diabetes

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0 height="100%"><tr> <td valign="top" width=210 BGCOLOR="#FFFFFF" TEXT="#080000" bgproperties="fixed" background="112f2f02egerdp.jpg"> <div> <A HREF="index.htm" TARGET="_top" TITLE="_"><U><B><U>HOME</U></B></U></A></div> <div> <TABLE BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="172" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#66FFFF HEIGHT= 23 WIDTH="172"><div> <A HREF="id91.htm" TARGET="_top" TITLE="BRUCE ROSEMAN, M.D. 140 WEST 86th Stree"><U>CONTACT ME</U></A></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFCC99 HEIGHT= 23 WIDTH="172"><div> <A HREF="id17.htm" TARGET="_top" TITLE="office info"><U>OFFICE INFO</U></A></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFF99 HEIGHT= 24 WIDTH="172"><div> <A HREF="id116.htm" TARGET="_top" TITLE="MEDICATION INFORMATION"><U>DRUG INFO</U></A></div> </tD> 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</TABLE></div> <bR> <div> <A HREF="http://ndep.nih.gov/" TARGET="_top" TITLE="http://ndep.nih.gov/"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">DIABETES EDUCATION PROGRAM</U></A>(THIS IS A GREAT SITE!)</div> <div> <A HREF="http://news.bbc.co.uk/hi/english/health/medical_notes/newsid_253000/253464.stm" TARGET="_top" TITLE="http://news.bbc.co.uk/hi/english/health/"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">DIABETES</U></A><A HREF="http://news.bbc.co.uk/hi/english/health/medical_notes/newsid_253000/253464.stm" TARGET="_top" TITLE="http://news.bbc.co.uk/hi/english/health/"><U> FACTS</U></A></div> <div> <A HREF="http://www.diabetic.com/" TARGET="_top" TITLE="http://www.diabetic.com/"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">DIABETES STATISTICS</U></A></div> <div> <A HREF="http://www.diabetes.org/main/application/commercewf" TARGET="_top" TITLE="http://www.diabetes.org/main/application"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">AMERICAN DIABETES ASSOCIATION WEBSITE</U></A></div> <div> <A HREF="http://www.joslin.harvard.edu/" TARGET="_top" TITLE="http://www.joslin.harvard.edu/"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">JOSLIN CENTER WEBSITE AT HARVARD</U></A></div> <div> <A HREF="http://www.diabetic-lifestyle.com/" TARGET="_top" TITLE="http://www.diabetic-lifestyle.com/"><U><B><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Diabetic-Lifestyle Online Magazine-</B></U></A><A HREF="http://www.diabetic-lifestyle.com/" TARGET="_top" TITLE="http://www.diabetic-lifestyle.com/"><U>articles and recipes to make understanding and controlling diabetes easier.</U></A></div> <div> <A HREF="#most_adult_diabetics_in_united_states" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Most Adult Diabetics In United States Have Hypertension</U></A></div> <div> <A HREF="#_new_england_journal_of_medicine_volume" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin</U></A>(NEW ENGLAND JOURNAL ARTICLE)</div> <div> <A HREF="#caffeine_linked_to_pre_diabetic" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Caffeine Linked to Pre-Diabetic Condition</U></A><A HREF="#caffeine_linked_to_pre_diabetic" TITLE="diabetes"><U> </U></A></div> <div> <A HREF="#ron_storage_raises_diabetes_risk_" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Iron Storage Raises Diabetes Risk </U></A></div> <div> <A HREF="#c_reactive_protein__crp__and_diabetes" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0"> </U></A><A HREF="#c_reactive_protein__crp__and_diabetes" TITLE="diabetes"><U>C-reactive Protein (CRP) and Diabetes</U></A></div> <div> <A HREF="#processed_meat_and_diabetes" TITLE="diabetes"><U><B><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">E</B></U></A><A HREF="#processed_meat_and_diabetes" TITLE="diabetes"><U>ating Processed Meats Ups Diabetes Risk in Men</U></A><A HREF="#processed_meat_and_diabetes" TITLE="diabetes"><U>  </U></A><A HREF="#processed_meat_and_diabetes" TITLE="diabetes"><U>SOURCE: Diabetes Care 2002;25:417-424 </U></A></div> <div> <A HREF="http://ndep.nih.gov/control/CVD.htm" TARGET="_top" TITLE="http://ndep.nih.gov/control/CVD.htm"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Link with Cardiovascular Disease explained</U></A></div> <div> <A HREF="#synthetic_compound_reverses_diabetes_in" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Synthetic Compound Reverses Diabetes in Mice</U></A></div> <div> <A HREF="http://www.joslin.harvard.edu/education/library/oral_agents.shtml" TARGET="_top" TITLE="http://www.joslin.harvard.edu/education/"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">BRIEF OVERVIEW OF ORAL DIABETIC MEDICATIONS</U></A></div> <div> <A HREF="http://www.joslin.harvard.edu/education/library/wbggoal.shtml" TARGET="_top" TITLE="http://www.joslin.harvard.edu/education/"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">GOALS FOR SUGAR CONTROL</U></A></div> <div> <A HREF="http://www.joslin.harvard.edu/education/library/glucose_on_sickday.shtml" TARGET="_top" TITLE="http://www.joslin.harvard.edu/education/"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Why Does Blood Glucose Become Elevated When I Am Sick?</U></A></div> <div> <A HREF="#replacing_hormone_helps_metabolic" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">leptin</U></A></div> <div> <A HREF="http://www.diabetes.org/main/info/risk/risktest.jsp" TARGET="_top" TITLE="http://www.diabetes.org/main/info/risk/r"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">diabetes risk test</U></A></div> <div> <A HREF="#__kidney_woes_blindness_strokes_may" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0"> Kidney Woes, Blindness, Strokes May B</U></A><A HREF="#__kidney_woes_blindness_strokes_may" TITLE="diabetes"><U>e Reduced</U></A></div> <div> <A HREF="#relationship_between_insulin_resistance" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">ADMA and insulin resistance and cardiac risk factors</U></A></div> <div> <A HREF="#overweight_kids_and_diabetes_risk" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Overweight Kids and Diabetes Risk</U></A></div> <div> <A HREF="http://diabetes.about.com/library/weekly/aa030501a.htm" TARGET="_top" TITLE="http://diabetes.about.com/library/weekly"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Getting a handle on diabetic kidney disease</U></A><I><U>diabetes-number one cause of chronic renal failure</U></I></div> <div> <A HREF="http://diabetes.about.com/library/weekly/aa030501b.htm" TARGET="_top" TITLE="http://diabetes.about.com/library/weekly"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Lowering your risk of diabetes-related kidney disease </U></A></div> <div> <A HREF="http://diabetes.about.com/gi/dynamic/offsite.htm?site=http://www.diabetes.org/ada/tight%5Fcontrol.asp" TARGET="_top" TITLE="http://diabetes.about.com/gi/dynamic/off"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Tight Diabetes Control</U></A></div> <div> <A HREF="#fish_oil_compound_may_help_ward_off" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Fish Oil Compound May Help Ward Off Diabetes </U></A></div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">CHICKEN DIET BETTER THAN RED MEAT FOR KIDNEYS IN TYPE 2 DIABETES </div> <div> <A HREF="http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof#moreinfo" TARGET="_top" TITLE="http://hin.nhlbi.nih.gov/atpiii/calculat"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Risk assessment for whether you will have a heart attack.</U></A></div> <div> <A HREF="#actos__pioglitazone_hcl__improves" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Actos (Pioglitazone HCl) Improves Glucose Control And Lipid Profiles In People With Type 2 Diabetes Who Use Insulin</U></A></div> <div> <A HREF="#aspirin_may_improve_glucose_tolerance" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Aspirin May Improve Glucose Tolerance In Type 2 Diabetes</U></A></div> <div> <A HREF="#no_more_insulin_shots_new_technologies" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">No More Insulin Shots: New Technologies</U></A></div> <div> <A HREF="http://www.intelihealth.com/cgi-bin/makelog.pl?pqsname=IHDiabetesMonth&mode=p&graphics=1&p=~br,IHW|~st,21054|~r,WSIHW000|~b,*|&tID=21054&WH=/IH/&MIval=ihtIH" TARGET="_top" TITLE="http://www.intelihealth.com/cgi-bin/make"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">DIABETES QUIZ</U></A></div> <div> <A HREF="#did_you_know__" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Did you know…?</U></A></div> <div> <A HREF="#overweight_kids_and_diabetes_risk" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Overweight Kids and Diabetes Risk</U></A></div> <div> <A HREF="#niacin_drug_cuts_blood_fat_in_diabetics_" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Niacin Drug Cuts Blood Fat in Diabetics </U></A></div> <div> <A HREF="#men_going_for_the_grains_may_cut" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Men: Going for the Grains May Cut Diabetes Risk </U></A></div> <div> <U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">I</U><U>NSULIN RESISTANCE</U></div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">1.<A HREF="#1__what_is_the_insulin_resistance" TITLE="diabetes"><U> What is the Insulin Resistance Syndrome (IRS)?</U></A></div> <div> <A HREF="#2__what_is_the_clinical_impact_of_the" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">2. What is the clinical impact of the Insulin Resistance Syndrome?</U></A></div> <div> <A HREF="#3__who_is_more_likely_to_have_the" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">3. Who is more likely to have the Insulin Resistance Syndrome?</U></A></div> <div> <A HREF="#4__how_can_the_insulin_resistance" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">4. How can the Insulin Resistance Syndrome be detected?</U></A></div> <div> <A HREF="#insulin_and_coronary_artery_disease" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">insulin and coronary artery disease</U></A></div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Glycemic Index explained</div> <div> <A HREF="id126.htm" TARGET="_top" TITLE="GLYCEMIC INDEX LISTS"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">GLYCEMIC INDEX LISTS</U></A></div> <div> <A HREF="#toxic_compound_is_formed_when_sugar" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">long cooking increases blood vessel damage</U></A></div> <div> <A HREF="#diabetes_and_chronic_kidney_disease" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Diabetes and Chronic Kidney Disease: Ten Facts</U></A><A HREF="#diabetes_and_chronic_kidney_disease" TITLE="diabetes"><U> </U></A></div> <div> <A HREF="#test_drug_stops_diabetes_related__eye" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Test: Drug Stops Diabetes-Related  eye Disease </U></A></div> <div> <A HREF="#vitamins_boost_immunity_of_diabetics__" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Vitamins boost immunity of diabetics - study</U></A></div> <div> <A HREF="#diabetes_risk_higher_in_those_with" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Diabetes Risk Higher in Those with Shorter Thighs</U></A></div> <div> <A HREF="http://www.niddk.nih.gov/health/diabetes/summary/pancisl/pancisl.htm" TARGET="_top" TITLE="http://www.niddk.nih.gov/health/diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Pancreatic Islet transplantation</U></A></div> <div> <A HREF="#transplant_trial_with_just_an_iv" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">transplant trial WITH JUST AN IV</U></A></div> <div> <A HREF="#regression_" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Regression of Microalbuminuria in Type 1 Diabetes</U></A></div> <div> <A HREF="#tigh" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Tight Glucose Control In Diabetes Lowers Risk Of Atherosclerosis</U></A></div> <div> <A HREF="#insulin_glargine" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Insulin glargin</U></A></div> <div> <A HREF="#cinn" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Cinnamon Improves Glucose and Lipids of People With Type 2 Diabetes </U></A></div> <div> <A HREF="#statins_for_every_diabetic_" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Statins for Every Diabetic?</U></A></div> <div> <A HREF="#gila_may_be_healer_for_type_2_diabetes" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">NEW PROMISING DIABETES DRUG(Gila May Be Healer for Type 2 Diabetes)</U></A></div> <div> <A HREF="#lipitor_halves_stroke_risk_in_diabetics" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Lipitor Halves Stroke Risk in Diabetics</U></A></div> <div> <A HREF="#serum_ferritin_and_risk_of_metabolic" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">IRON AS A PREDICTOR OF HEART DISEASE AND DIABETES</U></A></div> <div> <A HREF="id105_study_caffeine_interferes_with.htm" TARGET="_top" TITLE="CAFFEINE"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Caffeine Interferes with Diabetes Control</U></A></div> <div> <A HREF="#tomato_juice_may_cut_clotting_in" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Tomato Juice May Cut Clotting</U></A></div> <div> <A HREF="#effect_of_rosiglitazone_versus_insulin" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Effect of Rosiglitazone Versus Insulin on the Pancreatic ß-Cell Function of Subjects With Type 2 Diabetes </U></A></div> <div> <A HREF="#efficacy_and_safety_of_inhaled_insulin" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Efficacy and Safety of Inhaled Insulin (Exubera) Compared With Subcutaneous Insulin Therapy in Patients With Type 1 Diabetes</U></A></div> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">  </B><A HREF="http://www.drugdevelopment-technology.com/project_printable.asp?ProjectID=2688" TARGET="_top" TITLE="http://www.drugdevelopment-technology.co"><U><B>EXUBERA information click here </B></U></A></div> <div> <A HREF="#caffeine_ingestion_is_associated_with" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">caffeine ingestion was associated with a significant reduction (P < 0.05) in insulin sensitivity</U></A></div> <div> <A HREF="#_chromium_supplements_good_for_the" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0"> Chromium supplements good for the diabetic heart</U></A></div> <div> <A HREF="#testosterone" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Men with metabolic syndrome should be checked for low testosterone.