Here are lifestyle factors that can raise your risk.
No time for breakfast and too much TV time can trigger diabetes. Fitness magazine, in its April edition, reports on nine surprising diabetes risk factors. The disease affects 21 million people in the United States.
Skipping breakfast increases our risk 30 percent to 50 percent, and watching TV for two or more hours per day boosts it 14 percent, according to Fitness.
Pam O’Brien, the magazine’s article director, says the main reason for the story was to point out that people can lower their risk in about a month.
As a former no-breakfast type, O’Brien began forcing herself to eat breakfast a few years ago and has felt much better since.
“So many of us skip breakfast because we’re busy and just grab a cup of coffee,” she says, describing her own former habit. “It’s one of the worst things you can do. People that eat high fiber cereals respond better to insulin.”
Diabetes, according to the American Diabetes Association, is caused when the body doesn’t produce or properly use insulin. Insulin converts starches and sugars into fuel for the body.
While the exact cause is still unknown, the ADA points to studies that link genetics and lifestyle factors such as obesity and lack of exercise to the disease.
O’Brien says her staff based its conclusions and risk factor percentages on university research and other studies. While Fitness magazine targets women, the nine risks also affect men.
The two risk factors that most surprised O’Brien were a large waist (risk increases 330 percent) and high stress (184 percent).
“How much the waist thing raised your risk surprised me most,” O’Brien says. “We’re talking the apple-shaped body, fat in the abdomen, fat that is really dangerous.”
9 SURPRISING DIABETES RISKS
1. Watching two or more hours of TV daily Raises your risk: 14 percent.
How: More TV equals less activity.
The fix: Exercise and limit TV time to 10 hours a week.
2. Drinking one soda a day
Raises your risk: 83 percent
How: Soda adds extra calories.
The fix: Switch to diet soda, water or, even better, unsweetened tea.
3. Skipping breakfast
Raises your risk: Up to 50 percent
How: Not having that morning meal increases the appetite-stimulating hormone ghrelin.
The fix: Eat high-fiber cereal with low-fat milk and fruit in the morning.
4. A bout of major depression
Raises your risk: 23 percent
How: Depression may alter body chemistry in a way that makes us more prone to developing diabetes.
The fix: Take a walk.
5. A large waist
Raises your risk: 330 percent
How: Fat in the abdomen (visceral fat) produces compounds that make cells insulin-resistant. Women should keep their waist size below 35 inches (40 inches for men).
The fix: A half-hour to one hour of cardio, three to five times a week.
6. Waking up in the middle of the night
Raises your risk: 98 percent
How: You aren’t getting enough sleep.
The fix: No caffeine in the late afternoon and evening. No TV and alcohol right before bed. Try yoga, too.
7. Fast food more than twice a week
Raises your risk: 100 percent
How: People who ate burgers, fries and soda more than twice a week put on 10 extra pounds.
The fix: Eat smaller portions.
8. High stress
Raises your risk: 184 percent
How: Stress can interfere with your ability to make insulin and process glucose.
The fix: Relax 10 to 15 minutes a day.
9. Consuming a lot of processed meat
Raises your risk: 43 percent
How: These meats may destroy insulin-producing cells in your pancreas.
The fix: Cut back. Try a preservative-free type, too.
Source: Fitness magazine April 2007
Resistance training may not only help to build muscle in older people, it may also be warding off type 2 diabetes, a new study demonstrates.
Thirty-six men and women in their early 60s experienced significant improvements in glucose tolerance after a 12-week resistance-training regimen, Dr. Wayne W. Campbell of Purdue University in West Lafayette, Indiana, and his colleagues found.
“The idea that you could actually improve your glucose tolerance by about 25 percent to 30 percent with 12 weeks of strength exercise without having any weight loss, which is a typical therapy for this, is very encouraging,” Campbell told Reuters Health.
People lose their ability to metabolize sugar effectively as they age, even if they’re otherwise healthy, Campbell and his team note in their report in the American Journal of Clinical Nutrition. And the weight gain that frequently accompanies aging worsens glucose tolerance and compounds diabetes risk. One in five Americans older than 60 years has type 2 diabetes, they add.
