Diabetes News September 8th 2008

Belonging to a diabetes patients’ association is predictive of better metabolic control
Belonging to a patients’ organization was associated with better HbA(1c) in T1DM. In T2DM, which progresses relentlessly, similar HbA(1c) levels and better lipid profiles were observed, despite longer known disease durations and lower beta-cell function (PubMed)

Sir Ian launches diabetes centre
Former cricketer Sir Ian Botham has launched the construction of a new diabetes centre in Surrey (BBC, UK)

Diabetics missing out on life saving medication
This primary care project shows that despite their high cardiovascular risk, one in four patients with diabetes are not being treated with prophylactic aspirin and/or statins – medicines that could prevent their death from complications of their disease (Royal Pharmaceutical Society of Great Britain)

Dual-wave insulin pump improves postprandial glycemia in type 1 diabetic children
Compared to normal bolus, PPG was significantly reduced (by 47%) with a dual-wave bolus before low-glycemic index meals, thus also reducing the risk of hypoglycemic events (American Diabetes Association)

How can we best prevent new foot ulcers in people with diabetes?
Little evidence from randomised controlled trials is available to inform clinical guidelines on preventing diabetic foot ulcers. However, the effects of interventions that explicitly focus on foot health, specialist foot care, pressure deflection, and patient education have not been rigorously evaluated (BMJ, UK)

Hepatic dysfunction and insulin insensitivity in type 2 diabetes mellitus: a critical target for insulin-sensitizing agents
The current review addresses this topic from the perspective of the role of the liver in maintaining glucose homeostasis, its key involvement in the pathogenesis of type 2 diabetes and the tools currently available to reduce hepatic insulin insensitivity (Diabetes, Obesity and Metabolism)

A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with Type 2 diabetes
The high prevalence of comorbid disorders and the persistence of depressive affect and diabetes distress over time highlight the need for both repeated mental health and diabetes distress screening at each patient contact (Diabetic Medicine)

Depression in Patients with Diabetes: Does It Impact Clinical Goals?
Depression seems to have a variable impact on achieving these clinical goals, perhaps because the goals have differing measurement logistics and biological profiles (Journal of the American Board of Family Medicine )

Intensive Lipid Lowering With Atorvastatin in Patients With Coronary Artery Disease, Diabetes, and Chronic Kidney Disease
Patients with diabetes, stable coronary artery disease, and mild to moderate CKD experience marked reduction in cardiovascular events with intensive lipid lowering, in contrast to previous observations in patients with diabetes and end-stage renal disease (Mayo Clinic Proceedings)

Physicians Eager To Increase Their First- And Second-Line Prescriptions For Januvia For The Treatment Of Type 2 Diabetes
Endocrinologists and primary care physicians expect to shift their third- or later-line Januvia use to earlier lines of therapy in the next two years (Decision Resources)

Weight changes in type 2 diabetes and the impact of gender
This study provides evidence that weight gain is not a necessary consequence of the treatment of type 2 diabetes. Women were more successful than men in losing weight, and diet, with or without the addition of metformin, was the treatment type most usually associated with weight loss (Diabetes, Obesity and Metabolism)

Vision strategy aims to tackle sight loss ‘time bomb’
A landmark five-year strategy to improve the eye-care of Scots has been launched in Holyrood (RNIB, UK)

Guidelines for the Management of Diabetic Retinopathy
The objective of these guidelines is to assist practitioners in making decisions about the appropriate health care of patients with diabetes. 183-page PDF (NHMRC, Australia)

Less talk, more action to tackle Scotland’s soaring obesity epidemic
In advance of a debate on obesity in the Scottish Parliament today (Thursday 4 September), BMA Scotland called on politicians to take tough action to tackle childhood obesity (BMA, Scotland, UK)

Point-of-care testing (POCT) as a tool for screening for diabetes and pre-diabetes
POCT significantly underestimated the true blood glucose at diagnostic levels for diabetes. POCT cannot be recommended as a means of screening for or diagnosing diabetes or pre-diabetes (Diabetic Medicine)

Patient Safety in Diabetes Care and Intensive Glycemic Therapy
The two trials, ADVANCE and ACCORD, are clearly landmark trials, both because of the high quality of the studies, and the importance of the results. Yet, the two show what appears to be conflicting conclusions (American Association of Clinical Endocrinologists)