</U></A> </div> <div> <A HREF="http://www.americanheart.org/presenter.jhtml?identifier=3032114" TARGET="_top" TITLE="http://www.americanheart.org/presenter.j"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Dark Chocolate May Reduce Blood Pressure, Improve Insulin Resistance </U></A></div> <div>  <A NAME="top"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><FONT SIZE="3" COLOR="#660099" FACE="Verdana" ><A HREF="http://www.glucowatch.com/uk/default.html" TARGET="_top" TITLE="http://www.glucowatch.com/uk/default.htm"><U>Glucowatch</U></A></FONT></div> <div> <A HREF="#cholesterol_lowering_effect_of" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Cholesterol-Lowering Effect of Concentrated Pomegranate Juice Consumption in Type II Diabetic Patients with Hyperlipidemia.</U></A></div> <div> <A HREF="#januvia" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Januvia</U></A></div> <div> <A HREF="#once_weekly_exenatide_formulation" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Once-Weekly Exenatide Formulation Improves Glycemic Control and Body Weight</U></A></div> <bR> <bR> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="442" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 699 WIDTH="438"><div>  <A NAME="once_weekly_exenatide_formulation"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><I><B>DOC News</B></I> July 1, 2007</div> <div> Volume 4 Number 7 p. 18</div> <div> © 2007 <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>American Diabetes Association</U></FONT> </div> <bR> <div> <B>Once-Weekly Exenatide Safe and Effective</B></div> <div> New findings suggest an extended-release formulation of exenatide<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>(Byetta, Amylin/Lilly) appears to be a safe and effective once-weekly<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>therapy to control blood glucose and body weight in people with<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>type 2 diabetes.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> Investigators studied a long-acting release (LAR) formulation<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>of exenatide in 45 people with type 2 diabetes who were poorly<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>controlled with metformin and lifestyle modification. Participants<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>were randomized to receive 0.8 or 2 mg injection of LAR exenatide<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>or a placebo injection once weekly for 15 weeks.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> At the end of the study period, glycated hemoglobin (A1C) was<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>lower among study subjects: the mean A1C value was 7.2% for<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>the .8 mg exenatide group and 6.6% for the 2 mg group, down<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>from a mean 8.5% A1C value before the study. By comparison,<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>there was a slight rise to 9% among those receiving placebo. Subjects<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>also showed improvements in fasting glucose levels. Those receiving the<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>2 mg dose lost an average of 3.8 kg (8.6 lb). There was no weight<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>loss among those who received the 0.8 mg dose of LAR exenatide<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>or placebo.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> The most common side-effect from LAR exenatide was nausea. However,<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>none of the participants receiving LAR exenatide withdrew from<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>the study.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> If clinical research continues to show promise, this long-acting formulation<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>of exenatide may one day be introduced as a once-weekly therapy option<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>for type 2 diabetes, the authors suggest.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> Kim A, MacConell L, Zhuang D, et al.: Effects of once-weekly<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>dosing of a longacting release formulation of exenatide on glucose control<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>and body weight in subjects with type 2 diabetes. <I>Diabetes Care</I><FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>30:1487-1493, 2007.</div> <bR> <bR> </tD> </tR> </TABLE></div> <div> <B><U> <A NAME="januvia"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Januvia</U></B></div> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="442" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 3768 WIDTH="438"><div> <I>"FDA Approves Once-Daily Januvia(TM) (Sitagliptin Phosphate), the First and Only DPP-4 Inhibitor Available in the United States for Type 2 Diabetes"</I></div> <bR> <bR> <div> WHITEHOUSE STATION, NJ -- October 18, 2006 -- Merck & Co., Inc. announced today that the U.S. Food and Drug Administration (FDA) approved Januvia™ (sitagliptin phosphate), the first and only DPP-4 inhibitor available in the United States for the treatment of type 2 diabetes. Januvia has been approved as monotherapy and as add-on therapy to either of two other types of oral diabetes medications, metformin or thiazolidinediones (TZDs), to improve blood sugar (glucose) control in patients with type 2 diabetes when diet and exercise is not enough. The recommended dose of Januvia is 100 mg once daily. Januvia should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis, as it would not be effective in these settings. Januvia Enhances a Natural Body System to Significantly Lower Elevated Blood Sugar Januvia belongs to a new breakthrough class of prescription medications called dipeptidyl peptidase-4 (DPP-4) inhibitors that improves blood sugar control in patients with type 2 diabetes. Januvia enhances a natural body system called the incretin system, which helps to regulate glucose by affecting the beta cells and alpha cells in the pancreas. Through DPP-4 inhibition, Januvia works only when blood sugar is elevated to address diminished insulin due to beta-cell dysfunction and uncontrolled production of glucose by the liver due to alpha-cell and beta-cell dysfunction. "Those patients who are unable to adequately manage their type 2 diabetes with lifestyle changes, like healthy eating and increased physical exercise, and who require medications now have a new product to help regulate their blood sugar levels," said Edward S. Horton, MD, director of clinical research, Joslin Diabetes Center and professor of medicine, Harvard Medical School, Boston. "Januvia underscores Merck's commitment to the field of diabetes, and the benefits we strive to bring to patients and physicians who struggle in the treatment of type 2 diabetes," said Richard T. Clark, president and chief executive officer, Merck. "The approval of Januvia is a clear example of Merck's focus on developing innovative therapies to improve human health around the world." Januvia had an overall incidence of side effects comparable to placebo In clinical trials, Januvia demonstrated an overall incidence of side effects comparable to placebo. The most common side effects reported with Januvia (> 5% and higher than placebo) were stuffy or runny nose and sore throat, upper respiratory infection, and headache. Januvia Provides Powerful A1C1 Reductions as Monotherapy In two double-blind, placebo-controlled studies of 24 weeks (n=473) and 18 weeks (n=296) in patients with mild to moderate baseline A1C levels (mean 8.0%; enrollment range 7.0% to 10.0%), Januvia 100 mg once-daily showed significant mean differences in A1C from placebo of -0.8% and -0.6%, respectively (p<0.001). As is typical in trials of agents to treat type 2 diabetes, mean response to Januvia in A1C lowering appears to be related to the degree of A1C elevation at baseline. In a pooled analysis of these two monotherapy studies, a pre-specified subgroup analysis showed that when patients were grouped by baseline A1C into those with mildly elevated A1C levels (<8%, n=411), moderately elevated A1C levels (>8% to <9%, n= 239) and the highest elevated A1C levels (>9%, n=119), mean differences in A1C from placebo after 18 weeks were -0.6%, -0.7% and -1.4%, respectively (P <.001 for treatment by subgroup interactions). Januvia Has a Significant and Complementary Effect When Added to Metformin or TZDs Januvia addresses two of the three key defects that cause poor glucose control: diminished insulin release due to beta-cell dysfunction and uncontrolled production of glucose by the liver due to alpha-cell and beta-cell dysfunction. By adding Januvia to the insulin sensitizers metformin or pioglitazone (a TZD), the three key defects of type 2 diabetes can be addressed: insulin resistance, beta-cell dysfunction (decreased insulin release), and alpha-cell dysfunction (unsuppressed hepatic glucose production). In separate 24-week studies of patients with type 2 diabetes who were inadequately controlled on either metformin or pioglitazone alone, Januvia 100 mg once daily provided a complementary effect. Januvia showed significant mean differences in A1C from placebo of -0.7% in the metformin add-on study (P <.001) and -0.7% in the pioglitazone add-on study (P <.001). In those same studies, the mean A1C reduction from baseline with Januvia was 0.7% from a mean baseline A1C of 8.0% and 0.9% from a mean baseline of 8.1%, respectively. Approximately Twice as Many Patients Got to A1C Goal of <7% With Januvia In the metformin add-on study, more than twice as many patients uncontrolled on metformin got to A1C goal of <7% when Januvia was added (47% with Januvia and metformin vs. 18% for patients continuing on metformin alone) (P <.001). Similarly, in the pioglitazone add-on study, 45% of patients adding Januvia to their regimen reached the A1C goal of <7% compared with 23% who continued on pioglitazone alone (P <.001). Januvia Provides Powerful A1C Lowering Through Combined Reductions of Both PPG and FPG Throughout the Day Januvia has been demonstrated to provide a 24-hour glucose response at mealtime, between meals and overnight. In a 24-week, placebo-controlled study of patients uncontrolled on metformin, adding Januvia 100 mg once daily substantially reduced PPG (or post-meal glucose) levels by 51 mg/dL and FPG by 25 mg/dL compared to patients continuing on metformin alone (P <.001). Treatment With Januvia Was Not Associated With Weight Gain or Increased Risk of Hypoglycemia Januvia once-daily was weight neutral compared to placebo in clinical trials. Mean body weight decreased 0.2 kg (vs. 1.1 kg decrease for placebo) and 0.7 kg (vs. 0.6 kg), respectively, in two 24-week trials: one in patients taking Januvia as monotherapy (n=193) and one in combination with metformin (n=399). The overall incidence of hypoglycemia in patients treated with Januvia 100 mg was similar to placebo (1.2% vs. 0.9%, respectively) across the clinical program. The incidence of selected gastrointestinal adverse reactions in patients treated with Januvia was as follows: abdominal pain (Januvia, 2.3%; placebo, 2.1%), nausea (1.4%, 0.6%), and diarrhea (3.0%, 2.3%). Glucose-Dependent Mechanism of Action The novel mechanism of Januvia is glucose-dependent, responding to the presence of elevated glucose and resulting in the release of insulin and decrease of glucagon only when needed, thereby lowering the potential for hypoglycemia. By inhibiting the DPP-4 enzyme, Januvia significantly increases the levels of active incretin hormones, increasing the synthesis and release of insulin from the pancreatic beta cells and decreasing the release of glucagon from the pancreatic alpha cells. Indications and Contraindications for Januvia Januvia is indicated, as an adjunct to diet and exercise, to improve glycemic control in patients with type 2 diabetes mellitus. Januvia is also indicated to improve glycemic control, in combination with metformin or a TZD, in patients with type 2 diabetes when the single agent alone plus diet and exercise do not provide adequate glycemic control. Januvia should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis, as it would not be effective in these settings. There are no contraindications for Januvia. Selected Cautionary Information for Januvia Because Januvia is renally eliminated, and to achieve plasma concentrations of Januvia similar to those in patients with normal renal function, a dosage adjustment is recommended in patients with moderate renal insufficiency and in patients with severe renal insufficiency or with end-stage renal disease (ESRD) requiring hemodialysis or peritoneal dialysis. Safety and effectiveness of Januvia in pediatric patients have not been established. There are no adequate and well-controlled studies in pregnant women. Januvia should be used during pregnancy only if clearly needed. Caution should be exercised when Januvia is administered to a nursing woman. Dosing of Januvia The recommended dose of Januvia is 100 mg once daily, with or without food, for all approved indications. No dosage adjustment is needed for patients with mild to moderate hepatic insufficiency or in patients with mild renal insufficiency (CrCl >50 mL/min). To achieve plasma concentrations of Januvia similar to those in patients with normal renal function, lower dosages are recommended in patients with moderate and severe renal insufficiency as well as in ESRD patients requiring hemodialysis. For patients with moderate renal insufficiency (CrCl > 30 to <50 mL/min), the dose of Januvia is 50 mg once daily. For those with severe renal insufficiency (CrCl <30 mL/min) or with ESRD requiring dialysis, the dose of Januvia is 25 mg once daily. Because there is a need for dosage adjustment based upon renal function, assessment of renal function is recommended prior