There is evidence that resistance training can improve glucose tolerance, while adequate protein levels are necessary for resistance trainers and may even improve changes in body composition and glucose tolerance that come with weightlifting, the researchers note.
To investigate how resistance exercise and dietary protein affect metabolism, the researchers had the study participants work out on resistance machines three times a week for 12 weeks. Each workout session lasted for about an hour and 15 minutes, and included 8 exercises.
Half of the study participants consumed 0.9 grams of protein for each kilogram of body weight per day (low-protein group); the other half consumed 1.2 grams of protein per kilogram (high protein group). The current recommended amount of daily protein is 0.8 grams per kilogram of body weight.
Men and women in the high-protein and the low-protein groups experienced small but significant reductions in total cholesterol and in low-density lipoprotein, the “bad” cholesterol. The level of reduction was similar in both groups.
Changes were similar to what would have occurred with short-term weight loss. And both groups also experienced similar increases in lean body mass and reductions in fat mass.
However, the most dramatic effect was on glucose tolerance, Campbell said, with both groups showing a “profound” improvement in glucose tolerance after the 3-month training program.
The findings are especially significant, the researcher added, because the study participants were at risk of developing type 2 diabetes because of their age and, in some cases, their weight.
“Another five or ten years from now, if they follow the usual paths, they’re going to become heavier and move into the clearly overweight category,” he explained.
Campbell emphasized that all of the study participants were getting adequate amounts of high-quality protein, and urged anyone considering beginning a weight resistance program to do the same.
SOURCE: American Journal of Clinical Nutrition, April 2007.
Study: Women With Type 1 Diabetes May Need Early Bone Density Test
Women with type 1 diabetes may want to consider getting their bone density checked before menopause, researchers report.
The scientists studied bone density in women with and without type 1 diabetes. Their finding: Women with type 1 diabetes tended to have thinner bone and more bone fractures.
Thinner bone is at higher risk to break and can be a sign of developing osteoporosis, in which bone density dips dangerously low. Think of the difference between a thin, brittle twig and a thick, firm tree branch — denser is better to avoid a sudden snap.
The University of Pittsburgh’s Elsa Strotmeyer, PhD, and colleagues conducted the study, which appears in Diabetes Care.
Osteoporosis usually strikes later in life. In women, it’s typically seen after menopause. Men can also develop osteoporosis, but Strotmeyer’s study only included women.
Participants were 67 women with type 1 diabetes and 237 women without diabetes. The women were 33-55 years old and had not gone through menopause.
The researchers checked the women’s height, weight, and bone density. The women also completed surveys about health habits that can help bones (such as weight-bearing exercise) or hurt bones (such as smoking, heavy drinking, use of certain medications, and skimping on calcium and vitamin D).
Even after adjusting for those factors, women with type 1 diabetes had lower bone density than those without diabetes.
In addition, a third of women with type 1 diabetes reported having a bone fracture after age 20, compared with less than a quarter of those without diabetes.
It’s not known if the results apply to men or to people with type 2 diabetes, since they weren’t included in the study.
Most people with diabetes have type 2 diabetes, which usually starts later in life than type 1 diabetes. For instance, in Strotmeyer’s study, women with type 1 diabetes had been diagnosed at age 10, on average, and had had type 1 diabetes for more than 30 years.
To measure the women’s bone density, the researchers used a DEXA (dual-energy X-ray absorptiometry) machine. The machine checked the women’s overall bone density as well as the density of their hips, neck, and spine.
Bone density peaks in the 30s. After that, bones gradually lose density over time. Bone density tests usually aren’t done until after menopause, since that’s when bone density starts to decline at a greater rate.
If the study’s findings are correct, type 1 diabetes could join the list of other osteoporosis risk factors, which include:
Treating osteoporosis can mean taking prescription drugs, boosting intake of calcium, vitamin D, and other bone-friendly nutrients, and getting weight-bearing exercise. Walking, jogging, hiking, dancing, and lifting weights are some examples of weight-bearing exercise. Biking and swimming aren’t in that group, since the bike or water carries your weight.
