradually develops through the parasympathetic nervous system*, not as a result of the foods eaten by the mice. In other words, the persistent inability to secrete proper levels of insulin was an effect of a genetic mutation rather than of eating the “wrong” foods.

As the researchers investigated further into the implications of ankyrin B deficiency, they found that one ankyrin B mutation was associated with type 2 in whites and non-white Hispanics. These findings open the door to research into genetic therapies that could help prevent the onset of type 2 in certain populations.

The study was published online in the March 11 edition of the journal Science Signaling.

via:  Mutation That Affects Response to Smell and Taste Could Lead to Type 2 Diabetes


Being Introverted May Shorten Life Expectancy of Diabetics: Study

April 19, 2010
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Being bold is good for your health, so speak up!

New research suggests there is a social component to life expectancy among diabetes patients, according to a recent article from Private MD. Reseachers examined 3,535 adults with either Type 1 or Type 2 diabetes and found that those who are more introverted and less trusting had a 33% higher mortality rate than those who are extraverted.

The study’s authors suggest that being overly self-reliant may not actually be a good thing for people with diabetes. That’s because many self-management aspects of the disease are best carried out in conjunction with others.

via: Being Introverted May Shorten Life Expectancy of Diabetics: Study


Type 2 Drug Metformin More Effective When Taken Within Three Months of Diagnosis

April 16, 2010
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An article in The Times of India has found the diabetes drug metfomin works twice as long for those patients that begin taking it within three months of their diagnosis.

New research from Kaiser Permanente finds that the popular Type 2 diabetes drug metfomin works twice as long for those patients that begin taking it within three months of their diagnosis, according to an article in the Times of India.

Metformin is prescribed for the vast majority of Type 2 patients. However, it typically stops working and additional drugs need to be added to the mix to help the patients keep their blood sugar under control. People with Type 2 diabetes produce the insulin, the hormone that regulates sugar levels in the blood, but don’t use it efficiently. Many need to take medicine to help control their sugar levels.

With patients taking Metformin within three months of diagnosis, the drug failed at a rate of 12% per year, according to the study. For those that began taking it one to two years after diagnosis, the drug failed at a rate 21.4%. Researchers say they believe the reason for the discrepancy is that by taking the drug early on patients are able to preserve some of their own body’s ability to control blood sugar levels.

Researchers say the study is important because it can help patients with Type 2 diabetes avoid paying extra for additional medications and can help them avoid some of the added risks and complications, such as weight gain, associated with some additional drugs.

However, one of the biggest barriers for doctors and patients is that many people living with Type 2 diabetes don’t know they have the disease until some of the complications have started to kick in.

via: Type 2 Drug Metformin More Effective When Taken Within Three Months of Diagnosis


LighterLife relaunches magazine in a new smaller handbag size

April 15, 2010
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An even lighter ‘LighterLife’ is on it’s way…

LighterLife has relaunched its LighterLife magazine with a new look and improved content to offer readers added inspiration and understanding of just what LighterLife offers. The new feel and design of the magazine has been created with the help of publishing house, Specialist Publications.

The re-launch sees the weight loss magazine take on a new, clean direction. The size of the publication has moved from A4 to a smaller handbag size, making it more user friendly. The magazine also features more LighterLife clients than ever before, whether it’s at the beginning, middle or end of their weight-loss journey. Niki Webb, Specialist CEO said, “The relaunch gave us an opportunity to refresh the magazine from a photographic, design and content perspective. The new magazine is stylish and confident. The team at Specialist are very passionate about the LighterLife brand. The fact that thousands of people have battled obesity and are now managing their weight after following LighterLife is truly inspirational and something worth shouting about.”

The LighterLife magazine is now available exclusively through on-line subscriptions or via LighterLife counsellors and the new format sees the publication become available on a quarterly basis.

The decision to remove the magazine from the news stand provided the opportunity to make the magazine more specific to the LighterLife clients, whilst more care has been taken over the wording and language used, ensuring new clients and other audiences who might read the magazine will not be alienated but engaged in the content, and have an understanding of LighterLife.

