Wednesday, August 08, 2007
Diabetes problems 'vitamin link'
A simple vitamin deficiency may be the cause of many of the side effects of diabetes, a study suggests.
Researchers found people with the disease expelled thiamine - vitamin B1 - from their bodies at 15 times the normal rate in a study of 94 people.
The Warwick University team said thiamine helped ward off complications such as heart disease and eye problems, the Diabetologia journal said.
Experts said diet supplements could potentially help people with diabetes.
Supplementing diets could be an effective way of minimising the risk of these complications
Professor Paul Thornalley, lead researcher
It is the first time a deficiency of the vitamin, which is found in meat, yeast and grains, has been identified in people with diabetes.
It has been missed in the past because of the way thiamine levels were measured.
Traditionally, the activity of an enzyme called transketolase in red blood cells has been used to indicate thiamine levels.
But the researchers found that increased activity - usually a sign of high thiamine levels - was also associated with the body's response to deficiency.
Instead, the team measured thiamine levels in blood plasma and found concentrations were 76% lower in people with type 1 diabetes and 75% lower in people with type 2.
Thiamine is key to warding off vascular problems such as kidney, retina and nerve damage as well as heart disease and stroke.
It works by helping protect cells against the effect of high glucose levels.
Trials are now being carried out to see if supplementing diet with thiamine could return levels to normal.
Lead researcher Professor Paul Thornalley said: "It is early days, but it could have a huge difference.
"Supplementing diets could be an effective way of minimising the risk of these complications."
Matt Hunt, of Diabetes UK, which helped to fund the study, said more research was needed.
But he added: "The study could potentially have very exciting outcomes.
"Around 80% of people with diabetes die of cardiovascular disease and diabetes is the leading cause of blindness in the UK's working age population.
"Therefore, any research that could help must be looked at seriously."
Story from BBC NEWS:
Published: 2007/08/07 23:05:27 GMT
© BBC MMVII
Tuesday, May 01, 2007
0 Apr 2007
Research increasingly shows promise to both slow and relieve the effects of diabetic retinopathy, the most common complication of diabetes.
In its earliest stages, retinopathy often has no overt symptoms but can progress over time to a phase in which the blood vessels of the eye leak and rupture easily, eventually causing blindness. This frightening complication is caused by high blood glucose levels, and nearly all people with type 1 diabetes show some symptoms of the disorder.
An in-depth article in the spring 2007 edition of Countdown, the quarterly journal of the Juvenile Diabetes Research Foundation, details ongoing human clinical trials in this area, and important findings that have been made to date. In the article, JDRF-funded scientists share valuable insights into the causes of retinopathy, as well as the therapeutics that are being developed as a result of the identification of new biological targets.
One study mentioned within the article was led by Dr. Lloyd Aiello of the Joslin Diabetes Center, who showed that the compound ruboxistaurin slowed the progress of retinopathy by inhibiting an enzyme in the body called protein kinase C beta (PKC beta), which is believed to contribute to the blood vessel damage that leads to the disease. This is the first time a drug has been shown to protect against the complication in a human clinical trial.
According to Dr. Richard Insel, Executive Vice President of Research for JDRF, "Since retinopathy is the most common and serious eye-related complication of those with type 1 and type 2 diabetes - and is the leading cause of adult blindness in Americans - the outstanding research being done in this area will have a significant impact on the millions of people with diabetes."
JDRF was founded in 1970 by the parents of children with type 1 diabetes - a disease that strikes children, adolescents, and adults suddenly, makes them insulin dependent for life, and carries the constant threat of devastating complications. Since inception, JDRF has provided more than $1 billion to diabetes research worldwide. More than 80 percent of JDRF's expenditures directly support research and research-related education. JDRF's mission is constant: to find a cure for diabetes and its complications through the support of research. For more information please visit http://www.jdrf.org/
Contact: Peter Cleary
Juvenile Diabetes Research Foundation International
Article URL: http://www.medicalnewstoday.com/medicalnews.php?newsid=68974
Monday, February 12, 2007
British scientists have made a major breakthrough in the battle against diabetes by identifying the genes which raises the risk of getting the condition.
The findings mean there could soon be a test to identify those who could get Type 2 diabetes - of which there are around one million sufferers in Britain.
Many of them developed it because they are overweight or obese.
However experts believe some people are more susceptible than others due to their genetic make up.
Now for the first time researchers have pinpointed the most important genes that heighten the risk of getting type-2 diabetes.
The UK scientists hope it will lead to a test to spot those most at risk so they can take steps to prevent it developing.
It could also lead to new treatments for the condition, which if not properly controlled can lead to serious problems including loss of sight and organ damage.
Lead researcher Professor Philippe Froguel of Imperial College London said: "If we can tell someone that their genetics mean they are predisposed towards Type 2 diabetes, they will be much more motivated to change things such as their diet to reduce their chances of developing the disorder.