SOURCES: Strotmeyer, E. Diabetes Care, February 2006; vol 29: pp 306-311. WebMD Medical Reference from Healthwise: “Should I have a DEXA test to diagnose osteoporosis?” News release, American Diabetes Association.
Scientists at Zurich University have developed a promising new therapy that targets the progression of diabetes type 2, the most common form of the disease.
Type 2, which affects 90 per cent of diabetics, is on the rise worldwide due to health and lifestyle factors, such as being overweight.
Several companies are already interested in the treatment – the first of its kind for type 2 diabetes - with a drug estimated to come onto the market in three to five years’ time.
The results of the international study, led by Marc Donath, professor of endocrinology and diabetes at Zurich University Hospital, were published in the prestigious New England Journal of Medicine on Thursday.
Diabetes is an incurable condition in which there is too much glucose in the blood. Type 2 normally develops in later life and can lead to health complications, such as heart and liver problems.
In the study, Donath and his team found that daily injections of anakinra – a drug also used to treat rheumatoid arthritis – helped patients by targeting a cause of the disease.
“Until now we had treatments which weren’t able really to stop progression of the disease and here we are interfering with a mechanism responsible for it,” Donath told swissinfo.
Insulin problems
Type 2 diabetes occurs when the body cannot produce enough insulin or use it effectively. Insulin, a hormone produced in the pancreas, is needed to transport sugar from the blood to cells, where it is used for energy.
Insulin-producing beta cells are sometimes destroyed in type 2 diabetes. Donath and his team already knew that a substance called interleukin-1 beta was responsible for this in type 2.
Anakinra is an interleukin-1-receptor antagonist - it blocks the action of the interleukin-1 beta.
To test the effects of the drug in type 2 diabetes, 36 people received a once-daily placebo injection and 34 people received a daily dose of 100 mg of anakinra for 13 weeks.
Scientists found that glucose levels were lower and the secretion of insulin better in the group that had taken anakinra. Patients also showed reduced systematic inflammation in the body - a contributory factor for diabetes-related complications, such as heart problems.
The drug was found to have few side effects and Donath and his team are planning to conduct follow-up studies.
Common disease
The discovery could help fight a disease that is becoming increasingly common, said Donath. Around 500,000 people are said to have diabetes in Switzerland.
“Around 246 million patients worldwide have diabetes,” he told swissinfo. “What is especially worrying is that a dramatic increase is expected in the next years, not only in western countries, but also in Africa and India.”
Donath said his next step was to develop a treatment that could be used at least once a month, rather than the daily medications currently used by patients.
Two United States companies have expressed interest in developing the research.
Donath is convinced the new treatment could help thousands of patients lead more normal lives, especially as it has already been used for many years to treat rheumatoid arthritis.
“I’m not saying it’s a magic pill but currently it seems to be very safe,” he said.
1 pound trimmed lean round steak
1 large onion, sliced
1/2 cup low-sodium beef broth
2 tablespoons Worcestershire Sauce 1 bay leaf
1/4 teaspoon crushed red pepper
1/8 teaspoon allspice
Combine all ingredients in a large zip-top plastic bag. Seal and marinate in the refrigerator for at least 8 hours, turning occasionally. Remove steak from bag, reserving onion and marinade. Place steak on rack of a broiler pan coated with a non-stick cooking spray. Broil 7 to 8 minutes on each side or to desired degree of doneness. Set steak aside and keep warm. Coat a non-stick skillet with a non-stick cooking spray, add onion and sauté over medium-high heat until tender. Add reserved marinate, cover, reduce heat and simmer onion mixture 5 minutes. Remove and discard bay leaf. Transfer steak to a platter and spoon onion mixture over the steak. Makes 4 servings.
Nutritional Information (1 serving):
Calories: 182
Carbohydrates: 6 grams
Protein: 28 grams
Fat: 5 grams
Saturated fat: 2 grams
Cholesterol: 71 mg
Fiber: 1 gram
Sodium: 150 mg
Potassium: 545 mg
Calcium: 25 mg
Exchanges: 4 very-lean meat and 1 vegetable
More evidence has emerged suggesting a link between pollutants found in oily fish and type two diabetes.
