People who get fewer than six hours of sleep at night are prone to abnormal blood sugar levels, possibly putting them at risk for diabetes, U.S. researchers said on Wednesday.

They said people in a study who slept less than six hours were 4.5 times more likely to develop abnormal blood sugar readings in six years compared with those who slept longer.

"This study supports growing evidence of the association of inadequate sleep with adverse health issues," said Lisa Rafalson of the University at Buffalo in New York, who presented her findings at the Conference on Cardiovascular Disease Epidemiology and Prevention in Palm Harbor, Florida.

Several studies have shown negative health consequences related to getting too little sleep. In children, studies showed it raises the risk of obesity, depression and high blood pressure. In older adults, it increases the risk of falls. And in the middle aged, it raises the risk of infections, heart disease, stroke and cancer.

Adults typically need between seven and nine hours of nightly sleep, according to the U.S. Centers for Disease Control and Prevention.

Rafalson and colleagues wanted to see if lack of sleep might be raising the risk for type 2 diabetes, the kind that is being driven by rising rates of obesity and sedentary lifestyles. It develops when the body makes too much insulin and does not efficiently use the insulin it makes, a condition known as insulin resistance.

Using data from a large, six-year study, they identified 91 people whose blood sugar rose during the study period and compared them to 273 people whose glucose levels remained in the normal range.They found the short sleepers were far more likely to develop impaired fasting glucose -- a condition that can lead to type 2 diabetes -- during the study period than those who slept six to eight hours.

That difference held even after adjusting for age, obesity, heart rate, high blood pressure, family history of diabetes and symptoms of depression. 

"Our findings will hopefully spur additional research into this very complex area of sleep and illness," Rafalson said in a statement.

Reference: http://www.reuters.com/article/idUSTRE52A7EC20090311

http://www.reuters.com/article/idUSTRE60Q01M20100127

Small cerebral infarctions, which are known as "silent strokes" and are visible on cerebral MRI scans, can help to predict kidney failure in patients with type 2 diabetes, new research shows.  Scientists studied 608 patients with type 2 diabetes who had no clinical signs of cerebrovascular disease, cardiovascular disease, or overt nephropathy.  The study participants underwent cerebral MRI scans, and 177 patients had evidence of silent cerebral infarctions, which were defined as focal lesions at least 3 mm in diameter.  In a follow-up period of up to 10 years, patients with these "silent strokes" at study baseline later experienced death or kidney failure at more than two times the rate of the patients who did not have the strokes.  On average, those who had experienced small cerebral infarctions were more likely to be older, have had diabetes for a longer period of time, have higher blood pressure, and have a history of smoking.

New Delhi: All 30-40 year olds, living in India’s rural areas, will soon undergo mandatory check for diabetes.

The first version of an artificial pancreas -- a potential revolutionary way to manage insulin delivery in people with type 1 diabetes -- may be available in as little as four years.

The Juvenile Diabetes Research Foundation (JDRF) announced on Wednesday 13 Jan that it's partnering with Johnson & Johnson's insulin pump division, Animas Corp., to begin development of the first artificial pancreas system. The goal is to have a prototype ready for regulatory review in about four years.

The artificial pancreas will be a software that stays on the outside of the body, along with an insulin pump and a continuous glucose monitor (which measures blood sugar levels).

It would primarily benefit people with type 1 diabetes, an autoimmune disorder that destroys the body's ability to manufacture insulin. People with type 1 diabetes must replace that lost insulin through injections, either with shots or by using an insulin pump. However, it's difficult to know exactly how much insulin you need, and people with diabetes must constantly check their blood sugar to make sure it's not too high or too low. Numerous factors, such as exercise, illness and even stress, can affect blood sugar levels.

Of the announcement, Dr. Neslihan Gungor, a pediatric endocrinologist at Scott and White Memorial Hospital in Temple, Texas, who is not involved in the project, said, "There is much progress going on, and hopefully we will have that closed loop system someday. And, this gives me hope for the future."

More information

To learn more about the artificial pancreas, visit the Juvenile Diabetes Research Foundation or www.artificialpancreasproject.com

Using a pedometer for only half an hour each day for a year can significantly lower a person's chance of developing diabetes, according to a study of people with prediabetes.

Researchers from the University of Leicester divided 98 participants into three groups. The control group received a leaflet about diabetes, while a second group received a three-hour education session on the disease. The third group also received a three-hour seminar, as well as a pedometer and assistance in setting up a series of "steps-per-day" targets. These participants experienced declines of 15 percent in blood sugar levels after a year. In the long term, keeping up these goals could cut the risk of diabetes in half, the research team estimated.

Your contact lenses would one day help you manage diabetes, say researchers. The team from The University of Western Ontario has developed new kind of lenses that would continuously alert diabetics to variations in their glucose levels by changing colours.

Developed by Chemical and Biochemical Engineering professor Jin Zhang, the new technique uses extremely small nanoparticles embedded into the hydrogel lenses, reports firstscience.com

These engineered nanoparticles react with glucose molecules found in tears, causing a chemical reaction that changes their colour.

Zhang is conducting further research to develop technologies using multifunctional nanocomposites. These technologies have vast potential applications beyond biomedical devices, including for food packaging.

For example, nanocomposite films can prevent food spoilage by preventing oxygen, carbon dioxide and moisture from reaching fresh meats and other foods, or by measuring pathogenic contamination; others can make packaging increasingly biodegradable.

http://timesofindia.indiatimes.com/life/health-fitness/health/Diabetes-cancer-more-fatal-than-AIDS/articleshow/5284110.cms

This study documented the tobacco use among male diabetes patients in a clinic-based population of urban India, patient reports of physician cessation messages and patients’ perception of tobacco use as a risk factor for diabetes complications. All the 444 male diabetes patients who attended three public sector hospitals in Thiruvananthapuram district, Kerala, were surveyed to ascertain their tobacco use as well as the frequency and content of quit messages received from health staff. A significant proportion (59%) of diabetes patients were tobacco users prior to diagnosis and more than half of them continued to use tobacco, many daily, even after diagnosis. Of the 100 current smokers, 75% were asked about their tobacco use at the time of diagnosis; of those, 52% were advised to quit. However, a lack of patient awareness existed regarding the linkages of smoking and diabetes complications. Notably, 52% of patients did not associate smoking with diabetes complications.

