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Diabetes News July 11th 2008

July 11th 2008

Diabetes Briefing 12/08
New Diabetes Briefing is now available (NHS, UK)

44th EASD Annual Meeting Rome, Italy
Provisional Programme (EASD)

American Diabetes Association Applauds U.S. Congress for Extending Special Diabetes Programs
The American Diabetes Association (ADA) applauds the U.S. Congress for voting in favor of extending the Special Diabetes Programs (SDP) for two more years (American Diabetes Association)

New therapeutic approaches to diabetic gastroparesis.
Intrapyloric injection of botulinum toxin is effective in improving the complex symptoms and clinical syndrome associated with diabetic gastroparesis resistant to conventional treatmen (PubMed, USA)

The quality of life and economic burden of neuropathy in diabetic patients in Germany in 2002-Results from the diabetic microvascular complications (DIMICO) study
The results described in this report show that diabetic neuropathy in adults with type 1 or type 2 diabetes generates significant reductions in the patient’s quality of life and a substantial economic burden both for society and health insurance. (PubMed, USA)

The pathogenesis of diabetic nephropathy
We touch on the expanding clinical data regarding markers of nephropathy, such as microalbuminuria, and put them into context; microalbuminuria reflects cardiovascular and not renal risk (PubMed, USA)

Design of a nurse-run, telephone-based intervention to improve lipids in diabetics.
This randomized, controlled trial tested the effectiveness of a nurse-run, telephone-based intervention to improve lipid control in patients with diabetes (PubMed, USA)

Effects of dietary catechins on glucose tolerance, blood pressure and oxidative status in Goto-Kakizaki rats.
From these results it is concluded that dietary catechins may be effective in delaying the progression of diabetes and the associated oxidative stress (PubMed, USA)

Introducing GOAT: a target for obesity and anti-diabetic drugs?
Here, we review what is currently known about the regulatory role of ghrelin O-acyltransferase (GOAT) and discuss the potential of this novel approach for treating obesity and type-2 diabetes (PubMed, USA)

Type 2 diabetes mellitus: clinical and aetiologic types, therapy and quality of glycaemic control of ambulatory patients.
Type 2 diabetes is a heterogeneous disease where clinical judgement alone does not adequately tell the various aetiological types apart without additional laboratory testing of C-peptide levels and GAD antibody status. This may partly explain the inappropriate treatment choices for the various aetiological types with consequent sub-optimal glycaemic control of those patients (PubMed, USA)

India’s Public and Private Sectors Should Unite to Address Diabetes Epidemic
Central and state governments as well as private industry and universities are among some of the groups that should unite to enact policy changes addressing India’s growing diabetes epidemic, say leading U.S. and global diabetes researchers (WebWire)

Mixed results confuse diabetes debate
Researchers who are comparing two diabetes trials say they are getting some insight into why patients in one were more likely to die after aggressive treatment, while patients in another were not (ABC, Australia)

Study looks into diabetes remedy
A delivery agent known SNAC, developed by biopharmaceutical firm Emisphere Technologies, has been incorporated into tablets of GLP-1 peptide to asses how safely and effectively the treatment can be delivered (Pharmacy Europe)

New call for research into diabetes complications
Diabetes UK is asking researchers to put forward proposals looking at ‘novel interventions for the complications of diabetes.’ (Diabetes UK)

Delivering care closer to home: meeting the challenge
The document (PDF) is a resource for commissioners and others interested in shifting care closer to home. It aims to share local emerging practice, how national enablers can support shifting care, and highlights new products developed to support local commissioners and providers. Includes information on Year of Care for Diabetes project and Community Pharmacy Diabetes Services (DoH, UK)

Diabetes may cut male fertility
Tests showed DNA in sperm from diabetic men had more signs of damage than in men without the condition (BBC, UK)

Distinct monocyte gene-expression in autoimmune diabetes
Sub-groups of T1D patients show an abnormal monocyte gene expression with two profiles, supporting a concept of heterogeneity in the pathogenesis of immune-mediated diabetes only partly overlapping with the presently known diagnostic categories (Diabetes, USA)

Dietary Patterns, Insulin Resistance, and Incidence of Type 2 Diabetes in the Whitehall II Study
A dietary pattern associated with insulin resistance predicts type 2 diabetes risk after adjustment for a range of confounders. This study adds to the evidence that dietary patterns are an important risk factor for type 2 diabetes (Diabetes Care, USA)