An international team found high levels of persistent organic pesticides (POPs) in the blood correlated to insulin resistance, a precursor to diabetes.
POPs are stored in fatty tissues - the study suggested this may be why obese people are more vulnerable to diabetes.
However, experts have said that the study published in Diabetes Care is far from conclusive.
Patients resistant to the hormone insulin are unable to remove excess glucose from their blood, and this is normally an important step in the onset of type two diabetes.
The new research therefore suggests that POPs act critically at a very early stage in the development of diabetes.
In 2005 researchers in Sweden found people exposed to high levels of POPs were more at risk of developing type two diabetes.
They found higher levels of POP residues were present blood samples of men and women who had diabetes than in those who did not.
The authors of the current research, based at Kyungpook National University and the University of Minnesota, also previously found blood concentrations of POPs were linked to the prevalence of diabetes.
Obese patients with low POP levels had an unexpectedly low incidence of diabetes.
In the new study they observed a similar interaction between certain POPs and insulin resistance, even among non-diabetic patients.
No causal link
But the work does not confirm a causal link - it is possible that that having insulin resistance could reduce people’s ability to clear POPs from their system, thus explaining the association.
Lead author Professor Duk-Hee Lee said the evidence needed to be replicated and developed in other studies, and called for molecular studies to explain the link between pesticides and insulin resistance.
Matt Hunt, Head of Science Information at Diabetes UK, said: “Insulin resistance is often observed as an early warning sign for developing diabetes and therefore possible contributors to this state are always of interest.”
However, he said the current research was very complex and still speculative and did not provide a mechanism by the which the POPs could cause insulin resistance.
He said: “At the moment we would not conclude that the rise of obesity can be attributed to pesticide use, and should still be put down to increasingly unhealthy diets and lack of exercise.”
Avoiding pesticides
Frankie Phillips, a dietician from the British Dietetic Association said: “This research is interesting but we need to have more details before we can say any?hing conclusive.
“It would be useful to avoid pesticides where possible, by washing fruit and vegetables, but it is still essential to reduce the burden of obesity to reduce the incidence of type two diabetes.”
She added that there were clear benefits to eating oily fish, such as reducing the risk of heart disease, and recommended eating one portion a week.
Professor Lee agreed: “Even if POPs are causally related to diabetes, it is difficult for individuals to completely avoid POPs because they are detected in various foods.
“At present, the best thing we can do may be to avoid obesity, because obesity appears to increase the toxicity of POPs.”
Source: BBC News
Adults with diabetes may be at higher risk for developing mild cognitive impairment, a condition that is often seen as a precursor to Alzheimer’s disease, new research found.
“There is mounting evidence that diabetes is bad for cognition,” said Dr Jose A. Luchsinger, the lead author of the study and an assistant professor of medicine at Columbia University. “The mechanisms need to be elucidated. Type 2, or adult-onset diabetes, which the study refers to, is increasing in the US and in the world. The consequences of the potential cognitive complications of diabetes could be devastating from a public health standpoint.”
Still, there are perhaps more questions than answers in the new study, which was published Monday in the April issue of Archives of Neurology.
“What is the real message for diabetes control?” asked Dr Larry Deeb, president of medicine and science for the American Diabetes Association. “If the message is that you’re at greater risk for MCI (mild cognitive impairment) no matter what, that’s one thing. If taking good care of blood sugar makes a difference, as seems to be the case for most other complications of diabetes, that’s another thing. One would hope this might be another argument for controlling diabetes.”
Health experts already knew that type 2 diabetes can be a risk factor for Alzheimer’s disease. The evidence has been less clear on whether diabetes is related to a higher risk of mild cognitive impairment, often considered a bridge state between normalcy and Alzheimer’s.
“There are few studies looking at the outcome of mild cognitive impairment,” Luchsinger said.