"We can also use what we know about the specific genetic mutations associated with Type 2 diabetes to develop better treatments."
The research, published on-line in Nature, is the first time the genetic make-up of any disease has been mapped in such detail.
The team took 700 people with Type 2 diabetes and a family history of the condition, and compared their genetic mutations with 700 healthy people.
The researchers identified four points on sufferer's genetic maps that were linked to their risk of developing the disorder.
They then confirmed their findings by analysing the genetic make-up of another 5,000 people with Type 2 diabetes and a family history of the disorder, to check for the same mutations.
From this they concluded these four points explain up to 70 per cent of the genetic background of Type 2 diabetes.
They also believe one of the mutations might help explain one of the triggers for the condition and so lead to new treatments.
They found sufferers have a particular mutation in a gene involved in transportation of zinc around the body and insulin secretion.
By fixing this problem, they may therefore be able to overcome insulin deficiencies of some people with Type 2 diabetes.
Prof Froguel of the Division of Medicine at Imperial said: "The two major reasons why people develop Type 2 diabetes are obesity and a family link.
"Our new findings mean that we can create a good genetic test to predict people's risk of developing this type of diabetes."
Professor David Balding, study co-author, added: "The task now is to study the genes identified in our work more intensively, to understand more fully the disease processes involved, devise therapies for those affected and to try to prevent future cases."
Dr Iain Frame, Research Manager at Diabetes UK said: "We have known for some time that family history plays a part in whether or not someone might develop Type 2 diabetes.
Sunday, February 11, 2007
Fri Feb 9, 3:04 PM ET
In adults with type 2 diabetes, a common diabetes-related complication of the eye called retinopathy is associated with an increased risk of dying within in a given period of time, a study shows.
Retinopathy arises when diabetes damages the tiny blood vessels of the retina, the light-sensitive tissue at the back of the eye. It can lead to blurred vision and blindness if unchecked.
Dr. Markku Laakso, from the University of Kuopio in Finland, and colleagues compared the outcomes of 425 men and 399 women with type 2 diabetes who were divided into three groups based on results of eye exams: no retinopathy, background (early) retinopathy, or more advanced "proliferative" retinopathy. All of the subjects were free from heart and vascular disease initially. They were followed for 18 years.
In women, proliferative retinopathy was associated with a 2.9-fold increased risk of death from all causes. In women, this type of retinopathy was also associated with a 3-fold increased risk of cardiovascular death and a nearly 5-fold increased risk of coronary heart disease death.
Risks for death were also elevated, albeit to a lesser extent, in women with background retinopathy.
In men, proliferative retinopathy was significantly associated with death, increasing the risks of all-cause, cardiovascular, and coronary heart disease mortality by 3.05-, 3.32-, and 2.54-fold, respectively.
The association between retinopathy and mortality was independent not only of conventional cardiovascular disease risk factors but also of blood sugar control and duration of diabetes, the authors note.
SOURCE: Diabetes Care, February 2007.
Monday, February 05, 2007
Sunday, February 04, 2007
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Monday, January 29, 2007
Changing to a healthier lifestyle appears to be at least as effective as taking prescription drugs in reducing the risk of developing Type 2 diabetes, says a new BMJ study.
Type 2 diabetes is a growing problem - in England around 1.3 million people have diabetes and around 5% of total NHS resources are used for the care of people with diabetes.
Researchers from Leicester reviewed studies which measured the effects of different interventions - lifestyle, diabetes drug and anti-obesity drug - on people with impaired glucose tolerance (1).
They found that lifestyle changes, e.g. switching to a healthier diet and increasing exercise to be at least as effective as taking prescription drugs. On average, lifestyle changes helped to reduce the risk of developing type 2 diabetes by around half. Lifestyle changes were also less likely to have adverse side-effects.
However, the researchers say that both lifestyle changes and prescription drug taking must be sustained in order to prevent the development of Type 2 diabetes.
The authors say that as global rates of Type 2 diabetes are likely to double by 2030, interventions to prevent the condition will have an important role to play in future health policies. The study findings have large implications for public health policy, however, the authors note that if lifestyle changes are to be truly effective more needs to be done to support people to adopt healthier lifestyles.
(1) People with impaired glucose tolerance have a high risk of developing type II diabetes
Contact: Emma Dickinson
BMJ-British Medical Journal
Article URL: http://www.medicalnewstoday.com/medicalnews.php?newsid=61209
Positive Opinion For Type 2 Diabetes Treatment, JANUVIA - First In New Class Of Oral Treatments Known As DPP-4 Inhibitors, European UnionJANUVIA (sitagliptin), Merck, Sharp & Dohme's treatment for patients with type 2 diabetes, today received a positive opinion from the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Evaluation Agency (EMEA) in Europe. The CHMP opinion recommends that JANUVIA be approved in the European Union for the treatment of type 2 diabetes. Following the conclusion of the CHMP review, the opinion for JANUVIA will be transmitted to the European Commission (EC). If the EC adopts the opinion, JANUVIA will be the first and only prescription medication in a new class of drugs known as dipeptidyl peptidase-4 (DPP-4) inhibitors, which enhance the body's own ability to lower blood sugar (glucose) when it is elevated. The decision will be applicable to the 27 countries that are members of the European Union, including the United Kingdom, Germany, France, Italy and Spain. JANUVIA is currently approved in eleven countries including the United States and Mexico. Marketing authorization from the European Commission is expected in early April after the adoption of the opinion.