Metformin May Help Obese Teen Girls Lose Weight
The addition of the type 2 diabetes drug metformin to a lifestyle modification program may help female adolescents lose weight loss if they also make dietary changes, according to a new study (American Diabetes Association)

Fetuin-A and Incident Diabetes Mellitus in Older Persons
Among well-functioning older persons, serum fetuin-A is associated with incident diabetes, independent of other markers of insulin resistance (JAMA, USA)

Insulin intervention to preserve beta-cell function is effective, safe
Results of a recent study showed that in adult patients with slowly progressive insulin-dependent type 1 diabetes or latent autoimmune diabetes, insulin intervention to preserve beta-cell function is safe and effective (Endocrine Today, USA)

Nocturnal glucose metabolism after bedtime injection of insulin glargine or nph insulin in patients with type 2 diabetes
Nocturnal variations of EGP and Rd explain the reduced incidence of hypoglycaemia and lower fasting glucose levels reported for insulin glargine compared to human NPH insulin (Journal of Clinical Endocrinology & Metabolism)

Code on embryo screening planned
Doctors already screen DNA for lethal diseases, but in principle so-called gene chips could also test for less serious conditions (BBC, UK)

New drugs for diabetes: a technology assessment report in support of a NICE short guideline.
The NICE clinical guideline on Type 2 diabetes mellitus (T2DM) is being updated for release in 2008. Because of the number of new drugs for T2DM, an updating for release in 2009 is being produced as a short guideline. This TAR is being produced to assist with this process (Health Technology Assessment, UK)

Is Aliskiren plus Losartan renoprotective in patients with type 2 diabetes and nephropathy?
Despite this study suggesting some beneficial effects of aliskiren on biochemical markers of renal disease, it is still not known if adding aliskiren to an ACE inhibitor or angiotensin II receptor antagonist will reduce actual kidney disease or indeed morbidity or mortality over the long-term (NPC, UK)

Diabetes UK backs prevention research
Diabetes UK is delighted to announce its continued support of the National Prevention Research Initiative (NPRI), which funds research aimed at improving health and preventing conditions or diseases such as diabetes, cancer, obesity, stroke and dementia (Diabetes UK)

Diabetes drug causing lawsuits
Controversial diabetes drug Avandia has hit the news again this month as a group of diabetes patients seek compensation from manufacturer GlaxoSmithKline. Hundreds of people with diabetes are seeking compensation for health problems relating to taking Avandia (Diabetes.co.uk)

Type 2 Diabetes Epidemic Seen Looming
“The full impact of the childhood obesity epidemic,” Lee warns in the Archives of Pediatrics and Adolescent Medicine, “has yet to be seen because it can take up to 10 years or longer for obese individuals to develop type 2 diabetes.” (American Diabetes Association)

Commission to fund free fruit and veg for schools
As childhood obesity becomes increasingly common, the EU executive is proposing to allocate €90 million of Community funding per year to help member states finance the distribution of free fruit and vegetables in schools as of autumn 2009 (EurActiv)

Fetuin-A and Incident Diabetes Mellitus in Older Persons
Among well-functioning older persons, serum fetuin-A is associated with incident diabetes, independent of other markers of insulin resistance (JAMA. USA)

Intensive glucose control among older patients with diabetes and comorbid Illness
Among older diabetic patients, the presence of multiple comorbid illnesses or functional impairments is a more important predictor of limited life expectancy and diminishing expected benefits of intensive glucose control than is age alone (Annals of Internal Medicine, USA)

Inadequate Blood Glucose Control Is Associated With In-Hospital Mortality and Morbidity in Diabetic and Nondiabetic Patients Undergoing Cardiac Surgery
More than 50% of patients with moderate to poor BGC after cardiac surgery were not previously identified as diabetic. Inadequate postoperative BGC is a predictor of in-hospital mortality and morbidity (Circulation, USA)

Primary schools not able to support children with lunch time injections
A recent Diabetes UK survey of primary schools in England found that where children are not able to inject insulin themselves, parents in 70 per cent of primary schools in England are having to provide this support daily (Diabetes UK)

Type 1 diabetes and body fat
Although weight gain in adulthood is typically associated with increased mortality, this may not be the case for those with type 1 diabetes (Diabetes UK)