to initiation of Januvia and periodically thereafter. Pricing and Availability of Januvia The price of once-daily Januvia will be $4.86 per tablet. Januvia will be broadly available in pharmacies in the near future. About Type 2 Diabetes Type 2 diabetes is a condition in which the body has elevated blood sugar or glucose. With type 2 diabetes, the body may not make enough insulin, the insulin that the body produces may not work as well as it should, and/or the liver may release too much glucose. Nearly 21 million people in the United States (7% of the population) have diabetes, with type 2 accounting for 90-95% of cases. Approximately half of people diagnosed with type 2 diabetes have not achieved adequate control of their blood sugar levels. Patients with diabetes can develop heart disease, kidney disease, blindness, vascular or neurological problems that can lead to amputation and can suffer increased rates of mortality. It is estimated that one in three Americans born in 2000 will develop diabetes sometime during their lifetime. There are currently more than 230 million people with diabetes worldwide, and if nothing is done to slow the epidemic, the worldwide number may exceed 350 million by 2025. The American Diabetes Association recommends that patients with type 2 diabetes achieve a target A1C level of <7%, while the American Academy of Clinical Endocrinologists recommends a target A1C level of <6.5%. Expanding Clinical Development Program for Januvia Merck's clinical development program for Januvia is robust and continues to expand with 43 studies completed or under way, and four more studies set to begin this year. There are about 6,700 patients in the Company's clinical studies with about 4,700 of these patients being treated with Januvia. Additionally, about 1,100 patients have been treated with Januvia for more than a year. Januvia also is being investigated as part of a single tablet combination with metformin (MK-0431A). MK-0431A has been accepted for standard review by the FDA, and an FDA action is expected by the end of March 2007. Regulatory filings in countries outside the United States are moving forward as planned. Januvia™ is a registered trademark of Merck & Co., Inc. REFERENCE: 1. A1C is a measure of a person's average blood glucose over a two- to three-month period. SOURCE: Merck & Co., Inc</div> </tD> </tR> </TABLE></div> <bR> <bR> <div> <B> <A NAME="cholesterol_lowering_effect_of"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></B><B>Cholesterol-Lowering Effect of Concentrated Pomegranate Juice Consumption in Type II Diabetic Patients with Hyperlipidemia.</B></div> <bR> <div> <B><U>Esmaillzadeh A</U></B><FONT SIZE="3" COLOR="#660099" FACE="Arial" >, </FONT><B><U>Tahbaz F</U></B><FONT SIZE="3" COLOR="#660099" FACE="Arial" >, </FONT><B><U>Gaieni I</U></B><FONT SIZE="3" COLOR="#660099" FACE="Arial" >, </FONT><B><U>Alavi-Majd H</U></B><FONT SIZE="3" COLOR="#660099" FACE="Arial" >, </FONT><B><U>Azadbakht L</U></B><FONT SIZE="3" COLOR="#660099" FACE="Arial" >.</FONT></div> <bR> <div> Department of Human Nutrition, National Nutrition and Food Technology Research Institute, Tehran, Iran.</div> <bR> <div> This study was undertaken to assess the effect of concentrated pomegranate juice consumption on lipid profiles of type II diabetic patients with hyperlipidemia (total cholesterol or triglycerides >/= 200 mg/dL). In this pilot study 22 diabetic patients were recruited from the Iranian Diabetes Society. They were free of any other chronic diseases. The patients were followed for eight weeks to obtain more detailed data about their diet before concentrated pomegranate juice (CPJ) consumption period began. In this pre-study period a 24-hour food recall and a food record (containing flavonoid-rich foodstuffs) were completed every ten days. At the end of the eighth week, anthropometric and biochemical assessments were done. Thereafter the patients consumed 40 g CPJ for eight weeks. During this period, dietary assessment was continued. After completion of the study anthropometric and blood indices were evaluated again. The Wilcoxon signed-rank test was used for statistical analysis. P-value was considered significant at p < 0.05. There were 14 women (63.6%) and 8 men (36.4%) in this survey. Mean (+/- SD) of age, weight, and duration of diabetes were 52.5 (+/- 5.2) years, 71.5 (+/- 10.3) kg, and 7.9 (+/- 6.6) years, respectively. After consumption of concentrated pomegranate juice significant reductions were seen in total cholesterol (p < 0.006), low-density lipoprotein-cholesterol (LDL-c) (p < 0.006), LDL-c/high-density lipoprotein-cholesterol (HDL-c) (p < 0.001), and total cholesterol/HDL-c (p < 0.001). However there were no significant changes in serum triacylglycerol and HDL-c concentrations. Anthropometric indices, physical activity level, types and doses of oral hypoglycemic agents, and the intake of nutrients and flavonoid-rich foodstuffs did not change during the CPJ consumption period. It is concluded that CPJ consumption could modify heart disease risk factors in these hyperlipidemic patients. Therefore, its inclusion in their diets may be beneficial.</div> <bR> <div> PMID: 17048194 [PubMed - in process] </div> <bR> <bR> <div>  <A NAME="testosterone"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A>Men With Diabetes, Hypertension, or Hyperlipidemia More Likely to Be Hypogonadal</div> <div>  "Men With Diabetes, Hypertension, or Hyperlipidemia More Likely to Be Hypogonadal"</div> <bR> <bR> <div> By Maggie Schwarz WASHINGTON, DC -- May 25, 2005 -- According to results of the Hypogonadism in Males (HIM) study, men with diabetes, hypertension, or hyperlipidemia are also more likely to be hypogonadal than is the general population. Scott Segal, MD, director of men's health at Solvay Pharmaceuticals in Atlanta, Georgia, United States, presented the findings here May 19[th at the American Association of Clinical Endocrinologists (AACE) 14th Annual Meeting and Clinical Congress.</div> <bR> <div> "The percentages of men with diabetes, hypertension, or hyperlipidemia who also had low testosterone are higher than we would have expected," said Dr. Segal.</div> <bR> <div> The HIM study was a 2004 investigation undertaken by Solvay Pharmaceuticals looking at 2,162 men aged 45 years and older in 95 primary care practices nationwide. Dr. Segal noted that only 75% of men in this age group see a physician with any regularity.</div> <bR> <div> Blood samples were assayed for total testosterone, free testosterone, and bioavailable testosterone. Patient characteristics that were studied included comorbid conditions, demographics, and reason for presenting to a physician. Patients were queried about the presence of common symptoms associated with hypogonadism, including sexual dysfunction, fatigue or weakness, and mood changes.</div> <bR> <div> Hypogonadism was defined as a total testosterone <300 ng/dL. Of the 2,162 men enrolled, 836 (38.7%) had hypogonadism, and 80 were receiving testosterone replacement therapy.</div> <bR> <div> In men with a history of diabetes, 50% were hypogonadal. In men with a history of hypertension, 42% were hypogonadal, and in those with a history of hyperlipidaemia, 40% were hypogonadal.</div> <bR> <div> A decrease in ability or frequency of sexual performance was reported by 65.5%, 55.8%, and 52.0% of men with a history of either diabetes, hypertension, or hyperlipidemia, respectively. Within each group, rates of reporting were significantly higher in hypogonadal versus eugonadal (P less than or equal to .014). Differences in sexual desire or libido (P less than or equal to .014) and physical exhaustion or a lack of vitality (P less than or equal to .023) were statistically significant for hypogonadal versus eugonadal men who were also diagnosed with either diabetes or hyperlipidemia. A decline in general feelings of well-being was significantly different in hypogonadal men with hyperlipidemia versus eugonadal men (P = .011).</div> <bR> <div> According to Dr. Segal, the numbers of hypogonadal men with diabetes, hypertension, or hyperlipidemia are 10 to 20 points higher than would have been expected.</div> <bR> <div> "These numbers mean that physicians should check testosterone levels in these men with risk factors for the metabolic syndrome," he concluded. "Testosterone insufficiency is not only associated with sexual dysfunction, but exhaustion and lack of vitality. Their quality of life could be improved with replacement therapy."</div> <bR> <bR> <div> [Presentation title: Association of Testosterone Deficiency and Symptoms With Diabetes, Hypertension, and Hyperlipidemia: Data From the Hypogonadism in Males (HIM) Study. Abstract 790.]</div> <bR> <div> <B><U> <A NAME="_chromium_supplements_good_for_the"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U> Chromium supplements good for the diabetic heart</U></B></div> <bR> <div> Wed May 25,11:55 AM ET</div> <bR> <div> Chromium supplementation may be good for the heart in people with type 2 diabetes, according to study findings. It appears to lead to a shortening of a harmful heart rhythm, which may lower cardiovascular risk in type 2 diabetics.</div> <bR> <div> The heart rhythm disturbance known as a prolonged QT interval has been linked to fatal heart arrhythmias. Therefore, the changes in QT interval observed with chromium supplementation in patients with type 2 diabetes may also translate into a survival benefit, study investigator Dr. Bojan Vrtovec from Ljubljana University Medical Center in Slovenia told Reuters Health.</div> <bR> <div> In the study, researchers had 30 diabetic patients take 1000 micrograms of chromium daily for 3 months followed by an inactive placebo for 3 months. Another 30 diabetic patients started with 3 months of placebo and then crossed over to chromium for 3 months.</div> <bR> <div> At the start of the trial, the QT interval viewed on a standard electrocardiogram or ECG was similar in both groups -- 422 milliseconds in the first group and 425 in the second group.</div> <bR> <div> However, at 3 months, the QT interval was significantly shorter in the supplementation group (406 milliseconds) than in the placebo group.</div> <bR> <div> In the next 3 months, QT shortening was observed in the second group but not in the first group. At the end of the study, the OT interval duration was similar in both groups and was markedly lower overall than at the start of the trial before chromium supplementation.</div> <bR> <div> This study shows that increased intake of chromium may lower cardiovascular risk in type 2 diabetic patients, the researchers say.</div> <bR> <div> They also note in the American Heart Journal that blood insulin levels decreased significantly after 3 months of chromium supplementation and this may be partly responsible for the QT interval shortening.</div> <bR> <div> A prolonged QT interval has been associated with high blood sugar levels, high insulin levels and reduced sensitivity to insulin in type 2 diabetics, they explain. Chromium supplementation improves sensitivity to insulin, lowers blood insulin levels and improves glucose homeostasis.</div> <bR> <div> SOURCE: American Heart Journal April 2005. </div> <bR> <div> <B> <A NAME="caffeine_ingestion_is_associated_with"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></B><B>Caffeine Ingestion Is Associated With Reductions in Glucose Uptake Independent of Obesity and Type 2 Diabetes Before and After Exercise Training</B></div> <div> SoJung Lee, PHD1, Robert Hudson, MD, PHD2, Katherine Kilpatrick, MD3, Terry E. Graham, PHD4 and Robert Ross, PHD1,2</div> <bR> <div> 1 School of Physical and Health Education, Queen’s University, Kingston, Ontario, Canada</div> <div> 2 Department of Medicine, Division of Endocrinology and Metabolism, Queen’s University, Kingston, Ontario, Canada</div> <div> 3 Department of Medicine, Division of Geriatrics, Queen’s University, Kingston, Ontario, Canada</div> <div> 4 Department of Human Biology and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada</div> <bR> <div> Address correspondence and reprint requests to Robert Ross, PhD, School of Physical and Health Education, Queen’s University, Kingston, Ontario, Canada, K7L 3N6. E-mail: rossr@post.queensu.ca</div> <bR> <div> OBJECTIVE—We investigated the effect of caffeine ingestion on insulin sensitivity in sedentary lean men (n = 8) and obese men with (n = 7) and without (n = 8) type 2 diabetes. We also examined whether chronic exercise influences the relationship between caffeine and insulin sensitivity in these individuals.</div> <bR> <div> RESEARCH DESIGN AND METHODS—Subjects underwent two hyperinsulinemic-euglycemic clamp procedures, caffeine (5 mg/kg body wt) and placebo, in a double-blind, randomized manner before and after a 3-month aerobic exercise program. Body composition was measured by magnetic resonance imaging.</div> <bR> <div> RESULTS—At baseline, caffeine ingestion was associated with a significant reduction (P < 0.05) in insulin sensitivity by a similar magnitude in the lean (33%), obese (33%), and type 2 diabetic (37%) groups in comparison with placebo. After exercise training, caffeine ingestion was still associated with a reduction (P < 0.05) in insulin sensitivity by a similar magnitude in the lean (23%), obese (26%), and type 2 diabetic (36%) groups in comparison with placebo. Exercise was not associated with a significant increase in insulin sensitivity in either the caffeine or placebo trials, independent of group (P > 0.10).