Given the magnitude of tobacco use among diabetics, there is clearly a need for more proactive cessation efforts. The times of illness diagnosis, illness flare-ups and emerging illness complications are teachable moments when patients are primed to change their behavior and more motivated to quit tobacco.

Type 2 diabetes mellitus (T2DM) is a growing worldwide problem with WHO estimates suggesting that 300 million people will be affected by 2025. T2DM could result in both microvascular and macrovascular complications but the presentation of these complications could vary globally and be influenced by diabetic control.

787 patients of south-Asian origin in diabetic clinics in the UK (n = 351), Mauritius (n = 173) and India (n = 263) were surveyed. Prevalence of microvascular complications such as retinopathy (India 16.3%; Mauritius 2.3%; UK 2.6%), nephropathy (India 20.5%; Mauritius 10.5%; UK 2.3%) and neuropathy (India 8.4%; Mauritius 1.2%; UK 5.1%) complications is significantly higher in India compared to Mauritius and the UK.

Interestingly, macrovascular complications such as cardiovascular disease were significantly more prevalent in Mauritius and the UK compared to India. The use of diabetic medication such as Metformin, Sulphonylureas and Insulin was significantly higher in the UK and Mauritius compared to India. The mean HbA1c was significantly higher in India compared to the UK (India 8.68%; UK 8.30%). Results suggest that microvascular complications are higher in India due to poorer diabetic control. This could be explained by late-onset presentation of diabetic patients in India due to the lack of primary care initiatives to screen and monitor treatment of T2DM.

With world's largest cases of diabetes reported here, India can easily be called the diabetes capital of the world. But Ahmedabad is also the diabetes capital of the country with highest diabetes prevalence rate said a paper presented by Dr Banshi Saboo in the 37th annual conference of Research Society for Study of Diabetes in India (RSSDI) which concluded on 8^th Nov 2009.

Briefing about the outcome of the conference Dr Urman Dhruv, chairman, scientific sessions committee, RSSDI-2009, said that Ahmedabad has 13.8% prevalence rate of diabetes patients, whereas other 11 major cities have prevalence rate in the range of 6-8%. "About 25,000 people visited the diabetes Awareness Exhibition alone and benefited from the program regarding diabetes.

During the conference and Public awareness activities, over 4,270 people tested for blood sugar" said Dr Banshi Saboo, organising Secretary, RSSDI 2009.The last day of the conference started early at 6 am with 'Diabetes Walk' that was part of Public Awareness mega campaign 'project KADAM'. "More than 2,700 delegates participated which is the highest participation so far, and 114 research papers were presented during the four day meet. Discussions by specialists continued for 84 hours on the disease" said Dr Dhruv.

The best 6 out of 100 research papers were presented on the 3rd day of the conference. Research papers from Bengaluru, Chandigarh, Vellore, Salem and Kolkata managed to find their place too. The prominent features of the Continuous Education Program (CME) remained the picture demonstration by Dr M Rema, Chennai on the subject of 'Diabetic Retinopathy' and a program chaired by Dr SD Mehtalia on the 'Less-known complications of diabetes'. Total 48 lectures were presented by 32 experts from Delhi, Madurai, Lucknow, Vizag, Nagpur, Kolkata and Chennai.

Reference: http://www.dnaindia.com/health/report_ahmedabad-is-the-diabetes-capital-of-india_1309147

Americans of Indian descent may have a heightened risk of diabetes, even when their weight is in the normal range, research suggests.

Researchers found that among more than 7,400 Asian Americans in a national health study, those of Indian descent had roughly three times the risk of diabetes as U.S. whites as a whole, and a higher prevalence of the disease than people of other Asian ethnicities.

Moreover, although type 2 diabetes is closely associated with obesity, Asian Indians' risk began to climb even at lower weights.

Among those with weights in the normal range -- as measured by body mass index (BMI), a ratio of weight in relation to height - about 7 percent had diabetes. That compared with rates of anywhere from 2 percent to 4 percent among whites and people of other Asian ethnicities.

Among obese adults - as defined as a BMI of 30 or higher -- one-third of Indian adults had diabetes. Among other ethnicities, the rate ranged from 12 percent to 17 percent.

The reasons for the findings are not entirely clear, Dr. Reena Oza-Frank and colleagues at Emory University in Atlanta point out in the journal Diabetes Care.

However, the researchers note, ethnic differences in body fat levels and body fat distribution may play a role.

Studies have shown that compared with people of other races and ethnicities, Asians tend to have a higher proportion of body fat at any given weight - along with a higher type 2 diabetes risk.

It's possible that people of Indian background are particularly likely to have body fat distributions - including more abdominal fat - that are closely associated with diabetes, according to Oza-Frank and colleagues.

Some studies, the researchers note, have suggested that this may be a factor in the higher diabetes risk seen in Indian adults compared with Europeans.

Because Asian adults tend to have more body fat - and, therefore, greater health risks at relatively lower weights -- the World Health Organization (WHO) has proposed lowering the threshold for how "overweight" is defined in Asian populations.

The standard definition of overweight is a BMI of between 25 and 30; the WHO recommendation sets that at 23 to 27.5 for Asians.

However, the current findings, Oza-Frank and colleagues write, suggest that for Asian Indians, "ethnicity alone may be as informative as BMI with regard to diabetes risk."

They call for more research into the "complex relationships" among body size, body fat and disease risks across different Asian populations.

SOURCE: Diabetes Care, September 2009.

http://video.about.com/diabetes/Insulin-Delivery.htm

Times Of India - 14th Nov 2009, World Diabetes Day

Sion Koliwada resident Shakuntala is to undergo a cardiac bypass surgery next week. Even though the 56-year-old fisherwoman is scared about the operation, doctors feel it might be her only option. 