How the study was conducted
For this study, Luchsinger and his colleagues looked at 918 men and women older than 65 (average age 75.9) who did not have mild cognitive impairment or dementia at the start of the study. The participants, all from northern Manhattan in New York City, were assessed every 18 months with an in-person interview as well as physical and neurological examinations.
Almost one-quarter - 23.9 percent - of the participants had diabetes, 68.2 percent had high blood pressure, 33.9 percent had heart disease, and 15 percent had suffered a stroke.
During follow-up that averaged 6.1 years, 334 of the participants developed mild cognitive impairment. And people with diabetes had a higher risk of having mild cognitive impairment, especially amnestic MCI, which affects memory more than non-amnestic MCI.
Diabetes tied to impairment
Overall, 8.8% of cases of mild cognitive impairment among the study participants could be attributable to diabetes. And the rates were higher for black Americans (8.4 percent) and Hispanics (11 percent) than for non-Hispanic whites (4.6 percent). This makes sense, given that minority populations in the United States have a higher prevalence of diabetes.
What explains t?e possible link between diabetes and impairment?
Diabetes could contribute to plaque build-up in the brain, with such a build-up a hallmark of Alzheimer’s, the study authors said.
But, they added, more research is needed.
“Studies are needed to see if preventing diabetes prevents cognitive impairment and how diabetes treatment affects cognition,” Luchsinger said. “We also need to see how cognitive impairment in persons with diabetes affects their ability to follow their treatment, which is usually complex and involves several medications.”
Other experts applauded even the tentative findings.
This type of research may help target populations who could one day benefit from drugs, said Maria Carrillo, director of medical and scientific relations at the Alzheimer’s Association.
Risk factors are real
“This supports the idea that risk factors are real,” Carrillo added. “The field has now matured to a point where we can start looking at earlier and earlier aspects of the disease. It makes sense to look even earlier than that and try to tease out what the risk factors look like in that population, in case we have a disease-modifying drug coming up in near future.”
“This is documenting what we know a little bit better and emphasising that patients should control their blood sugar as well as they can early in the disease,” added Dr Joel Zonszein, director of the Clinical Diabetes Centre at Montefiore Medical Centre in New York City. “This is another piece of information, more wood to the fire.” – (HealthDayNews)
A new charity-biz collaboration is testing proteins that could prevent the immune system from destroying insulin secreting cells and help prevent the onset of diabetes.
MediGene has signed a two year deal with the Juvenile Diabetes Research Foundation (JDRF). The charity will pay €250,000 to help the Germany-headquartered biotech company advance its monoclonal T cell receptor (mTCR) therapeutics towards clinical trials. The soluble proteins are engineered to recognise intracellular antigens and block an immune system response by T cells.
These antigens are inaccessible for traditional monoclonal antibodies and so, the soluble T cell receptor technology opens a new field of options to target cancer, autoimmune, allergic and infectious diseases, according to the company.
Normally in Type I diabetics, receptors on the surface of T cells bind to antigens on pancreatic islet cells, which are responsible for the production of insulin. This marks them for destruction.
In its diabetes programme, MediGene has manufactured specific mTCRs which could bind to islet cell antigens, blocking them and preventing real T cell receptors from attacking the cells - “somewhat like taping over a keyhole to prevent a door from being unlocked,” according to the company.
MediGene also hopes the mTCRs could target known immunosuppressive agents to the islet cell’s local environment.
“Provided autoimmune destruction can be tamed, both the early diagnosis of pre-diabetic individuals and the recent advances in islet transplantation therapy offer the prospect of patients being able to maintain endogenous insulin production, with consequent improvements in quality of life,” said Dr Ulrich Delvos, chief operating officer at MediGene.
“MediGene’s mTCR technology holds the promise of tackling the underlying cause of this autoimmune disease.”
Dr Neill MacKenzie, MediGene’s head of commercial strategy and business development, explained to DrugResearcher.com that strategies to replace the body’s insulin directly or improve its ability to produce and use insulin do not prevent many side effects such as blindness, heart attacks, loss of limbs and kidney function.