</div> <bR> <bR> <div> <B><U> <A NAME="efficacy_and_safety_of_inhaled_insulin"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Efficacy and Safety of Inhaled Insulin (Exubera) Compared With Subcutaneous Insulin Therapy in Patients With Type 1 Diabetes</U></B> </div> <div> Results of a 6-month, randomized, comparative trial </div> <div> <B>Teresa Quattrin, MD</B><FONT SIZE="1" COLOR="#660099" FACE="Arial" ><B>1</B></FONT><B>, André Bélanger, MD</B><FONT SIZE="1" COLOR="#660099" FACE="Arial" ><B>2</B></FONT><B>, Nancy J.V. Bohannon, MD</B><FONT SIZE="1" COLOR="#660099" FACE="Arial" ><B>3</B></FONT><B> and Sherwyn L. Schwartz, MD</B><FONT SIZE="1" COLOR="#660099" FACE="Arial" ><B>4</B></FONT><B> for the Exubera Phase III Study Group </B></div> <div> 1<FONT SIZE="3" COLOR="#660099" FACE="Arial" > The Women and Children’s Hospital of Buffalo, School of Medicine and Biochemical Sciences, State University of New York at Buffalo, Buffalo, New York</FONT></div> <div> 2<FONT SIZE="3" COLOR="#660099" FACE="Arial" > Cité de la Santé Hospital, Laval, Quebec, Canada</FONT></div> <div> 3<FONT SIZE="3" COLOR="#660099" FACE="Arial" > Monteagle Medical Center, San Francisco, California</FONT></div> <div> 4<FONT SIZE="3" COLOR="#660099" FACE="Arial" > Diabetes and Glandular Disease Clinic, San Antonio, Texas </FONT></div> <div> Address correspondence and reprint requests to Teresa Quattrin, MD, Associate Professor of Pediatrics, Division of Endocrinology—Diabetes, The Women and Children’s Hospital of Buffalo, 239 Bryant St., Buffalo, NY 14222. E-mail: <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>tquattrin@upa.chob.edu</U></FONT> </div> <div> <B>OBJECTIVE</B>—The aim of this study was to determine whether<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>premeal pulmonary delivery of rapid-acting, dry-powder insulin<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>(Exubera) plus Ultralente could provide glycemic control comparable<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>to a conventional insulin regimen in type 1 diabetes.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> <B>RESEARCH DESIGN AND METHODS</B>—Three hundred thirty-five<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>subjects were randomly assigned to receive either premeal inhaled<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>insulin plus bedtime Ultralente or two to three injections of<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>regular and NPH insulin for 24 weeks. The primary end point<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>was a change in HbA<FONT SIZE="1" COLOR="#660099" FACE="Arial" >1c</FONT>.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> <B>RESULTS</B>—Mean decreases in HbA<FONT SIZE="1" COLOR="#660099" FACE="Arial" >1c</FONT> values were comparable<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>for inhaled (8.1–7.9%) and conventional groups (8.1–7.7%)<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>(adjusted treatment group difference 0.16% [95% CI –0.01<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>to 0.32]). There were greater reductions for inhaled versus<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>conventional regimen in fasting and postprandial plasma glucose<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>(adjusted mean change differences –25.17 and –30.28<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>mg/dl, respectively [95% CI –43.39 to –6.95 and<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>–54.58 to –5.97, respectively]). Hypoglycemia (events/subject<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>month) was lower for the inhaled (8.6) versus the conventional<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>(9.0) group (risk ratio, 0.96 [95% CI 0.93–0.99]). In<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>subjects receiving inhaled insulin, increased insulin antibody<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>levels were observed, but there were no associated clinical<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>or laboratory changes. Adverse events were comparable between<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>groups. Mild to moderate cough was more frequent in the inhaled<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>insulin group (27 vs. 5%) but decreased during the treatment.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>Pulmonary function tests were not different between the groups<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>except for a greater decrease in carbon monoxide diffusing capacity<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>in the inhaled insulin group. Treatment satisfaction was greater<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>in the inhaled than in the conventional group.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> <B>CONCLUSIONS</B>—Inhaled insulin is effective, well tolerated,<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>and well accepted in patients with type 1 diabetes and provides<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>glycemic control comparable to that with a conventional insulin<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>regimen.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> <B>Abbreviations:</B> DL<FONT SIZE="1" COLOR="#660099" FACE="Arial" >CO</FONT>, carbon monoxide diffusing capacity • FEV<FONT SIZE="1" COLOR="#660099" FACE="Arial" >1</FONT>, forced expiratory volume in 1 s • FPG, fasting plasma glucose • FVC, forced vital capacity • TLC, total lung capacity</div> <div> <B>    </B><A HREF="http://www.drugdevelopment-technology.com/project_printable.asp?ProjectID=2688" TARGET="_top" TITLE="http://www.drugdevelopment-technology.co"><U><B>EXUBERA information click here </B></U></A></div> <bR> <div> <U>Return to profile</U><FONT SIZE="3" COLOR="#660099" FACE="Arial" > </FONT></div> <bR> <bR> <div> <B><U> <A NAME="effect_of_rosiglitazone_versus_insulin"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Effect of Rosiglitazone Versus Insulin on the Pancreatic ß-Cell Function of Subjects With Type 2 Diabetes </U></B></div> <div> <B>Fernando Ovalle, MD, FACE and David S.H. Bell, MB, FACE </B></div> <div> Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama </div> <div> Address correspondence and reprint requests to David S.H. Bell, MB, 510 S. 20th St., Rm. 702, Birmingham, AL 35294. E-mail: <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>dshbell@uab.edu</U></FONT> </div> <div> <B>OBJECTIVE</B>—In a previous study, we found observational<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>evidence of improvement in ß-cell function when rosiglitazone<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>was added to a failing oral antihyperglycemic regimen consisting<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>of sulfonylureas and metformin. To confirm our previous observations,<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>we designed and performed a prospective, randomized, and controlled<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>study.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> <B>RESEARCH DESIGN AND METHODS</B>—A total of 17 subjects with<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>type 2 diabetes, inadequately controlled on a maximized oral<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>antihyperglycemic double regimen of glimepiride and metformin,<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>were randomized to the addition of rosiglitazone or insulin<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>to their treatment regimens for a period of 6 months. At baseline<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>and at 6 months, the following were performed: measurement of<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>fasting plasma glucose, fasting proinsulin, and insulin levels;<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>frequently sampled intravenous glucose tolerance test; and glucagon<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>stimulation test for C-peptide.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> <B>RESULTS</B>—Nine subjects were randomized to the addition<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>of 8 mg rosiglitazone, and eight subjects were randomized to<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>the addition of one injection of insulin (premixed 70/30) before<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>their evening meal. The treatment groups were well matched for<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>age, duration of diabetes, and BMI. Most important, the HbA<FONT SIZE="1" COLOR="#660099" FACE="Arial" >1c </FONT>was well matched between groups before treatment (8.7 ±<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>0.3 and 9.0 ± 0.3%; NS) and at the end of the 6 months<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>(7.8 ± 0.5 and 7.8 ± 0.3%; NS). After 6 months,<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>at the end of the study, there was a significant improvement<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>in acute insulin response to glucose in the rosiglitazone group<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>(+15.3 µIU · ml<FONT SIZE="1" COLOR="#660099" FACE="Arial" >–1</FONT> · 10 min<FONT SIZE="1" COLOR="#660099" FACE="Arial" >–1</FONT>;<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT><I>P</I> < 0.001) that led to an increase in the disposition index<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>from 0.18 at baseline to 4.18 at 6 months (<I>P</I> = 0.02). Furthermore,<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>at the end of the study, the proinsulin-to-insulin ratio had<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>decreased in the rosiglitazone group by 36% (<I>P</I> = 0.03) but did<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>not change significantly in the insulin treatment group.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> <B>CONCLUSIONS</B><B>—Rosiglitazone, but not insulin, induced a</B><B> </B><B>recovery of pancreatic ß-cell function, as evidenced</B><B> </B><B>by the restoration of the first-phase insulin response to glucose,</B><B> </B><B>improvement in the disposition index, and a decrease in the</B><B> </B><B>proinsulin-to-insulin ratio in subjects with type 2 diabetes</B><B> </B><B>in whom oral antihyperglycemic therapy failed. This improvement</B><B> </B><B>was independent of the correction of glucotoxicity.</B><B> </B></div> <div> <B>Abbreviations:</B> AIRg, acute insulin response to glucose • AUCab, area under the curve above the baseline • FFA, free fatty acid • fsIVGTT, frequently sampled intravenous glucose tolerance test • HOMA, homeostasis model assessment • TZD, thiazolidinedione</div> <bR> <bR> <bR> <div>  <A NAME="tomato_juice_may_cut_clotting_in"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A>Tomato Juice May Cut Clotting in Diabetics  Wed Aug 18, 7:03 PM ET  </div> <div> By Amanda Gardner </div> <bR> <div> WEDNESDAY, Aug. 18 (HealthDayNews) -- For people with type 2 diabetes, tomato juice may help stave off the heart troubles that often complicate the disease.</div> <bR> <bR> <div> Researchers have found that drinking tomato juice for three weeks had a blood-thinning effect in people with the disease. The juice reduced "platelet aggregation" -- the blood's ability to clot.</div> <bR> <bR> <div> The finding appears in a research letter in the Aug. 18 issue of the Journal of the American Medical Association (news - web sites).</div> <bR> <bR> <div> If corroborated by larger studies, the finding may one day also help "individuals with increased clotting tendency such as smokers, long-distance air travelers (deep vein thrombosis), etcetera," said Manohar L. Garg, one of the authors of the letter detailing the results. Garg is an associate professor of nutrition and dietetics at the University of Newcastle in Australia.</div> <bR> <bR> <div> "When platelets aggregate, they form the plug that clots the vessels," explained Dr. Stuart Weiss, a clinical assistant professor of medicine at New York University School of Medicine. "In diabetes patients, platelets are more sticky." Platelets are responsible for the blood's ability to clot which, in the case of an injury, is a good thing. Clotting can go too far, however, and cause strokes, heart attacks and other life-threatening problems.</div> <bR> <bR> <div> As a result of this excessive "stickiness," for instance, people with type 2 diabetes have an increased risk of atherosclerosis and cardiovascular problems, such as heart attack and stroke. Anti-clotting medications have been shown to reduce this risk.</div> <bR> <bR> <div> "In diabetes, there are a lot of pro-inflammatory markers that contribute to increasing platelet aggregation, so if there's something we can do that can reverse or limit that, that would be a very positive thing," Weiss added.</div> <bR> <bR> <div> Consumption of tomato products has been shown to reduce the incidence of various heart ailments, so the researchers behind the research letter decided to test the hypothesis in people with type 2 diabetes.</div> <bR> <bR> <div> For the study, they recruited 14 men and six women aged 43 to 82 years old with type 2 diabetes but no prior history of clotting problems. None was taking aspirin, nonsteroidal anti-inflammatory drugs or other medications that might influence clotting.</div> <bR> <bR> <div> The participants were randomly assigned to drink 250 milliliters of tomato juice or a placebo -- a tomato-flavored beverage -- every day for three weeks. All were instructed to maintain their normal diet.</div> <bR> <bR> <div> Blood samples were collected at the beginning and at the end of the study, then analyzed. Platelet aggregation turned out to be significantly lower at the end of the trial for the group drinking tomato juice. There was no significant difference in platelet aggregation in the placebo group.</div> <bR> <bR> <div> It's not clear why the juice had this effect, Garg said. Knowing why could be instrumental in helping to decide if tomato juice needs to be part of a dietary plan for those with type 2 diabetes.</div> <bR> <bR> <div> "Mechanisms of how tomato juice inhibits platelet aggregation need to be delineated prior to issuing practical recommendations," said Garg. "A substance named P3 has been isolated from the yellow, jelly-like fluid around the seeds of the tomato... P3 has been shown to possess anti-aggregatory effects."</div> <bR> <bR> <div> For now, a little tomato juice may be a fine thing for diabetics, but don't overdo it.