  What Shakuntala doesn’t know is that her uncontrolled diabetes is the main reason of her heart problems. For three months now, Shakuntala complained of a recurrent pain in her body. It was only when she went for a free check-up that she got to know that she had a heart problem.

  “Shakuntala has had uncontrolled diabetes for the last six years. And in the past few months, she has started complaining of convulsions with mild exertions, even while sleeping. Her tests showed that three of her vessels are blocked. So the only treatment is a bypass surgery,’’ said Dr Ameya Udyavar, consultant cardiologist with Hinduja Hospital.

  Cardiologists say that those suffering from diabetes are more susceptible to cardiovascular problems as compared to those who don’t. Statistics show that 65% patients with diabetes die from cardiovascular disease, 20-35% of patients with heart disease have diabetes and 55-60% patients undergoing bypass surgery are diabetics.

  Dr Hasmukh Ravat, head of cardiology department in Wockhardt Hospital in Mulund, says that one out of ten people in India suffer from diabetes. “Because of the high blood sugar level, the artery becomes thicker and may even lose its elasticity. In such a case, if the fatty materials deposit on the inner walls of the arteries, the blood flow towards the heart will be affected, leading to an attack,’’ said Dr Ravat.

  Cardiologists also believe that silent attacks are more common with diabetics. “Since the arteries get clogged, it causes pain in the chest. But with diabetic patients, these arteries also cause loss of the nerve function, because of which, the patient might not experience pain while getting an attack,’’ said Dr Udyavar.

  Doctors say that a treatment might not always be possible as the patiennt might not come to know that there is a heart problem if not for ECG tests. It is thus better for all diabetics to take precautionary measures.

“It might not be possible for a diabetic to prevent an attack. But precautionary measures can ensure decreased succeptibility of heart problems,’’ said Dr N Bansal, cardiologist from state governmentrun JJ Hospital in Byculla. “People tend to gain weight in their mid 30s and 40s. If diabetics keep a check on their diet, exercise regularly, avoid gaining weight, keep the sugar levels in control, there is no reason why they cannot live a healthy life,’’ he said.

India is becoming the diabetes capital of the world with over 50 million people affected by the lifestyle disease that is all too often discovered only in the advanced stages.

A new study conducted by doctors at the Artemis Health Institute (AHI), Gurgaon, near here, found that close to 95 percent people got to know about the disease only at an advanced stage despite the fact that they had developed obvious symptoms much earlier.

The doctors tested the blood samples of 300 people who came for a routine checkup within a span of two years and found that 15 percent of them were in pre-diabetes stage.

'Most of them knew they had obvious symptoms like increased appetite, constant thirst and high urine formation for the last few years but they did not get themselves tested until their condition deteriorated,' Ashutosh Shukla, head of internal medicine at AHI who conducted the study, told IANS. According to Shukla, awareness and early detection are the key to managing diabetes.

'Those with risk factors like obesity, high work stress, sedentary lifestyle, faulty diet and family history of diabetes must undergo a health check-up at least once a year and those without risk factors should take it once in two years,' Shukla said.

'Diabetes no longer remains an urban phenomenon or is restricted to adults,' Nikhil Tandon, professor of endocrinology at the All India Institute of Medical Sciences (AIIMS), told IANS.

He said due to urbanisation and industrialisation, villages were now becoming towns. 'Small towns have been industrialised. So the urban-rural divide has been blurred. And this means lifestyle changes,' said the endocrinologist.

Reference:http://sify.com/news/95-percent-Indians-wake-up-late-to-diabetes-Nov-14-is-World-Diabetes-Day-news-National-jlnn4bjabgc.html

http://professional.diabetes.org/GlucoseCalculator.aspx

Toronto: India leads the world in the number of people suffering from diabetes and by 2030, nearly 9 per cent of the country’s population is likely to be affected from the disease, the International Diabetic Federation (IDF) has warned.

About 50.8 million people are now suffering from the looming epidemic of diabetes, followed by China with 43.2 million.

According to a report released at the 20th annual World Diabetes Congress of IDF which opened on Monday in the Canadian city of Montreal, the U.S. has 26.8 million people suffering from the disease, while it is 9.6 million in Russia, 7.6 million in Brazil and 7.5 million in Germany.

Pakistan is the third Asian country with 7.1 million diabetic patients while Japan has 7.1 million and Indonesia has 7 million, according to the latest IDF data.

There are 285 million diabetes cases worldwide, accounting for seven per cent of the world’s population.

‘Development issue’

“Diabetes has become a development issue and it threatens the health and economic prosperity of people in low and middle-income countries,” the IDF report said.

It also predicted that diabetes would cost the world economy at least $376 billion in 2010, or 11.6 per cent of the total world health care expenditure.

“By 2030, this number is projected to exceed $490 billion. More than 80 per cent of spending on diabetes is in the world’s richest countries and not in the poorer countries, where over 70 per cent of people with diabetes now live,” it said.

According to the report, India currently spends $2.8 billion or one per cent of the global total expenditure.

‘Take serious action’

Addressing the congress, Martin Silink, outgoing president of the federation, said unless serious action was taken the epidemic of diabetes would increase from 7 million new cases a year in 2007 to 10 million new cases this year.

“The epidemic represents nothing short of a global health emergency,” said incoming IDF president Jean-Claude Mbanya. — PTI

Reference: http://www.thehindu.com/2009/10/21/stories/2009102162361800.htm

BOSTON, Oct 22 (Reuters) - Long-acting insulin works better than other types of injections for people who need more than pills for their type 2 diabetes, researchers reported on Thursday.

Long-acting Levemir insulin, given at bedtime, and NovoRapid insulin injections, given three times a day before meals, controlled insulin levels best in patients not doing well with the daily pills alone, the study found.

They were compared to results with twice-daily injections of NovoMix 30 in diabetes patients taking the pills metformin and sulfonylurea.

Drugmaker Novo Nordisk (NOVOb.CO) sponsored the trial of diabetes patients in Britain and Ireland and made all the insulin products tested.