Heather Butcher, LighterLife PR & Communications Manager commented “The new magazine will include further in-depth articles about our clients really exploring why they put on weight and how they found their individual LighterLife Journey. In the past the magazine concentrated on fantastic weight-loss to enable it to jump off the retailer’s shelves and into shopping baskets.”

The new look issue is on sale from 22nd March and features a wide spectrum of weight-loss stories, tips and advice on dealing with difficult situations that may arise while losing weight, along with information that may be useful to family members who want a better understanding of LighterLife. For potential clients these features and stories are design to prompt and answer any questions people may have before embarking on LighterLife Total or LighterLife Lite.

About LighterLife:
LighterLife is an industry leader in weight management, with an established, highly successful approach to significant weight loss and lifetime weight management. Since 1996 LighterLife has helped over 200,000 people all over the UK and Ireland with its quick weight loss diet.

Designed specifically for people who are one stone or more overweight and with a body mass index of 25 or above, the unique LighterLife weight loss solution offers programmes specific to the obese and the overweight using nutritionally balanced soups, shakes and bars combined with specialised counselling techniques. Clients benefit not only from safe, fast weight loss but they also learn the behavioural changes needed to sustain it.

via: LighterLife relaunches magazine in a new smaller handbag size


The more you weigh the more likely you are to underestimate your true size, according to new research

April 15, 2010
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They say the camera adds ten pounds… perhaps the mirror does too?

The more you weigh, the more likely you are to underestimate your true size, according to new research that reveals fascinating insights into the way severely overweight patients undergoing assessment for weight loss surgery see themselves.

According to the study, carried out by leading bariatric (weight loss) surgeon David Kerrigan and his team at Gravitas, 50% of patients surveyed had a distorted perception of their body image, making them unable to identify their correct body shape when shown a selection of images ranging from underweight to massively obese.

Yet while one in three patients with a body mass index (BMI) under 50 in this group overestimated their size, over three quarters of those who had a BMI over 50, ie the super-obese, thought they were actually lighter than they were.

As Mr Kerrigan points out, the findings may explain why certain patients allow themselves to go on gaining weight when they are already clearly massively obese.

“What is particularly interesting about these findings is that having a BMI of over 50 seems to represent a threshold that once crossed is associated with denial, underestimation of weight gain and thus progression to ever-more severe degrees of obesity,” says Mr Kerrigan, who advised the government on the NICE obesity guidelines used today.

“It is perhaps not surprising to discover that some lighter patients with a weight problem think they look bigger than they do. This may be because they feel guilty, embarrassed and dogged by low self-esteem and depression, and therefore have a tendency to an exaggerated perception as to how large their body is.

“But there seems to come a point at which patients start to bury their heads in the sand and go into denial about the true extent of their weight problem, which may lead them to abandon on-going attempts at weight control,” adds Mr Kerrigan, who is medical director at Gravitas.

For the study, Gravitas researchers asked 112 patients undergoing assessment for weight loss surgery to identify their correct body shape from a selection of standardised silhouettes ranging from underweight through to massive obesity.

The survey revealed:

• Half (50%) of all obese patients surveyed could not correctly identify their current body shape
• This distorted self-perception was most marked in the super-obese (BMI >50), over three quarters (77%) of whom were unable to identify their true body shape with any degree of accuracy
• All super obese patients who were unable to identify their body image correctly underestimated their size
• Of the one in three obese patients with a BMI under 50 who incorrectly identified their body shape almost all overestimated their size

Mr Kerrigan added that a reassuring finding from the study was that most patients had realistic expectations of what weight loss surgery can deliver, although a third wanted to end up with a normal body mass, something weight loss surgery rarely delivers. However, a worrying 5% chose a silhouette that was underweight when asked to identify the body shape they felt represented an ideal outcome from surgery.

“This simple screening technique may prove useful in identifying the small number of patients with significant mental health issues manifesting themselves as a desire for extreme degrees of post-operative weight loss, who should be guided towards psychological support rather than surgery in the first instance,” said Mr Kerrigan.