</div> <bR> <bR> <div> "There's some sugar in tomato juice but it's not particularly large," Weiss said. "Depending on your blood glucose control, you don't necessarily want to have a lot. It's also acidic so your stomach can get a little unhappy with large amounts."</div> <bR> <bR> <div> In time, Weiss predicted, "we'll find that more and more vegetables and more and more foods have things in them that keep us healthy."</div> <bR> <div> <B><U> <A NAME="serum_ferritin_and_risk_of_metabolic"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Serum Ferritin and Risk of Metabolic Syndrome in US Adults:</U></B> The Third National Health and Nutrition Examination Survey Abstract Information Presented during: <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>Novel Predictors of Type 2 Diabetes - 06/07/2004 (02:15 - 04:15 PM) </U></FONT>Abstract Number: 281-OR Authors: MEGAN L. JEHN, ELISEO GUALLAR Institution: Baltimore, MD Results: Several studies have suggested that elevated iron stores may be a risk factor for cardiovascular disease and diabetes, but limited data are available on the association between iron stores and the metabolic syndrome. The aim of this study was to examine the relationship between serum ferritin, metabolic syndrome and insulin resistance among 6,151 adults >20 years of age who participated in the Third National Health and Nutrition Examination Survey (NHANES III). The Homeostasis Model Assessment (HOMA) was used to estimate insulin resistance. Mean (95% CI) serum ferritin values were 140.3 (134.2-146.8) µg/L in men, 94.5 (88.9-100.4) µg/L in post-menopausal women and 33.8 (31.7- 35.9) µg/L in pre-menopausal women. After adjustment for age, ethnicity, body mass index, and C-reactive protein, the odds ratios (95% CI) of the prevalence of the metabolic syndrome for the highest compared to the lowest quartile of serum ferritin were 2.3 (1.5-3.5) in men, 1.9 (0.9-3.8) in pre-menopausal women, and 2.1 (1.3-3.2) in post-menopausal women. In all three groups, serum ferritin levels increased as the number of metabolic syndrome components increased (Figure). Ferritin levels also correlated with insulin resistance in men (r = 0.14, p < 0.001) and post-menopausal women (r = 0.19, p<0.001), but not in pre-menopausal women (r=0.04, p=0.13). Additional sensitivity analyses excluding individuals with suspected infection, inflammation and liver disease produced similar results. These findings indicate that elevated iron stores are positively associated with prevalence of the metabolic syndrome and insulin resistance in a representative sample of the US population. [figure1]</div> <bR> <div> <B><U> <A NAME="lipitor_halves_stroke_risk_in_diabetics"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Lipitor Halves Stroke Risk in Diabetics</U></B></div> <div> By Ben Hirschler, European Pharmaceuticals Correspondent </div> <bR> <div> LONDON (Reuters) - Pfizer Inc.'s cholesterol fighter Lipitor (news - web sites) halved the risk of stroke in patients with diabetes in a study and cut cardiovascular events, including heart attacks, by more than a third, researchers said on Sunday. </div> <bR> <div> The clear benefits mean doctors should now consider giving so-called statin drugs routinely to patients with diabetes, according to investigators involved with the British clinical trial. </div> <bR> <bR> <div> That could open up a huge new market for the cholesterol-lowering drugs -- already the world's top-selling medicines -- and Lipitor in particular, which has annual sales of $10 billion. </div> <bR> <bR> <div> "We need to shift thinking toward a presumption that most people with type II diabetes are likely to receive very substantial benefit," Helen Colhoun, professor of genetic epidemiology at University College Dublin, told Reuters. </div> <bR> <bR> <div> Type II diabetes, which typically occurs in adulthood and is closely linked with obesity, is one of the world's fastest growing health problems. </div> <bR> <bR> <div> It is closely related to cardiovascular disease, with two out of three sufferers dying from heart disease and stroke. Yet most of the world's diabetics, estimated by the International Diabetes Federation to number 194 million, are not currently given statins. </div> <bR> <bR> <div> That may be about to change. </div> <bR> <bR> <div> GROWING EVIDENCE </div> <bR> <bR> <div> The findings from the Lipitor study, which were presented at the annual meeting of the American Diabetes Association in Orlando, add to the growing body of evidence favoring statins in the treatment of diabetes. </div> <bR> <bR> <div> A similar study last year on Merck & Co Inc's rival statin Zocor showed it cut the risk of heart attack and stroke by a third. </div> <bR> <bR> <div> And it was already clear last June that Lipitor was having a significant impact when the British trial was halted two years early to allow patients on placebo to take the drug. </div> <bR> <bR> <div> Now the full results of the study -- sponsored by British charity Diabetes UK, Britain's Department of Health and Pfizer UK -- are being made available. </div> <bR> <bR> <div> They show that a 10 mg dose of Lipitor, known generically as atorvastatin, reduced cardiovascular events by 37 percent in diabetics with no previous history of cardiovascular disease, while the incidence of stroke fell by 48 percent. </div> <bR> <bR> <div> Current best practice is to use statins in diabetics only when they have elevated cholesterol levels or established heart disease. </div> <bR> <bR> <div> But researchers say the British trial demonstrates that a much wider group of patients would actually benefit and statins could become a third leg of a strategy that already includes treatment for blood sugar levels and high blood pressure. </div> <bR> <bR> <div> "We are hoping this will provide the necessary evidence base for policy to shift," said Colhoun. </div> <bR> <bR> <div> "The challenge is really whether there is anybody with type II diabetes at sufficiently low risk of heart disease not to warrant this treatment," she added. </div> <bR> <bR> <div> <B><U> <A NAME="gila_may_be_healer_for_type_2_diabetes"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Gila May Be Healer for Type 2 Diabetes</U></B></div> <bR> <div> By Kathleen Doheny</div> <div> HealthDay Reporter </div> <bR> <div> SATURDAY, June 5 (HealthDayNews) -- A new type 2 diabetes drug derived from the saliva of a huge, venomous lizard may control blood sugar without the weight gain associated with other diabetes medications.</div> <bR> <div> The trial drug, which has not yet won approval from the U.S. Food and Drug Administration (news - web sites), "will mean a new method, a novel treatment for type 2 diabetes patients, the likes of which we have not seen before," said Dr. Dennis Kim, director of clinical affairs for Amylin Pharmaceuticals in San Diego, which funded the study and makes the medication.</div> <bR> <bR> <div> The findings were presented June 5 at the annual meeting of the American Diabetes Association in Orlando, Fla.</div> <bR> <bR> <div> The origin of the novel drug, called exenatide, is itself novel. It is a synthetic version of the hormone exendin-4, found in the saliva of the Gila monster, a lizard native to several Southwestern U.S. states. The Gila monster eats just four times a year and turns its pancreas off between those meals. When it's time to turn its pancreas on again, it secretes exendin-4.</div> <bR> <bR> <div> The exendin-4 is similar in action to human GLP-1, a hormone produced in the gut that can stimulate insulin production without causing threateningly low blood sugar, which can occur after taking insulin and some oral anti-diabetes pills.</div> <bR> <bR> <div> Unlike other oral agents taken for type 2 diabetes, the drug has not been linked with weight gain and actually resulted in weight loss, according to the researchers.</div> <bR> <bR> <div> "This class of drugs has been shown to suppress appetite in humans," Kim said.</div> <bR> <bR> <div> More than 18 million Americans have diabetes, and most suffer from type 2, in which the body fails to use insulin properly.</div> <bR> <bR> <div> In the study, exenatide was given to 336 people whose type 2 diabetes was not controlled well with the maximum doses of metformin (Glucophage), a commonly used oral drug for type 2 diabetes. The study, which lasted 30 weeks, involved three groups, receiving five micrograms or 10 micrograms of exenatide or placebo, injected twice daily. </div> <bR> <bR> <div> Those on exenatide lost weight and reduced blood sugar, said Dr. Ralph DeFronzo, a physician at the University of Texas Health Science Center at San Antonio, who was to present the research at the meeting. Those on the higher dose lost 6.3 pounds on average and reduced their blood sugar levels. Those on the lower dose lost an average of 3.5 pounds and also lowered their blood sugar.</div> <bR> <bR> <div> The most common side effects were mild to moderate nausea.</div> <bR> <bR> <div> In animal studies, when exenatide was given, the formation of new beta cells resulted. Beta cells are the insulin-producing cells in the pancreas, and as type 2 diabetes progresses, they begin to fail. In the human study, markers of beta-cell function improved in those on the exenatide.</div> <bR> <bR> <div> "If everything goes as planned, we foresee being able to market the drug the middle of next year, hopefully," Kim said.</div> <bR> <bR> <div> Other experts agree the drug may be good news for type 2 diabetics. "The drug is acting like the hormone GLP, which is a gut hormone, and GLP is having a direct effect on the beta cells and causing the beta cells to secrete more insulin," said Dr. Martin Abrahamson, acting chief medical officer for the Joslin Diabetes Center in Boston, who serves on the scientific advisory board of Amylin.</div> <bR> <bR> <div> In type 2 diabetes, Abrahamson said, there is a gradual loss of beta cell function over time. "Will the drug reverse that decline? We don't know the answer to that."</div> <bR> <bR> <div> "This is a drug that will help control blood sugar, but [also] help with weight reduction," added Dr. Nathaniel Clark, a spokesman for the American Diabetes Association, who is familiar with the research on exenatide.</div> <bR> <div>  <A NAME="statins_for_every_diabetic_"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A>Statins for Every Diabetic?</div> <bR> <div> Thu Jun 3, By Maggie Fox, Health and Science Correspondent </div> <bR> <div> WASHINGTON (Reuters) - Almost everyone with diabetes should consider taking a statin drug to lower cholesterol, even if they already have low cholesterol levels, the American Diabetes Association advised on Thursday. </div> <bR> <bR> <div> Diabetes patients are at such high risk of heart disease that the statins almost certainly will do them some good, the group said in its latest treatment guidelines. </div> <bR> <bR> <div> People with diabetes should all consider taking a daily aspirin, too, the new guidelines say. </div> <bR> <bR> <div> "It may well be that everybody with diabetes should be on a statin," said Dr. Nathaniel Clark, vice-president for clinical affairs for the group. </div> <bR> <bR> <div> "We know that statins lower low-density cholesterol but they may also have some other qualities that have not been tested," Clark said in a telephone interview. </div> <bR> <bR> <div> An estimated 18 million Americans have diabetes, 90 to 95 percent of them type-2 diabetes. This once was called adult-onset diabetes but it is showing up in children more often now. </div> <bR> <bR> <div> Type-1 diabetes is an autoimmune disease caused when the body mistakenly destroys insulin-producing pancreas cells. </div> <bR> <bR> <div> Type-2 diabetes is strongly associated with being overweight and sedentary. It greatly raises the risk for heart disease, stroke and heart attack and can also lead to blindness and limb loss. </div> <bR> <bR> <div> Clark said the Association decided to add statins to the guidelines after seeing the results of a British study, published earlier this year in the Lancet medical journal, that showed people who took statins had a one-third lower risk of stroke. </div> <bR> <bR> <div> Their study included adults over the age of 40 whose total cholesterol levels were as low as 135 -- considered extremely low by most standards. Among normal healthy people, doctors do not usually consider giving drugs to lower cholesterol until total levels hit 200. </div> <bR> <bR> <div> But Clark said diabetics are a special case. </div> <bR> <bR> <div> "It is now a consensus that having diabetes is the equivalent in terms of cardiovascular risk of already having had a heart attack," Clark said. </div> <bR> <bR> <div> "We are talking about what we would consider a high-risk group." </div> <bR> <bR> <div> Statins are becoming more and more popular with doctors as study after study finds they can lower the risk of a range of heart conditions and may also help patients with multiple sclerosis and Alzheimer's disease (news - web sites). </div> <bR> <bR> <div> Worldwide, 25 million people take statins, but up to 200 million could be eligible. </div> <bR> <bR> <div> The drugs are not cheap, however. The United States already spending $12.5 billion on statin drugs, more than any other type of medicine, and the drugs can cause a rare type of side-effect called rhabdomyolysis, which damages muscles. </div> <bR> <div> <B><U> <A NAME="ron_storage_raises_diabetes_risk_"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Study Finds Iron Storage Raises Diabetes Risk   </U></B></div> <bR> <div> CHICAGO (Reuters) - A study has found that storing abnormal amounts of iron in the body can lead to adult onset diabetes in women, raising the possibility that a blood test earlier in life could help identify those at risk from the disease, researchers said on Tuesday. </div> <bR> <bR> <div> The finding came from a look at 698 women among thousands of nurses who gave blood samples between 1989 and 1990 as part of a multiyear study. The 698 women developed diabetes over the course of the study even though they were free of it and free of heart disease as well at the start. </div> <bR> <bR> <div> When their initial blood samples were compared with others who did not develop diabetes over a 10-year period, it was found that the diabetic group had significantly elevated levels of ferritin when the initial blood samples were taken. </div> <bR> <bR> <div> Ferritin is an iron-protein complex in blood that is a marker for iron storage. </div> <bR> <bR> <div> Women with higher ferritin levels at the start of the study had a nearly threefold increased risk of developing diabetes, the study found, even after taking into account such things as obesity and other risk factors including family history of diabetes, physical activity, alcohol use and diet. </div> <bR> <bR> <div> "The results provide the strongest evidence to date that increased iron stores in the body are an independent risk factor for type 2 diabetes," said Rui Jiang of the Harvard School of Public health, lead author of the study appearing in this week's Journal of the American Medical Association (news - web sites). </div> <bR> <bR> <div> Frank Hu, a senior author, added: "The findings suggest that a simple blood test which measures ferritin levels can be used to predict the development of type 2 diabetes in otherwise healthy people. This may help in identifying high-risk people who would possibly benefit from further lifestyle or therapeutic interventions that can lower iron stores in the body." </div> <bR> <bR> <div> It was known that excessive iron stores could cause diabetes among patients with hemochromatosis, a genetic defect in the regulation of iron absorption, the study said. But it had not been clear whether moderately higher iron stores raised the risk of developing diabetes in otherwise healthy individuals, it said. </div> <bR> <bR> <div> The authors said iron excess seems to contribute to insulin resistance and later to decreased insulin secretion. </div> <bR> <bR> <bR> <bR> <bR> <div> <I> <A NAME="cinn"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></I><I>Diabetes Care</I> 26:3215-3218, 2003</div> <div> © 2003 <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>by the American Diabetes Association, Inc.