The goal was to bring glycated hemoglobin levels -- a measure known as a1c -- down to 6.5 percent. This gives doctors an idea of insulin levels over the long term.

Dr Rury Holman of the Oxford Centre for Diabetes, Endocrinology and Metabolism in Britain and colleagues watched their 708 patients for three years.

Most did need extra insulin to control their diabetes -- ultimately, 68 percent to 82 percent of the patients needed to added a second type of insulin to keep their blood sugar low.

The long-acting insulin helped about 45 percent of the patients, while only 32 percent of those who got twice-daily shots of NovoMix 30 controlled their insulin well, the researchers reported in the New England Journal of Medicine.

But the patients who got the three insulin injections a day were more likely to gain weight and more than three times as likely to have an episode where their blood sugar dipped too low, compared to those who took the long-acting insulin, the researchers found.

Potentially dangerous hypoglycemia incidents were nearly doubled among patients who received the twice-daily injections.

Reference: http://www.reuters.com/article/bssHealthcareNews/idUSN2254542520091022

'Cheeny Kum' (which literally means 'less sugar'), a real-time monitoring and comprehensive management program for diabetes is now available in India. Cheeny Kum Plans cover blood sugar monitoring & supplies, medications, lab tests & lifestyle counseling- all made available to you at a pre-fixed cost. The webportal www.cheenykum.com provides a simple and clean interface to monitor and access your sugar levels and diabetic statistics to help you spot dangerous trends and better manage your lifestyle & diabetic health. You can easily input your data via any mobile phone, email or web-browser and access no matter where you are. So whether at home, on the road or in the office, your sugar levels, medications, diet & physical activity are monitored in real-time!

You can then share this information with your doctor, family and friends and even get further motivation, support and advice from our Diabetes Support Team. Also, with Cheeny Kum’s doorstep services, there’s no need to go anywhere for blood sugar monitoring supplies, medications and tests. "Our goal is to provide all stakeholders, i.e. patients, doctors, authorized healthcare professionals, caregivers and even patients' family members with a simple & easy-to-use solution that maximizes their benefits", says Dr. Ankit Khambhati, the program Director.

It is now well documented that diabetes is increasing globally in epidemic proportions across all age groups. According to WHO, there is an apparent epidemic of diabetes which is strongly related to lifestyle and economic change. Over the next decade the projected number will exceed 200 million. Global prevalence of diabetes will increase from 4% in 1995 to 5.4% 2025. A 42% increase from 51 to 72 million in the developed countries and 170% increase from 84 to 228 million, in the developing countries.

India leads the world with largest number of diabetics. The number of people with diabetes in India currently around 40.9 million and is expected to rise to 69.9 million by 2025 unless urgent preventive steps are taken. An increasing early age of onset of the disease combined with its increasing prevalence is of great concern, because if the epidemic shifts to children, it could have serious consequences on the health of the nation.

A chronic disease like diabetes, if not managed properly, can cause serious problems such as kidney failure, lower limb amputations, blindness, heart disease, strokes and nerve damage. Proper monitoring with real-time patient data is the key to managing the condition and preventing life-altering complications that could be the cause of serious economic burden- both individual & global. Soclench your fistand say 'Cheeny Kum',India's sloganin the fight against diabetes.

Reference: http://www.indiaprwire.com/pressrelease/health-care/2009091633837.htm

CHICAGO, Sept 15 (Reuters) - Drugs used to control diabetes do not reduce signs of inflammation that are linked with heart disease, U.S. researchers said on Tuesday in a study that reinforces the need for diet and exercise.

Both heart disease and diabetes are inflammatory diseases, and researchers had assumed that controlling diabetes would have an effect.

"At the time we initiated the trial, we were thinking if we treat the diabetes, we will lower inflammation," said Dr. Aruna Pradhan of Brigham and Women's Hospital and Harvard Medical School in Boston, whose study appears in the Journal of the American Medical Association.

"This study suggests that lowering glucose alone does not impact one important risk factor for heart disease, and that is inflammation," Pradhan said in a telephone interview.

She said the data may help explain the findings of a number of large studies in diabetics that found aggressive control of blood glucose did little to protect against heart attacks and stroke.

"Just simply treating diabetes does not seem to have a benefit at preventing these vascular events," she said.

An estimated 23.6 million people in the United States and 246 million people globally have diabetes. Most have type 2 diabetes, the kind linked with a poor diet and lack of exercise.

Adults with diabetes are two to four times more likely to have heart disease or suffer a stroke than people without diabetes. Seventy-five percent of diabetics die from heart disease or stroke, according to the American Heart Association.

DIABETES TREATMENTS

Pradhan and colleagues studied 500 people with type 2 diabetes to see whether insulin, or the common diabetes pill metformin, or both could lower levels of inflammatory markers such as C-reactive protein, an immune chemical called interleukin-6, and soluble tumor necrosis factor receptor 2 or sTNFr2, which plays a role in autoimmune disease.

People in the study got insulin plus a placebo pill, metformin alone or metformin plus insulin.

After 14 weeks, the team found the drugs helped lower blood glucose levels, but had little effect on inflammation.

Pradhan said everyone in the study was obese, with a body mass index of 36. BMI is equal to weight in kilograms divided by height in meters squared. Someone with a BMI of 25 to 29 is classified as overweight; 30 and over is considered obese.

While treating diabetes alone may not reduce inflammation, a study last November showed that taking AstraZeneca's (AZN.L: Quote, Profile, Research, Stock Buzz) cholesterol fighter Crestor, a statin, had a powerful effect at reducing deaths, heart attacks and strokes in people who had normal cholesterol but high levels of C-reactive protein.

Pradhan said her study confirms the need for diabetics to exercise and have a healthy diet and weight. Some may also need to take statins and aspirin to control their heart disease risk.