Addressing insulin resistance in Type 1 diabetes
This review examines the evidence for insulin resistance in the pathophysiology of Type 1 diabetes and its complications, the problems associated with its measurement, and summarizes the trials aimed at reducing insulin resistance in Type 1 diabetes (Diabetic Medicine)

Insulin detemir is characterized by a more reproducible pharmacokinetic profile than insulin glargine in children and adolescents with type 1 diabetes
The results from a randomized, double-blind, controlled trial (Pediatric Diabetes)

Generex Biotechnology to Sponsor International Diabetes Symposium in Rome
Generex Biotechnology Corporation the leader in drug delivery for metabolic diseases through the inner lining of the mouth, will sponsor an international diabetes symposium in Rome, Italy as an adjunct to the 44th Annual Meeting of the European Association for the Study of Diabetes taking place in Rome from September 6-11, 2008 (Market Watch)

Recent additions to the Diabetes Specialist Library
What’s New from the Diabetes Specialist Library (NDST, UK)

General effect on high-risk persons when general practitioners are trained in intensive treatment of type 2 diabetes
General practitioners identify a high number of incident diabetes cases in individuals with IFG or IGT found by high-risk screening. Intervention at the general practitioner’s level in intensive treatment type 2 diabetes does not have a significant spillover effect reducing the risk of diabetes from pre-diabetic conditions (Scandinavian Journal of Primary Health Care)

Advances in the Management of Patients with Diabetes Mellitus: Triumphs and Tragedies
The need for long term studies to establish the best means of treating Diabetes, was underlined by Prof John Cleland from the University of Hull at the ESC Congress in Munich (European Society of Cardiology)

Alcohol Abuse can Damage the Brain by Decreasing Insulin and Insulin-like Growth Factor Receptors
A new study using postmortem human brain tissue has found that chronic alcohol abuse can decrease levels of genes needed for brain cells to respond to insulin/IGF, leading to neurodegeneration similar to that caused by Type 2 diabetes mellitus (ATTC)

Interval training may be the best type of exercise to affect metabolic syndrome
These findings suggest that high-intensity interval exercise training is more beneficial to preventing and reversing metabolic syndrome compared with constant, moderate-intensity programs (Endocrine Today)

Diabetes UK Annual Professional Conference 2009
One of the largest healthcare conferences in the UK attracting up to 3000 attendees -11th to 13th March 2009 at the Scottish Exhibition and Conference Centre in Glasgow (Diabetes UK)

Call for abstracts for Diabetes UK’s Annual Professional Conference
Submission deadline: 17 October 2008 (Diabetes UK)

Community Diabetes Consultants (CDC) Annual Meeting
On the 4th October 2008 – Scarman Centre, Univeristy of Warwick (National Diabetes Support Team, UK)

National Diabetes Audit
The August edition of the NDA service update (NHS, UK)

Prasugrel better than Plavix for diabetics, says analysis
Eli Lilly and Daiichi Sankyo has presented data from a head-to-head study which shows that its investigational oral antiplatelet drug prasugrel could be more beneficial for diabetics than Sanofi-Aventis/Bristol-Myers Squibb’s blockbuster Plavix (Pharma Times)

Western European Diabetes Market Shows Movement to Exclusive Pill Therapy
Research Reveals Growing Use of Exclusive Pill Therapy Among Diabetes Population in Six European Countries, Fueled by Heavy Pill Use in Growing Segment of Type 2 Diabetes Patients (Market Watch)

Weighing Up the Burden of Obesity
A 25-page PDF review by (Dr Foster Research)

Obesity Not a Red Flag for Spotting Diabetes
Obese people with diabetes are just as likely to go undiagnosed as their slimmer peers with the disease, Harvard Medical School researchers report (American Diabetes Association)

Association Between Parental History of Type 2 Diabetes and Glycemic Control in Urban African Americans
Parental history did not appear to be associated with better knowledge or perception of adequate glycemic control (Diabetes Care)

Summit sets priorities for fighting diabetes
Diabetes Australia has called on the federal government to match any new Olympic sports funding with investment in community diabetes and obesity prevention programs (Diabetes Australia)

Gastric emptying and postprandial glucose excursions in adolescents with type 1 diabetes
Because amylin is co-secreted with insulin from beta cells, patients with type 1 diabetes (T1DM) are deficient in both insulin and amylin. Amylin delays gastric emptying and suppresses glucagon in the postprandial period. Hence, we hypothesized that children with complication-naive T1DM have accelerated gastric emptying in response to a mixed meal because of amylin deficiency (Pediatric Diabetes)