</U></FONT> </div> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="495" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 19 WIDTH="491"><div> Clinical Care/Education/Nutrition  Original Article</div> </tD> </tR> </TABLE></div> <div> <B>Cinnamon Improves Glucose and Lipids of People With Type 2 Diabetes </B></div> <div> <B>Alam Khan, MS, PHD</B><FONT SIZE="1" COLOR="#660099" FACE="Arial" ><B>1,2,3</B></FONT><B>, Mahpara Safdar, MS</B><FONT SIZE="1" COLOR="#660099" FACE="Arial" ><B>1,2</B></FONT><B>, Mohammad Muzaffar Ali Khan, MS, PHD</B><FONT SIZE="1" COLOR="#660099" FACE="Arial" ><B>1,2</B></FONT><B>, Khan Nawaz Khattak, MS</B><FONT SIZE="1" COLOR="#660099" FACE="Arial" ><B>1,2</B></FONT><B> and Richard A. Anderson, PHD</B><FONT SIZE="1" COLOR="#660099" FACE="Arial" ><B>3</B></FONT><B> </B></div> <div> 1<FONT SIZE="3" COLOR="#660099" FACE="Arial" > Department of Human Nutrition, NWFP Agricultural University, Peshawar, Pakistan</FONT></div> <div> 2<FONT SIZE="3" COLOR="#660099" FACE="Arial" > Post Graduate Medical Institute, Hayatabad Medical Complex, Peshawar, Pakistan</FONT></div> <div> 3<FONT SIZE="3" COLOR="#660099" FACE="Arial" > Nutrients Requirements and Functions Laboratory, Beltsville Human Nutrition Research Center, Beltsville, Maryland </FONT></div> <div> Address correspondence and reprint requests to Dr. Richard A. Anderson, Nutrient Requirements and Functions Laboratory, Beltsville Human Nutrition Research Center, Bldg. 307, Rm. 224, Beltsville, MD 20705. E-mail: <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>Anderson@307.bhnrc.usda.gov</U></FONT> </div> <div> <B>OBJECTIVE</B>—The objective of this study was to determine<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>whether cinnamon improves blood glucose, triglyceride, total<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>cholesterol, HDL cholesterol, and LDL cholesterol levels in<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>people with type 2 diabetes.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> <B>RESEARCH DESIGN AND METHODS</B>—A total of 60 people with<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>type 2 diabetes, 30 men and 30 women aged 52.2 ± 6.32<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>years, were divided randomly into six groups. Groups 1, 2, and<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>3 consumed 1, 3, or 6 g of cinnamon daily, respectively, and<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>groups 4, 5, and 6 were given placebo capsules corresponding<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>to the number of capsules consumed for the three levels of cinnamon.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>The cinnamon was consumed for 40 days followed by a 20-day washout<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>period.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> <B>RESULTS</B>—After 40 days, all three levels of cinnamon reduced<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>the mean fasting serum glucose (18–29%), triglyceride<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>(23–30%), LDL cholesterol (7–27%), and total cholesterol<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>(12–26%) levels; no significant changes were noted in<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>the placebo groups. Changes in HDL cholesterol were not significant.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <div> <B>CONCLUSIONS</B>—The results of this study demonstrate that<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>intake of 1, 3, or 6 g of cinnamon per day reduces serum glucose,<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>triglyceride, LDL cholesterol, and total cholesterol in people<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>with type 2 diabetes and suggest that the inclusion of cinnamon<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>in the diet of people with type 2 diabetes will reduce risk<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>factors associated with diabetes and cardiovascular diseases.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT></div> <bR> <bR> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="369" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 20 WIDTH="365"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="20" ALIGN="bottom" WIDTH="365" HSPACE="0" VSPACE="0"></tD> </tR> </TABLE></div> <bR> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="785" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 1519 WIDTH="781"><div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="627" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 20 ><NOBR><div> <B>: </B>Heart Dis. 2003 May-Jun;5(3):231-40. </div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="236"><div> <U>Related Articles,</U><FONT SIZE="3" COLOR="#660099" FACE="Arial" > </FONT><U>Links</U><FONT SIZE="3" COLOR="#660099" FACE="Arial" > </FONT></div> </tD> </tR> </TABLE></div> <bR> <div> <B> <A NAME="insulin_glargine"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></B><B>Insulin glargine: a new once-daily Basal insulin for the management of type 1 and type 2 diabetes mellitus.  </B><FONT SIZE="3" COLOR="#660099" FACE="Arial" ><B>Lam S.</B>Geriatric Research, Education & Clinical Center (GRECC), Veterans Affairs Medical Center, Durham, NC.</FONT></div> <div> Optimal glucose control is the primary goal for treating diabetes mellitus and preventing long-term complications of diabetes, such as coronary heart disease, nephropathy, neuropathy and retinopathy. Insulin glargine is a novel, long-acting human insulin analog that is indicated in type 1 diabetic patients aged >/=6, or in type 2 diabetic patients who require basal insulin for glycemic control. Insulin glargine is a recombinant insulin with a modified structure that allows it to dissolve in an acidic solution, but to precipitate in the physiological subcutaneous tissue forming a depot effect. In contrast to Neutral Protamine Hagedorn (NPH) insulin, insulin glargine has a slower onset, a longer duration of action, and no peak in metabolic activity. Once-daily subcutaneous administration of insulin glargine at bedtime has comparable efficacy to that of NPH insulin once or twice daily when used in combination with bolus insulin in type 1 diabetic patients, or in conjunction with oral antidiabetic drugs in type 2 diabetic patients. Overall, insulin glargine has similar adverse effects when compared with NPH insulin. Insulin glargine has been associated with less nocturnal hypoglycemia and improved treatment satisfaction in several clinical trials with durations of < 52 weeks. Pharmacoeconomic analysis comparing insulin glargine with other intermediate- or long-acting insulin preparations used as basal insulin therapy has not been performed. In summary, insulin glargine offers a promising alternative as a once-daily basal insulin therapy in patients with type 1 and type 2 diabetes.</div> <div> PMID: 12783637 [PubMed - in process] </div> <bR> <bR> <div> <B> <A NAME="tigh"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></B><B>Tight Glucose Control In Diabetes Lowers Risk Of Atherosclerosis</B></div> <div> BETHESDA, MD -- June 5, 2003 -- Strict glucose control in type 1 diabetes reduces the risk of atherosclerosis, a benefit that persists for years, according to a study published in the June 5, 2003 issue of the New England Journal of Medicine. Since 1993, when the Diabetes Control and Complications Trial (DCCT) ended, researchers have known that intensive glucose control greatly reduces the eye, nerve, and kidney damage of type 1 diabetes. Now, researchers conclude, the benefits of tight control also extend to the heart. "Intensive control is difficult to achieve and maintain, but its benefits are even greater than we realized," says study chair Dr. Saul Genuth of the Case Western University. "The earlier intensive therapy begins and the longer it can be maintained, the better the chances of reducing the debilitating complications of diabetes." The DCCT was a multicenter study that compared intensive versus conventional management of blood glucose in 1,441 people with type 1 diabetes. Patients on intensive treatment kept glucose levels as close to normal as possible with at least three insulin injections a day or an insulin pump and frequent self-monitoring of blood glucose. Intensive treatment aimed to keep hemoglobin A1c (HbA1c), which reflects average blood sugar over 2 to 3 months, to as close to normal (6 percent) as possible. Conventional treatment at that time consisted of one or two insulin injections a day with daily urine or blood glucose testing. After 6½ years of the DCCT, HbA1c levels averaged 7 percent in the intensively treated group and 9 percent in the conventionally treated group. When the DCCT ended, those who had been assigned to conventional treatment were encouraged to adopt intensive control and shown how to do it, and researchers began a long-term follow-up study of the participants, called the Epidemiology of Diabetes Interventions and Complications (EDIC) study. The DCCT could not study atherosclerosis because the participants were relatively young, and heart disease takes years to develop. In 1994-95 and again in 1998-2000, EDIC researchers used ultrasound to measure the thickness of participants' carotid arteries, the two blood vessels in the neck that carry blood from the heart to the brain. Carotid wall thickness reflects the amount of atherosclerosis, or plaque build-up, in the artery: the thicker the arterial wall the greater the risk of later heart attack and stroke. At the time of their first ultrasound, the diabetic participants' carotid wall thickness was similar to that of non-diabetic controls matched for age and gender. Five years later, however, the participants had thicker arterial walls than those of the non-diabetic group. In addition, the thickness of the carotid walls had increased less in the intensively treated group during the 5 years than in the conventionally treated group. "This finding strongly suggests that atherosclerosis progressed more slowly in the intensively treated group," noted Dr. Genuth. Carotid thickening was also linked to known cardiovascular risk factors including age, higher systolic blood pressure, smoking, LDL:HDL cholesterol ratio, and urinary albumin (a measure of kidney function). After adjusting for these factors, the study found that the differences in carotid wall thickness between the two groups were due to the differences in blood glucose levels during the DCCT. "The risk of heart disease is about 10 times higher in people with type 1 diabetes than in people without diabetes, but it was unclear to what extent blood glucose contributed to the development of heart disease," said Dr. David Nathan of Massachusetts General Hospital, who co- chaired the DCCT/EDIC research group. "Now we know that intensively controlled glucose significantly reduces the atherosclerosis underlying heart disease just as it reduces damage to the eyes, nerves, and kidneys in people with type 1 diabetes. What's striking is that the benefits of intensive control persisted despite a gradual rise in the HbA1c levels of the intensively treated group during the 5 years after DCCT ended." "For many people, diabetes is difficult to manage with today's tools. Every new finding about the importance of blood glucose control in preventing complications heightens our determination to foster research that results in new therapies that take the burden off the patient," said Dr. Judith Fradkin, director of the Diabetes, Endocrinology, and Metabolic Diseases Division of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). About 17 million people in the United States have diabetes, the most common cause of blindness, kidney failure, and amputations in adults and a major cause of heart disease and stroke. About 1 million have type 1 diabetes. Formerly known as juvenile onset or insulin-dependent diabetes, type 1 diabetes usually begins in children and adults under age 30. It develops when the body's immune system attacks the insulin-producing cells of the pancreas. Type 2 diabetes accounts for up to 95 percent of all diabetes cases. Most common in adults over age 40, type 2 diabetes affects 6.2 percent of the U.S. population. It is strongly associated with obesity (more than 80 percent of people with type 2 diabetes are overweight), inactivity, family history of diabetes, and racial or ethnic background. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes. The prevalence of type 2 diabetes has tripled in the last 30 years, due in large part to the upsurge in obesity. SOURCE: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) </div> <bR> </tD> </tR> </TABLE></div> <bR> <bR> <bR> <div> <B><U> <A NAME="regression_"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>"Regression of Microalbuminuria with tight controld of gjucose</U></B></div> <div> <B>New England Journal of Medicine (NEJM)</B></div> <bR> <div> 06/12/2003</div> <div> By Martha Kerr</div> <bR> <div> Elevated urinary albumin excretion does not imply inexorably progressive nephropathy, say investigators.</div> <bR> <div> Researchers with the Joslin Study of the Natural History of Microalbuminuria in Boston, Massachusetts, United States, report that modification of factors that lead to elevated urinary excretion can reduce those levels back to normal.</div> <bR> <div> Lead investigator Dr. Bruce A. Perkins of the Joslin Diabetes Center and colleagues studied 386 patients with type 1 diabetes and persistent microalbuminuria with urinary albumin excretion rates ranging from 30 micrograms/min to 299 micrograms/min over a 6-year period. Excretion rates were grouped into 2-year intervals during follow-up.</div> <bR> <div> Regression of microalbuminuria occurred frequently during the study period, with a 6-year cumulative incidence of 58%. Only 19% went on to develop overt proteinuria.</div> <bR> <div> Regression of microalbuminuria was associated with glycosylated haemoglobin levels below 8%, systolic blood pressure below 115 mmHg, cholesterol levels below 198 mg/dL and triglyceride levels below 145 mg/dL.</div> <bR> <div> Dr. Perkins notes that "our study results indicate that microalbuminuria is more likely to subside to normal levels than to progress to overt proteinuria" with modification of risk factors.</div> <bR> <div> He adds that "although our findings support a new model of early diabetic nephropathy, the contributing variables are not known with precision. Clinical trials that assess the optimal target level of albumin excretion - in terms of the regression of microalbuminuria - as well as the optimal levels of other factors are warranted." </div> <div> N Engl J Med 2003;348:23:2285-2293. <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><I><U>"Regression of Microalbuminuria in Type 1 Diabetes"</U></I></FONT></div> <bR> <bR> <bR> <div> <B><U> <A NAME="transplant_trial_with_just_an_iv"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>transplant trial WITH JUST AN IV</U></B></div> <div> WASHINGTON (Reuters Health) - Twelve diabetic patients who have taken part in a transplant trial no longer need to take insulin shots, according to early data released here Monday. </div> <bR> <div>   The patients have all had at least one transplant of pancreatic islet cells, which are meant to replace their own non-functioning cells. Islets are clusters of cells in the pancreas that contain insulin-producing beta cells. </div> <bR> <bR> <div> The hope is that these patients, who have type 1 diabetes, will never have to be insulin-dependent again, and that they won't experience the disease's common complications, such as blindness, and heart and kidney disease, said James Shapiro, the trial's principal investigator and director of the islet transplant program at the University of Alberta in Edmonton, Canada. </div> <bR> <bR> <div> Shapiro and colleagues at nine sites around the world began transplanting islet cells into diabetic patients in late 2001, and have reported on a few patients before. They gave an update Monday at a briefing held in conjunction with the American Transplant Congress. </div> <bR> <bR> <div> Twelve patients have stopped taking insulin, and 16 others are showing good donor islet function, but are still taking some insulin. </div> <bR> <bR> <div> One of the patients, Anthony Pecora of Ashland, Virginia, has been insulin-free for almost a year. "On July 7, 2002, at 7 p.m., I took my last dose of insulin," Pecora told reporters. </div> <bR> <bR> <div> He had been taking insulin for 29 years, and no longer had good control of his blood sugar when he was accepted into the study at the University of Minnesota. Pecora was given two islet cell transplants. </div> <bR> <bR> <div> In the procedure, patients receive an infusion of islet cells into their main liver vein. After a two-day hospital stay, they are put on a regimen of immune-suppressing drugs. </div> <bR> <bR> <div> Most of the side effects have come from the drugs, not the procedure itself, said Shapiro. </div> <bR> <bR> <div> Eighty-three percent of the patients had severe mouth sores, and a majority also had low white blood cell counts. Almost forty percent of the patients had to start taking cholesterol lowering drugs to counteract the increase brought on by the anti-rejection medications, said Camillo Ricordi, another lead investigator from the University of Miami. </div> <bR> <bR> <div> The transplants seemed to work best at centers that had more experience -- Miami, Edmonton and Wisconsin. "That was expected somewhat," said Shapiro, noting that it is difficult to prepare islet cells for transplant and to figure out proper dosing of anti-rejection drugs. </div> <bR> <bR> <div> The researchers will report final results when all 36 patients being studied have had a chance to respond to up to three transplants. That could be a year from now, said Shapiro. </div> <bR> <bR> <div> It is not easy to find donor islet cells because they have to come from donor pancreases that can't be transplanted whole. The researchers are hoping that rules will be issued by the United Network for Organ Sharing to set aside a certain percentage of pancreases for islet cell harvesting. </div> <bR> <bR> <div> That policy is under consideration now. </div> <bR> <bR> <div> "I think we could do much better and move forward faster if we had access to better pancreases," said Bernhard Hering, another investigator who directs the islet transplant program at the University of Minnesota. </div> <bR> <bR> <div> Type 1 diabetes is sometimes called juvenile diabetes because it usually strikes at a younger age than the more common type 2 diabetes. In type 1 diabetes, the immune system launches a misguided attack against insulin-producing cells in the pancreas. This leads to low or nonexistent levels of the sugar-regulating hormone. People with this type of diabetes must take daily insulin injections to survive. </div> <bR> <bR> <bR> <div> <B><U> <A NAME="vitamins_boost_immunity_of_diabetics__"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Vitamins boost immunity of diabetics - study</U></B></div> <bR> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="207" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 38 ><NOBR><div> March 04 2003 at 06:19AM</div> <bR> </NOBR></tD> </tR> </TABLE></div> <div> Philadelphia - Daily multivitamin and mineral supplements could help adults with diabetes fight off some minor infections, according to a study released on Monday.</div> <bR> <div> The year-long study of 130 patients in North Carolina showed that daily vitamin use reduced the rate of minor respiratory and urinary tract infections, influenza and gastrointestinal infections among all people aged 45 and older.</div> <bR> <div> But the findings were most striking among subjects with adult-onset diabetes. Results showed infection occurring among only 17 percent of diabetic patients who took multivitamins, compared with the 93 percent of diabetics who received a placebo.</div> <bR> <div> The supplements proved effective enough to reduce absenteeism due to infectious diseases. Diabetic patients who received multivitamins recorded no days of absenteeism. But 89 percent of those who took a placebo were absent from work for one or more day.</div> <bR> <div> Subjects who received supplements were given a mix of multivitamins and minerals similar to so-called one-a-day tablets sold at most supermarkets.</div> <bR> <div> "Our trial, which was performed in a sample of middle-aged persons, demonstrated a benefit in incidence of infection. However, this benefit was almost entirely observed in participants with diabetes," said the study, which was published in the Annals of Internal Medicine.</div> <bR> <div> Researchers from the University of North Carolina's School of Medicine believe the supplements were useful to diabetics because people who suffer from the disease often lack nutrients in their systems.</div> <bR> <div> In an accompanying editorial that appeared in the Annals, officials from the Harvard School of Public Health suggested that multivitamins could play a larger role in preventing deadly infectious diseases in developing regions of the world where many are malnourished. </div> <bR> <div>  <A NAME="diabetes_risk_higher_in_those_with"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><B>Diabetes Risk Higher in Those with Shorter Thighs</B> By Alison McCook   </div> <div> NEW YORK (Reuters Health) - People who have relatively short thighs appear to have an increased risk of developing diabetes or a condition that often precedes the disease compared to those with longer gams, researchers said Friday. </div> <bR> <div> But study author Dr. Keiko Asao cautioned that the study does not mean that thigh length in any way causes diabetes. </div> <bR> <div> Asao explained that a third factor, such as the environment in the womb or nutrition in childhood, likely influences both leg length and future diabetes risk. </div> <bR> <div> The precise identity of that third factor remains unclear, she added. </div> <bR> <div> "We are struggling with how to explain that," said Asao, who is at the Johns Hopkins University in Baltimore, Maryland. </div> <bR> <div> People who have relatively short thighs are not doomed to develop diabetes, Asao said. These results are preliminary, she said, and diabetes is a "multifactorial disease" that results from many different causes. </div> <bR> <div> Those with relatively short thighs would not harm themselves if they chose to spend extra energy trying to ward off diabetes, Asao noted. But she recommended people who are concerned about diabetes pay more attention to well-established risk factors, such as obesity. </div> <bR> <div> The study focused on type 2 diabetes, the most common form of the disease, and not type 1 diabetes, which often develops in children or young adults and requires daily insulin injections for survival. Type 2 diabetes more commonly occurs in adults and can sometimes be controlled with diet and exercise. </div> <bR> <div> Asao and her colleagues presented their findings at the American Heart Association (news - web sites)'s 43rd Annual Conference on Cardiovascular Disease Epidemiology and Prevention in Miami. </div> <bR> <div> To obtain their findings, Asao and her team reviewed information about 8,738 adults between the ages of 40 and 74 collected during national surveys conducted by the US government. </div> <bR> <div> The authors found that the shorter people's thighs, the greater their risk of having diabetes or insulin resistance, a condition marked by a loss of sensitivity to this key blood-sugar-regulating hormone that often precedes diabetes. After taking into account other risk factors, the researchers found the link remained true for white and Mexican-American women, but not blacks or men. </div> <bR> <div> Previous research has suggested that shorter people may be at an overall higher risk of diabetes, Asao noted, but added that in the current study, height was not linked to diabetes risk. She suggested that differences in the people included in the two studies may explain the diverging results. </div> <bR> <div> She noted that previous research has also linked height to other chronic diseases, with one study suggesting that taller people have an elevated risk of high blood pressure. The relationship between height and blood pressure could also stem from early growth factors that resemble those that may explain the link between thigh length and diabetes risk, she said. </div> <bR> <div> Whether the length of other body appendages could also be linked to diabetes risk remains unknown, Asao added. </div> <bR> <bR> <bR> <bR> <bR> <div> <B> <A NAME="test_drug_stops_diabetes_related__eye"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></B><B>Test: Drug Stops Diabetes-Related  eye Disease </B></div> <div> Sun Feb 16, 3:23 PM ET  Add Health - AP to My Yahoo! </div> <div>  </div> <bR> <div> By RANDOLPH E. SCHMID, Associated Press Writer </div> <bR> <div> WASHINGTON - A synthetic form of vitamin B1 that is used in Europe to treat nerve problems has been found to prevent the most common form of diabetes-related eye disease in rats. </div> <bR> <div> Diabetic rats treated with benfotiamine for 36 weeks did not develop any of the retina damage found in a similar group of untreated rats, according to a research team led by Dr. Michael Brownlee of the Albert Einstein College of Medicine in New York. </div> <bR> <bR> <div> Brownlee said he hopes to begin a clinical trial to determine whether a similar result would occur in humans once an effective dose for the drug in people is determined. That could happen as soon as a year, he said. </div> <bR> <bR> <div> "We can't say it works in humans because there has never been a double-blind clinical study" of it, Brownlee said. </div> <bR> <bR> <div> The new findings are published Monday in the online edition of the journal Nature Medicine. </div> <bR> <bR> <div> In the United States, diabetes is the leading cause of blindness in people age 20 to 70. Diabetic retinopathy — damage to the small blood cells in