And she said diabetics still need to control their blood sugar to reduce other complications such as eye and kidney problems, and damage to blood vessels that can lead to amputations. (Editing by Eric Walsh)

Reference: http://www.reuters.com/article/rbssHealthcareNews/idUSN156713020090915

Diabetics who took the drug metformin, which makes the body process insulin better, had a 62 percent lower risk of pancreatic cancer compared to those who had never received it, U.S. researchers said on Saturday.

But the risk of getting the cancer, one of the deadliest, was significantly higher among diabetics who took insulin or drugs that make the body produce more insulin, according to their study published in the journal Gastroenterology.

"We find that diabetics that had ever used metformin alone or in combination with other drugs had like a 60 percent reduced risk for pancreatic cancer, compared to diabetic patients who never used metformin," lead researcher Donghui Li from The University of Texas M.D. Anderson Cancer Center said.

Prior studies showed a lower cancer risk in diabetics who took metformin. The drug is used to treat type 2 diabetes, which is linked with poor diet and lack of exercise and accounts for about 90 percent of all worldwide cases.

"In addition, we see some increased risk of pancreatic cancer associated with the use of insulin and the use of insulin secretagogues." Those are drugs, such as sulfonylureas and glinides, which stimulate the pancreas to secrete more insulin or raise circulating levels of insulin.

Diabetics in the study who had taken insulin were nearly five times more likely to develop pancreatic cancer. And those who took insulin-stimulating drugs were 2.55 times more likely to develop pancreatic cancer.

Insulin is known to promote cell growth. "Insulin seems to have a growth promoting effect in cancer," Li said.

That interaction could help explain the findings of four recent studies published in the journal Diabetologia, which suggested the popular Sanofi-Aventis insulin drug Lantus might raise the risk of cancer.

The European Medicines Agency said last week flaws in the studies made the findings inconclusive, and Sanofi-Aventis said it would do further research in the area.

For her study, Li evaluated 1,800 people, including more than 900 who had pancreatic cancer and 350 with diabetes. The groups were matched by age, race and gender and completed detailed surveys of their health histories.

The study, however, was too small to find a benefit for people who had taken another popular type of insulin sensitizing drug in a class called thiazolidinediones, which include GlaxoSmithKline's rosiglitazone or Avandia and Takeda Pharmaceutical's pioglitazone or Actos.

Li said the study needs to be repeated in a bigger group of diabetics but added: "Our findings show metformin's potential as a chemopreventive agent."

There are dozens of diabetes drugs in different classes on the market. Metformin, available generically, is usually one of the first prescribed, with sulfonylureas such as glimepiride, sold by Sanofi-Aventis under the brand name Amaryl, added if patients cannot control blood sugar levels.

The American Diabetes Association already recommends metformin, which has been proven to lower the risk of heart disease.

Reference: http://www.reuters.com/article/healthNews/idUSTRE5700DF20090801

LONDON (Reuters) - Two studies published on Thursday provide evidence that common viruses may cause childhood diabetes, paving the way for potential vaccines against the life-threatening condition, researchers said.

One team showed that enteroviruses -- which normally cause colds, vomiting or diarrhea -- were found frequently in the pancreases of young people who had recently died from type 1 diabetes, sometimes called juvenile diabetes, but not in healthy samples.

This suggests a virus could trigger the disease in children genetically predisposed to the condition, which affects an estimated 440,000 people worldwide, said Alan Foulis of the Royal Infirmary in Glasgow, who worked on one of the studies.

"The story that is emerging is there is a virus infection that precedes the onset of autoimmunity," he told a news conference. "There is a thought that we are looking at the culprit."

Type 1 diabetes is caused by the destruction of beta cells of the pancreas that produce the insulin necessary to regulate blood sugar levels. The autoimmune disease is different from the far more common type 2 diabetes, which is strongly associated with obesity.

Genetics play a role in diabetes but researchers know other factors such as diet are also important, with viruses long suspected as a possible trigger, researchers said.

Foulis and colleagues examined 73 pancreas samples of young people who had died from diabetes and found that 60 percent of the donated organs contained evidence of enteroviral infection of beta cells.

By contrast, the researchers hardly ever saw infected beta cells in tissue samples taken from 50 children without diabetes, they reported in the journal Diabetologia.

They also found a large proportion of these infected cells in adults with the more common type 2 diabetes, suggesting that viruses may also trigger this form of the disease in some people.

A second study from Cambridge University researchers found that rare genetic mutations in a gene involved with the body's response to viruses reduce the risk of juvenile diabetes.

They looked at 480 young people with type 1 diabetes and another 480 healthy people to identify the gene and the variants involved.

"We have pinpointed a specific gene, which acts as a warning report for virus infection," John Todd, a Cambridge University researcher, who worked on a study published in the journal Science. "Not only have we found a specific gene but this gene also has an intriguing function in dealing with virus infection."

While Todd cautioned that many environmental factors besides viruses could contribute to type 1 diabetes, Foulis and his team said they wanted to whittle down the some 100 enteroviruses to find which ones played the main roles.

Doing this, and better understanding of how cells respond to viral infection, are steps toward a vaccine that could one day protect children against diabetes, Foulis said.

"The aim would be for a vaccine that would prevent many cases of type 1 diabetes," he added.

Reference:http://www.reuters.com/article/email/idUSTRE5246GM20090305

LONDON: People from South Asian countries including India living in the UK are up to four times more likely to develop diabetes than the rest of the population, a research has revealed.

The research that was conducted at Edinburgh and Dundee universities showed that people of South Asian descent - those from India, Bangladesh and Pakistan - can be four times more likely to develop diabetes than other non-Asians.

Once they were diagnosed - even though they receive equal health-care- they are more likely to suffer eye complications and higher blood sugar levels.

"This study shows that South Asians are more likely to get diabetes and that they suffer morecomplications,"Colin Fischbacher, of the Edinburg university'sschool of clinical sciences and community health said.

The researchers used a database of all diabetes patients in Tayside in Scotland and studied the progress of about 10,500 patients with type 2 or late onset diabetes, 176 of whom were South Asian Scots.