Young Endocrinologists Prize Lectures – call for abstracts
Applications are now invited from Clinician-in-Training and Scientist-in-Training members to submit an abstract for the Clinical and Basic Science Prize Lectures (Society for Endocrinology)

New stories of diabetes in pregnancy
Diabetes UK has enhanced and extended the Pregnancy and diabetes section of its website. These webpages help to explain the diverse issues that affect women with diabetes when planning for a family and during their pregnancy (Diabetes UK)

Normal Fasting Plasma Glucose and Risk of Type 2 Diabetes Diagnosis
The strong independent association between the level of normal fasting plasma glucose and the incidence of diabetes after controlling for other risk factors suggests that diabetes risk increases as fasting plasma glucose levels increase, even within the currently accepted normal range (American Journal of Medicine)

Latest GI News
Including: High GI diet speeds progression to type 1 diabetes in at risk kids (GI News, Australia)

Insulin sensitivity is correlated with glomerular filtration rate
After a follow-up of 7 years, the investigators found a direct and independent correlation between insulin sensitivity and GFR (American Diabetes Association)

Removal of the following Rosiglitazone subsidies from the PBS
As of 01 October 2008 – Rosiglitazone for the initiation or continuation of combination therapy with insulin, and as of 01 November 2008 – Rosiglitazone for the initiation of triple oral combination therapy with metformin and a sulfonylurea (PBS, Australian Government)

Diamyd Medical’s NTDDS Technology Effective against Diabetes Pain
These new data indicate that not only is the NTDDS platform with enkephalin effective at reducing pain, it reverses the root cause of diabetes related pain. This means that the approach is not just pain relief, but local pain prevention (Diamyd)

AMA Position Statement on obesity
Obesity – 2008 (Australian Medical Association)

Glycosmedia on the Young Diabetologists website
Glycosmedia has been selected as a news feed “Tab” (Young Diabetologists)

Diabetes UK swimmers take on the English Channel
Twelve spirited swimmers braved the waters of the English Channel in a relay race that took place in the middle of the night to raise vital funds for (Diabetes UK)

Special needs of children with type 1 diabetes at primary school: perceptions from parents, children, and teachers
The three population groups agreed about the necessity of having more available information on diabetes at schools. Although some discriminatory behavior was still occurring, it seemed it has been diminishing in recent years (Pediatric Diabetes)

Should we prescribe diuretics for patients with prediabetes and hypertension?
Diuretics are known to achieve long term cardiovascular results as good as, or better than, alternative antihypertensives—at least in people aged 55 years or older. But clinicians may not initially treat patients with prediabetes and hypertension with a diuretic because they worry that the induced diabetes might result in a worse outcome (BMJ, UK)

Tracking Developments In Diabetes Research
Scientists report that they have been able to selectively kill the defective autoimmune cells that were destroying insulin-producing islets in samples of human blood. Listen now as Denise Faustman, director of immunobiology at Massachusetts General Hospital East, describes the latest diabetes research (npr)

Type 2 Diabetes in the 21st Century: Where Are We Heading?
What are our goals in the management of type 2 diabetes? With an ever-expanding pharmacologic armamentarium, does the choice of agent(s) influence the ability to safely reach these goals? (Medscape)

Prevalence of Structural Central Nervous System Abnormalities in Early-Onset Type 1 Diabetes Mellitus
Early age of onset of T1DM per se is associated with a high incidence of CNS abnormalities, particularly MTS, suggesting hippocampal damage. Early-onset severe hypoglycemia may have an effect on gray matter volume (The Journal of Pediatrics)

Recent Advances in GLP-1 Receptor Agonists in the Treatment of Type 2 Diabetes Mellitus
A Conference Report From the 68th Scientific Sessions of the American Diabetes Association (Medscape)

Inhaled Human Insulin Causes Small Changes in Pulmonary Function in Type 2 Diabetes
Therapy with inhaled human insulin (Exubera) caused small changes in forced expiratory volume in 1 second (FEV1), and weight gain was less with inhaled human insulin vs subcutaneous insulin in adult patients with type 2 diabetes, according to the results of a 2-year safety study reported in the September issue of Diabetes Care (Medscape)