The CHMP, comprised of regulators from all European Union countries, gave the positive opinion following a review of comprehensive data supporting the efficacy and safety and tolerability profile of JANUVIA. The submission package consisted of studies involving approximately 4,000 patients with type 2 diabetes treated with JANUVIA.
JANUVIA has been investigated in patients with type 2 diabetes to improve glycaemic control in combination with metformin when diet and exercise, plus metformin, do not provide adequate glycaemic control. JANUVIA has also been studied as add on therapy with PPARγ agonists in patients with type 2 diabetes mellitus in whom use of a PPARγ agonist (e.g. a thiazolidinedione) is appropriate. In addition, JANUVIA has been studied as monotherapy in many patients.
In a clinical study, JANUVIA plus metformin, compared to treatment of a sulfonylurea (SU) plus metformin, showed comparable glucose lowering efficacy. In this study patients taking JANUVIA plus metformin lost weight (-1.5 kg) compared to patients taking glipizide plus metformin who gained weight gain (+1.1 kg). Hypoglycaemia (when blood sugar becomes too low) was more common in patients treated with glipizide plus metformin (32 percent) compared to patients treated with JANUVIA plus metformin (4.9 percent). In the overall phase III clinical programme the incidence of hypoglycaemia in patients taking JANUVIA was similar to patients taking placebo (1.2 percent, JANUVIA vs. 0.9 percent, placebo). In clinical trials of up to 2 years in duration, patients have received treatment with JANUVIA alone or in combination with metformin, a sulfonylurea (with or without metformin) or a PPARγ agent. In these trials, the rate of discontinuation due to adverse experiences considered drug-related was 0.8 percent with JANUVIA and 1.5 percent with other treatments. No adverse reactions considered as drug- related were reported in patients treated with JANUVIA occurring in excess (> 0.2 % and difference > 1 patient) of that in patients treated with control. Reported adverse events included nausea (common), somnolence, upper abdominal pain, diarrhoea and hypoglycaemia (uncommon).* 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 (sitagliptin) is an oral, once daily, potent and highly selective DPP-4 inhibitor. DPP-4 inhibitors work by enhancing a natural body process that lowers blood sugar, the incretin system. When blood sugar is elevated, incretins work in two ways to help the body regulate high blood sugar levels: they trigger the pancreas to increase the release of insulin and signal the liver to reduce its production of glucose. DPP-4 inhibitors enhance the body's own ability to control blood sugar levels by increasing the active levels of these incretin hormones in the body, helping to decrease blood sugar levels in patients with type 2 diabetes.
Expanding Clinical Trial Program for JANUVIA
MSD'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.
Merck & Co., Inc., which operates in many countries as MSD (Merck Sharp & Dohme), is a global research-driven pharmaceutical company dedicated to putting patients first. Established in 1891, Merck currently discovers, develops, manufactures and markets vaccines and medicines to address unmet medical needs. The Company devotes extensive efforts to increase access to medicines through far-reaching programs that not only donate Merck medicines but help deliver them to the people who need them. Merck also publishes unbiased health information as a not-for-profit service. For more information, visit www.merck.com.
This press release contains "forward-looking statements" as that term is defined in the Private Securities Litigation Reform Act of 1995. These statements are based on management's current expectations and involve risks and uncertainties, which may cause results to differ materially from those set forth in the statements. The forward-looking statements may include statements regarding product development, product potential or financial performance. No forward-looking statement can be guaranteed, and actual results may differ materially from those projected. Merck undertakes no obligation to publicly update any forward- looking statement, whether as a result of new information, future events, or otherwise. Forward- looking statements in this press release should be evaluated together with the many uncertainties that affect Merck's business, particularly those mentioned in the cautionary statements in Item 1 of Merck's Form 10-K for the year ended Dec. 31, 2005, and in its periodic reports on Form 10-Q and Form 8-K, which the company incorporates by reference.
-- JANUVIA - Patient and Caregiver Web Site
-- JANUVIA - Health Care Professional Web Site
* Frequencies are defined as: very common (≥ 1/10); common (≥ 1/100, < 1/10); uncommon (≥ 1/1,000, < 1/100); rare (≥ 1/10,000, < 1/1,000); and very rare (< 1/10,000).
(R) JANUVIA is a registered trademark of Merck & Co., Inc., which operates in many countries as MSD (Merck, Sharp & Dohme).