CHICAGO (Reuters) - Diabetics with stable heart disease do just as well taking drugs alone as getting quick angioplasty or bypass surgery to open blocked heart arteries, U.S. researchers said on Sunday.

They said patients advised to have angioplasty and a heart stent to restore blood flow and ease chest pain could safely wait and give drugs a chance to work.

But those with more severe disease sent for more invasive heart bypass surgery might be able to avoid a future heart attack if they have the surgery right away.

The study also found no difference in heart risks between two strategies for treating type 2 diabetes -- increasing the amount of insulin or lowering the body's resistance to its own insulin with drugs such as either metformin or GlaxoSmithKline's Avandia, also known as rosiglitazone, which had been thought to raise the risk of heart attacks.

"If you have diabetes and heart disease such that a bypass surgery is a recommended procedure, you should have that early rather than delaying it," said Dr. Trevor Orchard of the University of Pittsburgh, whose study appears in the New England Journal of Medicine.

Orchard said the study, also being presented at the American Diabetes Association meeting in New Orleans, offers evidence on how best to treat people with both type 2 diabetes and heart disease. More than 65 percent of people with diabetes die from heart disease or stroke.

For GlaxoSmithKline, the study represents a positive sign that Avandia may be safer than earlier analyses had suggested.

But it may be another blow for stent makers such as Boston Scientific Corp and Johnson & Johnson, whose U.S. sales plummeted after a similar study two years ago showed stents were no better than drugs at preventing death and heart attacks in all types of heart patients.

Stents are wire mesh tubes that prop open diseased arteries after they have been unclogged during angioplasty.

Reference: http://www.reuters.com/article/email/idUSTRE5561VS20090608

Christmas could have increased the risk of diabetes for millions of people, experts have warned.

Charity Diabetes UK said that eating and drinking too much over the festive period could have increased many people''s risk of developing prediabetes – an under-diagnosed and symptomless condition that puts you up to 15 times more likely to develop Type 2 diabetes.

The charity said that high-calorie foods enjoyed by most people over Christmas could boost their weight over a very short time.

With mince pies containing about 200 calories each, Christmas cake with 250 calories per slice and mulled wine at 250 calories a glass, the recommended calorie intake of 2,000 a day for women and 2,500 for men can be quickly exceeded.

The charity said that if people were already overweight, had high blood pressure or a family history of Type 2 diabetes, they were at serious risk of prediabetes.

Those with prediabetes have blood sugar levels higher than normal, but not high enough to be diagnosed as Type 2 diabetes.

However, Diabetes UK said that prediabetes could often be reversed through losing even just a moderate amount of weight, adopting a healthy, balanced diet and increasing physical activity levels.

"Prediabetes is often a precursor to Type 2 diabetes which can lead to a shortened life expectancy and devastating complications such as heart disease, stroke, blindness, kidney failure and amputation,” the Scotsman quoted Diabetes UK chief executive Douglas Smallwood as saying.

"Make it your New Year''s resolution to eat more healthily and take regular physical activity," Smallwood added.

Reference:http://timesofindia.indiatimes.com/life/health-fitness/health/Christmas-increases-diabetes-risk-for-millions/articleshow/5387598.cms

http://www.timesonline.co.uk/tol/news/uk/health/article6954603.ece

Various modes of physical activity, combined with dieting, have been widely recommended to prevent or delay type 2 diabetes. One important regimen for people with diabetes and for those at risk for developing diabetes is engagement in appropriate physical activity. The beneficial effects of physical activity typically include reductions in glucose level, body weight, blood pressure (BP) and cholesterol. As a particular form of physical activity, yoga programs using various physical postures have been shown to benefit individuals with a wide range of health conditions including hypertension and diabetes. Yoga appears to be especially effective in reducing BP, glucose and cholesterol. Many researches showed that yoga practice was effective in lowering BP in healthy people, people with hypertension and people with metabolic syndrome. Adults with chronic diseases including hypertension, coronary artery disease and diabetes have shown significant improvements in the blood sugar and cholesterol levels after short-term, intensive yoga practice (3–4 h per day for 8 days). Yoga has also improved exercise tolerance. Deep relaxation, a unique part of a yoga program, relaxes the nervous system and helps with physiological stress reduction. Physiological stress itself is related to metabolic disease, including diabetes. The practice of yoga generally includes meditation, relaxation, breathing exercises and various physical postures.

Reference:http://ecam.oxfordjournals.org/cgi/content/full/nep117

The number of diabetics is rapidly rising all over the globe at an alarming rate and it is estimated that India will have 79.4 million diabetics by the year 2030. An important factor contributing to the increasing number of type 2 diabetics in Asian Indians is high insulin resistance compared to Europeans which could be due to an environmental or genetic factor or a combination of both. Traditionally, aerobic activities have been recommended for people with type 2 diabetes because of the known benefits on insulin sensitivity and glucose tolerance. It is estimated that only 28% of individual’s with type 2 diabetes who follow these recommendations, achieve glycemic control.

When it comes to diabetes management, blood sugar control is often the central theme. After all, keeping your blood sugar level within your target range can help you live a long and healthy life with diabetes. But do you know what makes your blood sugar level rise and fall? The list is sometimes surprising.

Food

Healthy eating is a cornerstone of any diabetes management plan. But it's not just what you eat that affects your blood sugar level. How much you eat and when you eat matters, too.

What to do:

• Be consistent. Your blood sugar level is highest an hour or two after you eat, and then begins to fall. But this predictable pattern can work to your advantage. Simply eating about the same amount of food at about the same time every day can help you control your blood sugar level.
• Even out your carbs. Carbohydrates have a bigger effect on your blood sugar level than does protein or fat. Eating about the same amount of carbohydrates at each meal or snack will help keep your blood sugar level steady throughout the day.
• Coordinate your meals and medication. Too little food in comparison to your diabetes medications — especially insulin — may result in dangerously low blood sugar (hypoglycemia). Too much food may cause your blood sugar level to climb too high (hyperglycemia). Your diabetes health care team can help you strike a balance.