Warning over diabetes amputations
A hundred people a week in the UK have a lower limb amputated as a result of diabetes, warns (Diabetes UK)

Tight glucose control and heart disease
The first papers on the ACCORD trial and an Australian study (ADVANCE) have now been published (GI News, Australia)

More meds, more quickly to treat type 2 diabetes
A new attitude is evolving among some doctors who believe a more aggressive approach would better control the disease and help patients avoid its severe consequences in later life (American Diabetes Association)

Amelioration of diabetes-associated abnormalities in the vitreous fluid by an inhibitor of albumin glycation
These results indicate that inhibiting the formation of glycated albumin, which is increased in diabetes, ameliorates vitreous changes in angiogenic and metabolic factors that are associated with the development of diabetic retinopathy (PubMed, USA)

Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus
In well controlled GDM pregnancies, maternal lipids are strong predictors for fetal lipids and fetal growth. Infants with abnormal growth seem to be exposed to a distinct intrauterine environment compared to those with appropriate growth (Diabetes Care, USA)

The Impact of Diabetes and its Treatment on Cognitive Function among Adolescents Who Participated in the DCCT
Despite relatively high rates of severe hypoglycemia, cognitive function did not decline over an extended period of time in the youngest cohort of patients with type 1 diabetes (Diabetes Care, USA)

Increased serum adiponectin levels predicted progression to ESRD
Increased serum adiponectin levels predicted the progression from overt diabetic nephropathy to end-stage renal disease in patients with type 1 diabetes (Endocrine Today, USA)

Tomorrow’s Diabetologist
News and viewpoints from the Young Diabetologists’ Forum. 8-page PDF magazine (Tomorrow’s Diabetologist)

Professor Rhys Williams Named New Editor-in-Chief of Primary Care Diabetes
Professor Rhys Williams (Swansea, UK) has been named the new Editor-in-Chief of Primary Care Diabetes as of July, 2008. Primary Care Diabetes is the official journal of Primary Care Diabetes Europe (Elsevier)

Tripdatabase
Glycosmedia is a supporter of Tripdatabase a leading resource for Evidence-Based Medicine. Tripdatabase has sections for diabetes, endocrinology and metabolism (Tripdatabase, UK)

The association between dietary macronutrient intake and the prevalence of the metabolic syndrome
A diet high in carbohydrates, low in fat and protein, with low-to-moderate alcohol intake, is associated with a reduced prevalence of the metabolic syndrome (British Journal of Nutrition)

Fasting plasma glucose is inadequate screening test for prediabetes in obese youth
A fasting plasma glucose is recommended by the American and Canadian Diabetes Associations (ADA and CDA) for screening obese young people for prediabetes, but a recent Canadian study says it is inadequate (BMJ, UK)

Chronic Care Model and Shared Care in Diabetes: Randomized Trial of an Electronic Decision Support System
Specialty telemedicine did not significantly enhance the value of CCM in primary care (Mayo Clinic, USA)

Relationship between the classification of diabetic macular edema and its related factors
The classification and degree of DME correlates with the stages of DR, diabetic duration, the classification of diabetes, the use of insulin, and visual loss (PubMed, USA)

Effect of diet and physical exercise treatment on insulin resistance syndrome of schoolchildren.
PGL measured 180 minutes after GC may define an important subgroup of pre-diabetic children. The similar prevalance of CRF in both praediabetic groups underlines the importance of this subgroup. Lifestyle modification for two years improves CRF in this population (PubMed, USA)

Too much glucagon, too little insulin: time course of pancreatic islet dysfunction in new-onset type 1 diabetes.
Postprandial hyperglucagonemia worsens significantly during the first year after diagnosis of type 1 diabetes and may represent a distinct therapeutic target. Fasting glucagon values may underestimate the severity of hyperglucagonemia (PubMed, USA)

Diabetes care – insulin delivery in a changing world.
This review discusses how these approaches can help patients manage their diabetes (PubMed, USA)

Isolated Hyperglycemia at 1 Hour on Oral Glucose Tolerance Test in Pregnancy Resembles Gestational Diabetes Mellitus in Predicting Postpartum Metabolic Dysfunction
Like GDM, 1-h GIGT is associated with postpartum glycemia, insulin resistance, and ß-cell dysfunction (Diabetes Care)

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