the retina — is the most common problem. The American Diabetes Association estimates that between 12,000 and 24,000 people lose their sight each year because of diabetes. </div> <bR> <bR> <div> In diabetics (news - web sites), excess sugar in the blood can damage some cells, especially those lining blood vessels, that are unable to block the sugar from entering. That sugar is burned for fuel by mitochondria, the energy engines of cells. </div> <bR> <bR> <div> In cells that cannot regulate their amount of sugar, byproducts accumulate that can activate three different pathways of cell damage that can lead to blindness and other complications. </div> <bR> <bR> <div> Brownlee's group focused on two compounds involved in this damage. Those compounds are affected by an enzyme called transketolase, which depends on thiamine — also known as vitamin B1 — for its activity. </div> <bR> <bR> <div> The researchers sought to block the cell damage by using thiamine to boost the activity of transketolase, but this increased the enzyme activity only about 20 percent. </div> <bR> <bR> <div> German researchers on the team suggested trying the synthetic thiamine form, benfotiamine, and it increased the enzyme activity by 300 percent to 400 percent, Brownlee said. </div> <bR> <bR> <div> "So that was a stroke of luck," Brownlee said in a telephone interview. Benfotiamine blocked all three damage pathways by converting the damaging compounds into harmless chemicals. </div> <bR> <bR> <div> While benfotiamine is a synthetic derivative of thiamine, it is different from that vitamin, Brownlee said. He cautioned diabetics that "going out to a health food store and buying (news - external web site) a lot of thiamine is not going to help." </div> <bR> <bR> <div> Dr. Francine Kaufman, president of the American Diabetes Association, said the findings are exciting because they show a way to block all three damage pathways in cells lining blood vessels. </div> <bR> <bR> <div> There are other products in the pipeline dealing with one or another of the pathways but not all three, she said. </div> <bR> <bR> <div> In addition, benfotiamine has been in use in Germany for years to treat painful types of nerve damage, including nerve damage caused by diabetes, and seems to have few side effects. Thus "it might not take forever to get into clinical trials," said Kaufman, a pediatric endocrinologist at Children's Hospital in Los Angeles. </div> <bR> <bR> <div> "It's a big leap from animals to humans, but this is quite encouraging," she said. </div> <bR> <bR> <div> <B><U> </U></B></div> <div> <B><U> </U></B></div> <bR> <bR> <div> <B> <A NAME="diabetes_and_chronic_kidney_disease"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></B><B>Diabetes and Chronic Kidney Disease: Ten Facts</B><FONT SIZE="3" COLOR="#660099" FACE="Arial" > </FONT></div> <div> Diabetes is the leading cause of kidney failure in the United States. Because a cure for diabetic kidney disease has not yet been found, treatment involves controlling the disorder and slowing its progression to kidney failure. Current research suggests that control of high blood pressure is a key factor in slowing this disease. Careful control of blood sugar levels and reduction of dietary protein intake is also very important. Treatment to prevent diabetic kidney disease should begin early — before kidney damage is obvious. It is important for everyone to know more about diabetic kidney disease and to learn to recognize its early warning signs. </div> <div> Nearly 16 million Americans, or about 6 percent of the U.S. population, have diabetes. Of these, 10.3 million are diagnosed and 5.4 million are undiagnosed. Diabetes is more prevalent in older people. However, the most common type of diabetes, type 2 diabetes, is becoming more common in younger people. This change may be related to poor diets and increasing prevalence of obesity among younger people.</div> <bR> <div> Diabetes is the single leading cause of kidney failure in the U.S., accounting for 45 percent of the people who start treatment for kidney failure each year, and 38 percent of all Americans being treated for kidney failure. Each year, nearly 25,000 people with diabetes develop kidney failure.</div> <bR> <div> In the U.S., diabetes is more common among certain minority groups: Nearly 10 percent of American Indians and Alaska Natives have diagnosed diabetes. Among 35 million African-Americans, 1.5 million have been diagnosed with diabetes, but an estimated 730,000 do not know they have the disease. Hispanic Americans are almost twice as likely to have diabetes as non-Hispanic whites of similar age. Some Asian Americans also are at increased risk for diabetes; for example, Native Hawaiians are twice as likely to have diagnosed diabetes as white residents of Hawaii.</div> <bR> <div> Diabetes is a group of diseases characterized by high levels of blood sugar resulting from insufficient production of insulin by the pancreas or defects in insulin action in the body. The most common forms of diabetes are type 1 diabetes, which develops in childhood and is sometimes called insulin-dependent diabetes, and type 2 diabetes, which generally develops in adulthood, and is sometimes called non-insulin-dependent diabetes. Type 2 diabetes is far more common, accounting for about 90 to 95 percent of all diagnosed cases of diabetes. </div> <bR> <div> Risk factors for type 1 diabetes may include autoimmune, genetic and environmental factors. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes (diabetes during pregnancy), impaired glucose tolerance, physical inactivity and race or ethnicity. </div> <bR> <div> Diabetes damages small blood vessels throughout the body, affecting the kidneys as well as other organs and tissues, including skin, nerves, muscles, intestines and the heart. Patients with diabetes can develop high blood pressure as well as rapid hardening of the arteries, which can lead to heart disease and eye disorders.</div> <bR> <div> Researchers feel that the presence of high blood pressure may be the most important predictor of which diabetics develop chronic kidney disease. Therefore, the detection and control of high blood pressure are very important for people with diabetes. Specific high blood pressure medicines, such as the angiotensin converting enzyme inhibitors, may be the most effective in preventing diabetic kidney disease. About 60 to 65 percent of people with diabetes have high blood pressure.</div> <bR> <div> The risk of developing chronic kidney disease increases with the length of time a patient has diabetes. For those surviving 20 to 30 years with type 1 diabetes, about 30 percent develop chronic kidney disease — making it a frequent, but not inevitable, complication among people in this group. About 10 to 40 percent of people with type 2 diabetes develop chronic kidney disease and kidney failure. </div> <bR> <div> Some of the signs that someone who has diabetes may be developing chronic kidney disease are: </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Protein in the urine </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">High blood pressure </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Leg swelling, leg cramps </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Increased need to urinate, especially at night </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Abnormal blood tests, such as a rise in blood urea nitrogen (BUN) and creatinine </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Less need for insulin or anti-diabetic pills </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Morning sickness, nausea and vomiting </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Weakness, pallor and anemia </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Itching </div> <div> A cure for diabetic kidney disease has not yet been found; the treatment involves controlling the disorder and slowing its progression to irreversible kidney failure. Some of the treatments that may be effective are: </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Controlling high blood pressure </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Controlling blood sugar levels </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Reducing dietary protein intake </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Avoiding medications that may damage the kidneys </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Treating urinary tract infections </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Exercise and weight loss (under the supervision of a physician) </div> <div> <B>Last Modified: 07/09/01</B> </div> <div> <B>Source:</B></div> <div> American Diabetes Association</div> <div> National Institute of Diabetes, Digestive and Kidney Diseases</div> <div> National Kidney Foundation</div> <div> United States Renal Data System</div> <bR> <bR> <div> <B> <A NAME="toxic_compound_is_formed_when_sugar"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></B><B>toxic compound is formed when sugar, proteins and fat are processed at cooking temperatures for long periods of time. This compound may increase blood vessel damage in diabetics </B></div> <bR> <div> In a study appearing this week in the Proceedings of the National Academy of Sciences (<FONT SIZE="3" COLOR="#0000FF" FACE="arial" ><U>news</U></FONT> - <FONT SIZE="3" COLOR="#0000FF" FACE="arial" ><U>web sites</U></FONT>), researchers say a toxic compound is formed when sugar, proteins and fat are processed at cooking temperatures for long periods of time. This compound may increase blood vessel damage in diabetics, the study suggests. </div> <div> Dr. Helen Vlassara, a diabetes researcher at Mount Sinai School of Medicine in New York and first author of the study, said the compound, called advanced glycation end products or AGEs, can prompt an angry reaction from the immune system, eventually damaging blood vessels. </div> <div> "AGEs attack virtually every part of the body," said Vlassara. "It is as if we have a low-grade infection. They tend to aggravate the immune cells." </div> <div> She said a lifelong diet high in AGEs leaves the immune system in a constant state of low-grade inflammation which damages the small and mid-sized arteries. This, in turn, can prompt heart disease and other problems common to diabetics, she said. Diabetics are particularly sensitive to the effects of vessels damaged by AGEs, she said. </div> <div> But dietary AGEs can be controlled by cooking foods differently, she added. </div> <div> Dr. Eugene Barrett, a professor of medicine at the University of Virginia and the president-elect of the American Diabetes Association, said the study by Vlassara is potentially important in the control of diabetes, but more research is needed to understand the role AGEs may play in heart disease. </div> <div> He said research into AGEs is still at an early stage and it may be too soon to conclude that limiting AGEs will reduce heart disease among diabetics. </div> <div> Vlassara's study used 24 diabetic patients divided into two groups. One group maintained a normal diet recommended for diabetics which included chicken, fish and meat. The other group had the same foods, but cooked differently. </div> <div> At the end of six weeks, said Vlassara, the AGEs in the test group registered declines ranging from 33 percent to 40 percent. She said the study was too short to detect any fundamental changes in the patients' health. </div> <div> However, she said studies using diabetic animals have shown that a reduction in AGEs can reduce the incidence of heart disease or delay its onset. Such studies need to be conducted in humans to prove the value of AGE control, she said. </div> <div> The key to lowering AGEs, said Vlassara, is to cook for a short time in the presence of high humidity. This means either boiling or steaming meats for the minimum time required. Meat can be sauteed, she said, but it should be cut very thin and cooked quickly with a small amount of oil. </div> <div> She said one of the worst AGE offenders is turkey cooked in the traditional American way. </div> <div> "We cook for many hours," she said. "That would tend to make a tremendous number of AGEs." </div> <div> Vlassara said coffee, cola and chocolate drinks also are loaded with AGEs. For diabetics, she recommends sugar-free versions of clear sodas instead of the diet versions of dark drinks. Some of the dark colas, she said, add caramelized products which are heavy in AGEs. </div> <bR> <bR> <div> <B><U> <A NAME="insulin_and_coronary_artery_disease"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>insulin and coronary artery disease</U></B></div> <div> "Insulin promotes growth of endothelial cells, </div> <div> cells that line blood vessels. Extra insulin in </div> <div> the body could mean extra cell growth in the </div> <div> blood vessels. This, in turn, may cause </div> <div> atherosclerosis and lead to the progression</div> <div>  of coronary artery disease.</div> <bR> <div> <B> <A NAME="1__what_is_the_insulin_resistance"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></B><B>1. What is the Insulin Resistance Syndrome (IRS)?</B></div> <div> The Insulin Resistance Syndrome describes a condition that is characterized by decreased tissue sensitivity to the action of insulin, leading to a compensatory increase in insulin secretion. This metabolic dysfunction leads to a cluster of abnormalities with serious clinical consequences, most importantly, cardiovascular disease and/or type 2 diabetes. The Insulin Resistance Syndrome conference extended the concept of the Metabolic Syndrome (NCEP/ATPIII) by:</div> <div> 1) Addressing the underlying pathophysiology of insulin resistance, which leads not only to cardiovascular disease, but also to diabetes and other disorders.</div> <div> 2) Recognizing additional associated disorders such as polycystic ovary syndrome (PCOS) and non-alcoholic fatty liver disease.</div> <div> 3) Improving the detection of the Insulin Resistance Syndrome by emphasizing the use of the 2-hour post glucose challenge as the most sensitive clinically available test for insulin resistance.</div> <bR> <