Exercise

Physical activity is another important part of your diabetes management plan. When you exercise, your muscles use sugar (glucose) for energy. Regular physical activity also improves your body's response to insulin. These factors work together to lower your blood sugar level. The more strenuous your workout, the longer the effect lasts. But even light activities — such as housework, gardening or being on your feet for extended periods — can lower your blood sugar level.

What to do:

• Get your doctor's OK to exercise. This is especially important if you've been inactive and plan to start exercising regularly.
• Adjust your diabetes treatment plan as needed. If you take insulin, you may need to adjust your insulin dose before exercising or wait a few hours to exercise after injecting insulin. Or your doctor may suggest other changes to your diabetes treatment plan.
• Exercise good judgment. Check your blood sugar level before, during and after exercise, especially if you take insulin or medications that can cause low blood sugar. Drink plenty of fluids while you work out. Stop exercising if you experience any warning signs, such as severe shortness of breath, dizziness or chest pain.

Medication

Insulin and other diabetes medications are designed to lower your blood sugar level. But the effectiveness of these medications depends on the timing and size of the dose. And any medications you take for conditions other than diabetes can affect your blood sugar level, too.

What to do:

• Store insulin properly. Insulin that's improperly stored or past its expiration date may not be effective.
• Report problems to your doctor. If your diabetes medications cause your blood sugar level to drop too low, the dosage or timing may need to be adjusted.
• Be cautious with new medications. If you're considering an over-the-counter medication or your doctor prescribes a new drug to treat another condition — such as high blood pressure or high cholesterol — ask your doctor or pharmacist if the medication may affect your blood sugar level. Sometimes an alternate medication may be recommended.

Illness

When you're sick, your body produces hormones to help fight the illness. These hormones raise your blood sugar level by preventing insulin from working effectively. This can help promote healing — and wreak havoc with your diabetes management plan.

What to do:

• Plan ahead. Work with your health care team to create a sick-day plan. Include instructions on what medications to take, how often to measure your blood sugar and urine ketone levels, how to adjust your insulin dosage, if you need insulin, and when to call your doctor.
• Continue to take your diabetes medication. If you are unable to eat because of nausea and vomiting, contact your doctor. In these situations, you may need to temporarily stop taking your medication because of risk of hypoglycemia.
• Stick to your diabetes meal plan. If you can, eating as usual will help you control your blood sugar level.

Alcohol

The liver normally releases stored sugar to counteract falling blood sugar levels. But if your liver is busy metabolizing alcohol, your blood sugar level may not get the boost it needs. If you take insulin or oral diabetes medications, even as little as 2 ounces (59 milliliters) of alcohol — the equivalent of two shots of hard liquor — can cause low blood sugar.

What to do:

• Get your doctor's OK to drink alcohol. Alcohol can aggravate diabetes complications, such as nerve damage and eye disease. But if your diabetes is under control and your doctor agrees, an occasional alcoholic drink with a meal is fine.
• Choose your drinks carefully. Light beer and dry wines have fewer calories and carbohydrates than do other alcoholic drinks. If you prefer mixed drinks, stick with sugar-free mixers — such as diet soda, diet tonic, club soda or seltzer.
• Tally your calories. Remember to include the calories from any alcohol you drink in your daily calorie count. Ask your doctor or dietitian how to incorporate calories from alcohol into your diet plan.

Hormone levels

Hormone levels fluctuate for women during their menstrual cycle, as can blood sugar levels — particularly in the week before a period. Menopause may trigger fluctuations in blood sugar levels as well.

What to do:

• Look for patterns. Keep careful track of your blood sugar readings from month to month. Soon you may be able to predict fluctuations related to your menstrual cycle.
• Adjust your diabetes treatment plan as needed. Your doctor may recommend changes in your meal plan, activity level or diabetes medications to make up for monthly blood sugar swings.

Stress

If you're stressed, it's easy to abandon your usual diabetes management routine. You might exercise less, eat fewer healthy foods or test your blood sugar less often — and lose control of your blood sugar in the process. The hormones your body may produce in response to prolonged stress may even prevent insulin from working properly, which only makes matters worse.

What to do:

• Look for patterns. Log your stress level on a scale of 1 to 10 each time you log your blood sugar level. A pattern may soon emerge.
• Take control. Once you know how stress affects your blood sugar level, fight back. Learn relaxation techniques. Prioritize your tasks. Set limits. Most importantly, take good care of yourself.

The more you know about factors that influence your blood sugar level, the more you can anticipate fluctuations — and plan ahead accordingly. If you're having trouble keeping your blood sugar level in your target range, ask your diabetes health care team for help.

Reference: http://www.youtube.com/watch?v=UVfDHtJ76gA

Intake of at least three cups of tea every day can reduce the risk of diabetes by almost half, concludes a new study. To reach the conclusion, researchers studied more than 40,000 people whose consumption was monitored for 10 years.

After analyses, boffins discovered that chemicals found in all types of tea cut the dangers of developing type 2­diabetes by 42 per cent. Drinking more than three cups did not reduce the risk any further, reports The Daily Express.

The study was carried out by a team of Dutch researchers from the University Medical Centre in Utrecht.

The team concluded: "Consumption of at least three cups of tea and/or coffee was associated with a lowered risk of type 2 diabetes. Blood pressure and intake of magnesium, potassium and caffeine did not explain these associations."

Instead, the beneficial effects in tea were probably explained by "flavonoid antioxidants" which are found in every cup.

Dr Carrie Ruxton, of Britain''s Tea Advisory Panel, said: "The study did not distinguish between black and green tea, but 95 per cent of tea drunk in the Netherlands is black tea, that is regular tea. The results remained the same even when the researchers accounted for other factors which might have influenced diabetes risk, such as body mass index, blood pressure, caffeine, dietary magnesium and potassium.

"This suggests that ingredients other than caffeine, magnesium and potassium (all found in tea) could be causing the beneficial effect. Likely candidates are the flavonoid antioxidants found in tea which are known to protect body cells from damage."

