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Diabetes News June 9th 2008

June 9th 2008

Aggressive approach to diabetes proves harmful
Patients with type 2 diabetes, a high risk of cardiovascular disease, and who use aggressive measures to reduce their blood sugar levels could actually be shortening their lives, according to a large clinical trial [Nature News, UK]

Intensive Glucose Control Reduces Diabetic Nephropathy
Intensive glucose control significantly reduces the risk for nephropathy, according to the results of a 5-year trial to assess the effects of intensive glucose control and blood pressure lowering on vascular complications of type 2 diabetes [Medscape]

The largest ever study of diabetes shows intensive glucose control reduces serious complications
New results from the world’s largest ever study of diabetes treatments show that intensive blood glucose (sugar) control using modified release gliclazide and other drugs as required, protects patients against serious complications of the disease [The George Institue, Australia]

Diabetes Week diary
A range of events taking place throughout Diabetes Week [Diabetes UK]

Panel Calls for Better Diabetes Screening
Better screening and diagnosis for diabetes is being called for to help the 6.2 million Americans who don’t realize they have the disease, a new report says [Washingtonpost.com, USA]

Doctors Slow to Prescribe and Intensify Insulin in Type 2 Diabetes: Presented at ADA
Researchers are reporting evidence of clinical inertia among primary care doctors in Canada regarding insulin initiation and intensification in people with type 2 diabetes [Doctors Guide]

Silent Ischemia in Diabetes Not as Common Nor Threatening as Thought
Silent myocardial ischemia — restriction of blood flow to the heart — occurred in only 22% of the asymptomatic adults with type 2 diabetes that we screened, a far lower percentage than expected [American Diabetes Association]

Antioxidant Treatment Associated With Lower Incidence of Diabetes
While demonstrating no efficacy on reducing cardiovascular events in a population of patients with acute coronary syndromes (ACS), treatment with the antioxidant succinobucol (AGI-1067) resulted in a 63% reduction in new-onset diabetes compared with placebo

A1C = eAG
If you’ve ever tried to explain what an A1C score means to someone who wouldn’t know glycated hemoglobin from hash browns, you’ll be glad to know there’s a new, simpler way to talk about blood glucose levels. Instead of A1C percentages, doctors will soon start reporting to patients their eAG, or “estimated average glucose” l [American Diabetes Association]

Insulin Glulisine APIDRA® efficacy in the treatment of children and adolescents with type 1 diabetes
A new study comparing efficacy and safety of APIDRA® and insulin Lispro as part of a basal-bolus regimen. 4-page PDF [Sanofi-Aventis]

Study Shows LANTUS® Helped People Living with Type 2 Diabetes Reach the ADA’s Recommended Target for Blood Sugar Control
New data presented at the American Diabetes Association’s Annual Scientific Sessions demonstrated the value of beginning insulin promptly when glycemic targets are not achieved with diet, exercise and oral medications alone. 4-page PDF [Sanofi-Aventis]

Onglyzatm (saxagliptin) Demonstrated Significant Reductions in Key Measures of Glucose Control in Treatment Naive People with Type 2 Diabetes
Results from a 24-week Phase III study presented at the 68th American Diabetes Association Annual Scientific Sessions [Bristol-Myers Squibb]

Doctors Urged to Look for Link Between Type 2 Diabetes, Sleep Apnea
The ties being found between type 2 diabetes and obstructive sleep apnea (OSA) indicate these disorders have major implications on public health, the International Diabetes Federation warns [U.S. News]

Glycemic instability in type 1 diabetic patients: Possible role of ketosis or ketoacidosis at onset of diabetes
We have developed criteria for evaluating glycemic instability and investigated the factors responsible [Extract – PubMed]

New treatments for type 2 diabetes mellitus: combined therapy with sitagliptin
Sitagliptin is a highly selective oral dipeptidyl peptidase-4 inhibitor. This drug increases the plasma concentration of active glucagon like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide. These two hormones then simulate the secretion of insulin in a glucose-dependent manner and inhibit glucagon secretion, thus reducing circulating glucose levels [Extract – PubMed]