The findings of the study were presented recently at the inaugural Scientific Meeting of the British Obesity and Metabolic Surgery Society (BOMSS), which awarded Gravitas the BOMSS Council Prize for the best research presentation. ENDS

Notes to editors:
A person is classified as obese if they have a BMI (body mass index) greater than 30 and morbidly obese if it is more than 40. A person with a BMI over 50 is classified as super obese. Surgical candidates should have a BMI of at least 35 (if they have other medical problems) or 40 (if they do not). A healthy BMI is between 18.5 and 25. A person’s BMI is calculated by dividing their weight in kilograms by their height in metres squared.

About Gravitas (www.gravitas-ltd.co.uk)
Gravitas is a network of doctors and surgeons in the UK and Ireland committed to working to the highest ethical and professional standards in bariatric surgery. Awarded the prestigious ‘team of the year’ accolade for innovative surgical practice by the independent Association for the Study of Obesity in 2009, Gravitas treats both private and NHS patients and has helped train many bariatric surgeons in the UK through its fellowship programme for senior surgical trainees.

About Mr David Kerrigan
MD with Distinction (1992), FRCS, FRCSEd (1986), MBChB (1982)
Honorary senior lecturer in surgery at the University of Liverpool, Mr Kerrigan practises at the Spire Murrayfield Hospital, Wirral and is amongst the elite of UK bariatric surgeons. He is also medical director of Gravitas. Widely respected by both the public and his surgical peers for his technical skill and commitment to uncompromisingly high standards of bariatric care and aftercare, David Kerrigan is a pioneer of laparoscopic (keyhole) bariatric surgery in the UK and has lectured widely on this subject both here and abroad. His work has been featured in numerous television and newspaper reports.

For further information, please contact:
Tracey Williams, PR Consultant
Tel: 01225 723237
Email: tracey.williams@twpr.co.uk

via: THE MORE YOU WEIGH, THE MORE LIKELY YOU ARE TO UNDERESTIMATE YOUR TRUE SIZE, ACCORDING TO NEW RESEARCH


Only Lunchtime Coffee-Drinking Cuts Diabetes Risk: Study

April 14, 2010
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News on your coffee fix from Diabetes Newshound….

There have been many studies linking coffee with a reduced risk of Type 2 diabetes. However, a new study suggests that the java must be consumed during lunchtime, according to a recent article from Reuters.

A study of nearly 70,000 women found that those drinking coffee at lunch reduced their risk of developing Type 2 diabetes by a third. The results help true for both decaf and caffeinated coffee, both with sugar and without it. Those drinking it at other times during the day showed no reduced risk. The findings only applied to those drinking coffee without milk.

Researchers hypothesize that the lunchtime-effect may have to do with timing, but also may relate to the types of foods people eat during lunchtime.

via: Only Lunchtime Coffee-Drinking Cuts Diabetes Risk: Study


Although Statins Increase Diabetes Risk, Study Says They’re Still Worth Taking

April 13, 2010
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Weighing up the pros and cons of Statins…

An article by Scottish researchers, published in the British medical journal Lancet, says that although people taking statins are nine percent more likely to develop type 2 diabetes, that risk is outweighed by the drug’s ability to lower cholesterol and protect against heart disease.

Different studies over the years have reached different conclusions about whether statins increase, decrease, or do not affect the risk of acquiring type 2. Consequently, the scientists at the Glasgow Cardiovascular Research Center at the University of Glasgow conducted a meta-analysis of all the research into statins and type 2 diabetes. They reviewed data from 13 trials, involving more than 91,000 patients, that took place between 1994 and 2009.

After analyzing the data, the researchers found a clear link between taking statins and an increased risk of diabetes. They concluded, however, that the risk is outweighed by the benefits that statins confer. They said that whereas treating 255 patients with statins over a four-year period  would result in only one extra case of diabetes, the same group over the same timespan would avoid 5.4 deaths or heart attacks and a similar number of strokes or surgeries for clogged arteries.

Lead researcher Naveed Sattar said that given statins’ beneficial effects, which include lowering bad cholesterol and vascular inflammation, he was surprised by the statins-diabetes link. He speculated that because statins also affect the liver and muscles, which are crucial elements in the body’s creation and metabolization of blood glucose, the link may be found there.

The most common commercial forms of statins are Pfizer’s Lipitor and AstraZeneca’s Crestor.

via: Although Statins Increase Diabetes Risk, Study Says They’re Still Worth Taking


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