Reference:http://timesofindia.indiatimes.com/life-style/health-fitness/health/3-cups-of-tea-a-day-can-cut-diabetes-risk/articleshow/5029962.cms

NEW YORK (Reuters Health) - A low-carbohydrate, Mediterranean-style diet is more effective than a typical low-fat, calorie-restricted diet for diabetes management, according to a study released Monday.

Not only did the Mediterranean diet lead to greater weight loss, it also resulted in better blood sugar control, delayed the need for blood sugar-lowering medication, and improved some heart disease risk factors, the study team found.

Mediterranean-style eating generally means plenty of fruits, vegetables and whole grains, limited amounts of red meat and processed foods, and a relatively high amount of fat from olive oil and nuts and few carbohydrates. A typical low-fat diet advises cutting down on all types of dietary fat.

Both Mediterranean and low fat diets are recommended for weight loss in overweight and obese patients with type 2 diabetes. However, there have been few direct, long-term studies comparing the two.

This led Dr. Dario Giugliano, from the Second University of Naples, Italy, and associates to randomly assign 215 type 2 diabetic patients to follow either a low carbohydrate, Mediterranean-style diet or a low-fat diet for four years.

Nutritionists and dietitians counseled both groups of patients in monthly sessions for the first year and bimonthly sessions for the next three years.

After four years, 44 percent of patients in the Mediterranean-style diet group required medication to lower their blood sugar compared to 70 percent in the low-fat diet group, the researchers report in the September 1st issue of the Annals of Internal Medicine.

After 1 year, patients in the Mediterranean diet group also experienced greater weight loss. The absolute difference in weight loss between the two groups was -2.0 kg (-4.4 lbs). The Mediterranean dieters also had trimmer waistlines.

In addition, significantly greater increases in "good" HDL-cholesterol levels and greater decreases in harmful blood fats called triglycerides were seen in the Mediterranean diet group and these heart-healthy benefits were maintained for the duration of the study.

These findings, the investigators conclude, "reinforce the message that benefits of lifestyle interventions should not be overlooked despite the drug-intensive style of medicine fueled by the current medical literature."

Reference: http://www.reuters.com/article/email/idUSTRE57U5MZ20090831

Mumbai: Depressed over their condition, two ailing senior citizens committed suicide in separate cases on Saturday.A 70-year-old man, who had been suffering from diabetes for a long time, jumped from the bedroom window of his fifth floor house at Santacruz (E) on Saturday morning. Sources at Vakola police station said that Prabhakar Padwal had diabetes for the last 20 years, and had been taking treatment at a private hospital. A couple of years ago, he had developed gangrene on his right leg and it had to be amputated from the knee level. As a result, he had been fitted with an artificial foot, the police said. However, he had been acutely frustrated with this condition, and had told his family members that he wanted to end his life. He had even tried to attempt suicide once before, but was saved due to the presence of his family members, said an officer from Vakola police station. Since the last few days, he had been highly depressed and was not taking his medicines on time. Early on Saturday, Padwals family members heard some noise from his bedroom and on entering found the bedroom window open. Looking outside, they saw him lying injured on the first floor ledge of the building . He was taken to VN Desai Hospital , where he was declared dead on arrival, and the cause of death was given as haemmorhage and shock due to multiple injuries . In a similar incident, a 62-year-old diabetes patient from Borivli (W), also ended his life on Saturday, hanging himself at home. Police sources said Shridhar Shivdekar had diabetes for a long time and had taken treatment at various hospitals. Recently, he had developed injuries on his feet and had been advised by doctors to get three toes of one foot amputated, sources said.
The family went to sleep on Friday night after having a discussion on the subject, and the senior citizen appeared to be quite normal at that time. However, when the family woke up on Saturday, they found him to hanging from the ceiling, and was declared dead by a doctor, the police said. The cause of death was given as asphyxia due to hanging , and an officer from the Borivli police station said that there is nothing suspicious in this case.
Dr Alka Deshpande, former head of medicine department, JJ Hospital, said diabetes patients often tend to get depressed because their injuries do not heal quickly. Such chronic ailments that do have any permanent cure often affect the morale of the patient , and amputation can further complicate this, she said.

Reference:http://timesofindia.indiatimes.com/news/city/mumbai/Frustration-drives-two-diabetes-patients-to-suicide/articleshow/4952388.cms

Canadian researchers have found that citrus fruits can prevent weight gain and help control Type-2 diabetes and increased risk of heart disease A flavonoid called naringenin found in citrus fruits helps the body burn extra fat to check weight gain. It also has insulin-like properties to check Type-2 diabetes, says a study by the University of Western Ontario.

Flavonoids, which are found in plants, promote antioxidant activity in the human body.

They work by genetically reprogramming the liver to burn up excess fat, rather than storing it, according to the study.

In their study, the university researchers fed one group of mice with a high-fat diet to induce the symptoms of metabolic syndrome. A second group was fed the exact same diet but treated with naringenin.

The researchers found that naringenin corrected the rise in triglyceride and cholesterol levels, prevented the development of insulin resistance and thus completely normalized glucose metabolism in mice.

"Furthermore, the marked obesity that develops in these mice was completely prevented by naringenin," Murray Huff of the Schulich School of Medicine & Dentistry at the university said.

"What was unique about the study was that the effects were independent of caloric intake, meaning the mice ate exactly the same amount of food and the same amount of fat. There was no suppression of appetite or decreased food intake, which are often the basis of strategies to reduce weight gain and its metabolic consequences."

He said: "We are examining the pharmacological properties of naringenin. The next step is to find out if naringenin prevents heart disease in animal models and to explore the feasibility of clinical trials to determine its safety and efficacy in humans."

Huff said his team is also investigating whether naringenin can treat obesity and other metabolic problems. "These studies show naringenin, through its insulin-like properties, corrects many of the metabolic disturbances linked to insulin resistance and represents a promising therapeutic approach for metabolic syndrome."

Reference:http://timesofindia.indiatimes.com/NEWS-Health-Science-Health-Citrus-fruits-check-obesity-diabetes/articleshow/4784328.cms