Long-term Pesticide Exposure May Increase Risk of Diabetes
Licensed pesticide applicators who used chlorinated pesticides on more than 100 days in their lifetime were at greater risk of diabetes, according to researchers from the [National Institutes of Health , USA]

Two-Drug Combo Reduces Diabetic Kidney Damage
Almost 25 percent of participants saw urine protein levels lowered significantly [MedlinePlus, USA]

Sun and vitamin D levels may play a strong role in risk of type 1 diabetes in children
Sun exposure and vitamin D levels may play a strong role in risk of type 1 diabetes in children, according to new findings by researchers at the Moores Cancer Center at University of California, San Diego (UCSD) and the Department of Family and Preventive Medicine [News-Medicine, USA]

Two-Year Pulmonary Safety and Efficacy of Inhaled Human Insulin (Exubera) in Adult Patients with Type 2 Diabetes
Two-year prandial EXU therapy showed a small nonprogressive difference in FEV and comparable sustained A1C improvement but lower FPG levels and less weight gain than SC insulin in adults with type 2 diabetes. [Diabetes Care]

Regulation of cardiomyocyte hypertrophy in diabetes at the transcriptional level
We concluded that data from these studies demonstrate a novel glucose-induced epigenetic mechanism regulating gene expression and cardiomyocyte hypertrophy in diabetes [Abstract – American Journal of Endocrinology and Metabolism]

Vascular disease and diabetes: is hypoglycaemia an aggravating factor?
The concept that acute hypoglycaemia could aggravate vascular complications associated with diabetes is discussed in relation to evolving comprehension of the pathogenesis of atherosclerosis and blood vessel disease. Abstract [Diabetes/Metabolism Research and Reviews]

Eleven New NDST Infopoints
Infopoints are good stories or examples of good practice that other people in the diabetes community should know about. There are an addtional eleven new NDST Infopoints for you to read and download [National Diabetes Support Team, NHS, UK]

Too Few Diabetes Trials are Seeking Answers to Issues Important to Patients, Including Hard CV End Points
That’s the conclusion of a new analysis published in the June 4, 2008 issue of the Journal of the American Medical Association [Medscape]

Dipeptidyl Peptidase-IV Inhibitors: Pharmacological Profile and Clinical Use
One DPP-IV inhibitor is available for use in the United States, and the approval of a second agent is imminent. DPP-IV inhibitors offer a safe and efficacious method for modestly reducing hyperglycemia alone or in combination with other agents in patients with type 2 diabetes without causing weight gain, significant hypoglycemia, or other major side effects [Clinical Diabetes]

Retinal Arteriolar Dilation Predicts Retinopathy in Adolescents with Type 1 Diabetes
Our data suggest that arteriolar dysfunction may play a critical role in the pathogenesis of early diabetic retinopathy and that computer-based retinal vascular caliber measurements may provide additional prognostic information regarding risk of diabetic microvascular complications. Abstract [Diabetes Care]

Continuous Glucose Monitoring: The Future of Diabetes Management
Continuous glucose monitoring (CGM) technology has the potential to revolutionize diabetes care in the near future because of the real-time feedback it provides about therapeutic interventions and variations in lifestyle or dietary intake. Abstract [Diabetes Spectrum]

Discovery of new signal pathway important to diabetes research
Scientists at Karolinska Institutet and Miami University have discovered that cells in the pancreas cooperate – signal – in a way hitherto unknown. The discovery can eventually be of significance to the treatment of diabetes [News-Medical]

Final results of the AusDiab Study on retinal vascular caliber and diabetes
Multivariate analysis revealed that retinal arteriolar caliber, but not retinal venular caliber, was associated with incident diabetes [American Diabetes Association]

Screening Adults for Type 2 Diabetes: A Review of the Evidence for the U.S. Preventive Services Task Force
Direct evidence is lacking on the health benefits of detecting type 2 diabetes by either targeted or mass screening, and indirect evidence also fails to demonstrate health benefits for screening general populations [Annals of Internal Medicine, USA]

Diabetes May Increase Risk for Hepatocellular Carcinoma in Patients With Hepatitis C
In patients with hepatitis C and advanced cirrhosis, diabetes increases the risk for hepatocellular carcinoma (HCC), according to the results of a study reported in the June issue of Hepatology [MedScape, USA]

Vitamin D for Babies May Prevent Type 1 Diabetes
A new analysis of current research provides “the strongest evidence to date” that giving small children supplemental vitamin D will help prevent them from developing type 1 diabetes later on [American Diabetes Association]

Men And Women May Metabolize Fructose Differently
Men and women appear to differ in how they metabolize high levels of fructose, a simple sugar commonly used to sweeten drinks and foods [American Diabetes Association]

Type 2 diabetes : the management of type 2 diabetes
This guideline offers best practice advice on the care of people with type 2 diabetes. 44-page PDF [NICE, UK]

Blood glucose systems
Buyers guide. 48-page PDF [NHS Purchasing and Supply Agency, UK]

Diabetes Foot Screening
Diabetic foot screening, leading to early intervention and intensive foot care education, is a principal component of diabetes care. 3-page PDF link from this page [Australian Diabetes Educator]

Number of diabetics soars above 30,000
The Lothian Diabetes Register was set up in 2002 to allow patient information to pass quickly between medical professionals [Edinburgh News, UK]

Facing up to the diabetes challenge
The disease currently affects 3% of the adult population, but among those aged 70 and above, the figure rises to between 7% and 9% [BBC, UK]

Adherence to Mediterranean diet and risk of developing diabetes
Prospective cohort study [BMJ, UK]

Eating Away from Home
tips for health professionals and consumers on making healthier food choices when you are not at home [Canadian Diabetes Association]

Merck Alliance to Reduce Disparities in Diabetes.
Later this year, the Foundation will announce several five-year health care disparities and diabetes programs in selected communities around the country. Competitive Call for Proposals and letters of intent [Merck, USA]

Microvascular and Macrovascular Complications of Diabetes
It is important for physicians to understand the relationship between diabetes and vascular disease because the prevalence of diabetes continues to increase in the United States, and the clinical armamentarium for primary and secondary prevention of these complications is also expanding [Clinical Diabetes Journal]

Choosing an Insulin Regimen for Patients With Type 2 Diabetes
Biphasic and prandial insulin regimens produced somewhat lower mean A1C levels than a basal regimen but were associated with more minor hypoglycemic events and weight gain and required more injections [Clinical Diabetes Journal]

Pyruvate dehydrogenase kinase 4: regulation by thiazolidinediones and implication in glyceroneogenesis in adipose tissue
These data show that PDK4 upregulation in adipocytes participates in the hypolipidemic effect of thiazolidinediones through modulation of glyceroneogenesis [Abstract, Diabetes Journal, USA]

People with diabetes not getting retinal screening
Three quarters of a million people with diabetes in England are at risk of losing their sight because they are not being screened for diabetic retinopathy [Diabetes, UK]

Diabetic Retinopathy Screening Statement
Data from Local Delivery Plan Returns shows that by December 2007 85.7 percent of people diagnosed with diabetes were offered screening for diabetic retinopathy that met stringent national clinical standards of quality and safety in the previous twelve months. -page PDF [DoH, UK]

Diabetes found to worsen cognitive function in patients with schizophrenia
A study conducted at the University of Maryland compared the cognitive performance of patients with schizophrenia and diabetes [American Diabetes Association]

Diabetologia
Contents for June issue [Diabetologia]

Mothers’ High Normal Blood Sugar Levels Place Infants at Risk for Birth Problems
Pregnant women with blood sugar levels in the higher range of normal — but not high enough to be considered diabetes — are more likely than women with lower blood sugar levels to give birth to babies at risk for many of the same problems seen in babies born to women with diabetes during pregnancy, according to a study funded in large part by the [National Institutes of Health, USA]

Mediterranean Diet May Thwart Diabetes
The study included 13,380 Spanish university graduates (age range 20 to 90, average age 36) who were followed for about four years [WebMD]

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