MediGene hope to overcome this by creating a “therapy that tries to maintain some level of islet functioning,” said Dr MacKenzie. He explained that the mTCRs are currently in preclinical testing and it would be “at least a couple of years before first-in-man trials.” That is partly because animal models of diabetes take time to generate and this slows research down: “First we have to generate diabetes, and then cure it,” said Dr MacKenzie.
Dr MacKenzie explained that the technology’s main other application is in cancer where it could be used in exactly the opposite way - to activate an immune response and kill tumour cells. He also said that early on, MediGene had looked at using mTCRs as a drug delivery mechanism but it is not looking into it anymore because it “doesn’t think it has enough power”.
If, in the future, they decided to resurrect this research, Dr MacKenzie pointed to Wyeth’s Mylotarg (gemtuzumab ozogamicin) product as an example of how it might be achieved. Mylotarg is an anticancer drug composed of an antibody attached to a toxic antitumor antibiotic.
JDRF also supports other industry diabetes research, including studies at AGTC, Develogen, ESI, Genzyme, Novocell, Macrogenics and Tolerx. The last two are the most advanced research sponsored by the charity with both companies conducting Phase II trials of antibodies that target the CD3 T cell receptor called CD3. Both therapies aim to disarm T cells once they have become activated to attack islet cells.
“Targeted delivery of therapeutics is an attractive prospect,” said Dr Richard Insel, head of research at JDRF.
“This collaboration between MediGene and JDRF provides an exciting opportunity to validate the concept, and hopefully identify a lead compound for entry into the clinic.”
Talking about the JDRF support, Dr MacKenzie said: “It could hopefully lead to a much bigger grant - if we’re successful.”
Vision problems can occur during pregnancy, and women should talk to their doctor if they do notice any vision changes, say experts at Prevent Blindness America.
April is Women’s Eye Health and Safety Awareness Month, according to the volunteer eye health and safety organization.
Discomfort with contact lenses, refractive changes, dry eyes, puffy eyelids that obscure side vision and sensitivity to light due to migraines are among vision changes that may occur during pregnancy. Some vision changes, such as blurred vision and seeing spots, may indicate serious problems.
“Women who have any pre-existing conditions, like glaucoma, high blood pressure or diabetes, must let their eye doctor know that they are pregnant or planning to become pregnant, so the doctor can monitor closely for any changes in vision,” Daniel D. Garrett, senior vice president of Prevent Blindness America, said in a prepared statement.
Problems that pregnant women may experience include:
Refractive changes. During pregnancy, changes in hormone levels may affect the strength a women needs in her contact lenses or eyeglasses. This slight change is usually no cause for concern. Women should talk to their eye doctor about it.Dry eyes. This problem is usually temporary and goes away after delivery. Lubricating or rewetting eye drops are safe to use during pregnancy or while nursing.Migraines. These are caused by hormonal changes and are common among pregnant women. In some cases, migraine headaches can make eyes feel more sensitive to light. Talk to your doctor before you take any migraine headache medications.Diabetes. Pregnant women are at increased risk for developing diabetes. Blurred vision may be an indication of elevated blood sugar levels. All women who are pregnant or planning to get pregnant and have been diagnosed with diabetes should get a full, dilated eye exam.High blood pressure. Blurry vision and seeing spots may be a sign of high blood pressure during pregnancy. Very high blood pressure can cause retinal detachment.
SOURCE: Prevent Blindness America, news release, March 27, 2007
The reigning Mr. Universe was sprayed with Mace and wrestled to the ground by police officers, who mistakenly believed he was intoxicated when the diabetic bodybuilder actually was going through insulin shock.
Despite the misunderstanding, Doug Burns was arrested for misdemeanor assault and resisting arrest for the incident at a downtown movie theater Sunday night. Redwood City Police Capt. Chris Cessina said officers reported that Burns, 43, had assumed a fighting stance and it took four officers to bring him into submission.
“The fact is Mr. Burns assaulted our officer,” Cessina said. “If he had just stood there and let us help him, maybe they would have called the medics if he didn’t seem to fit the description of being under the influence.”
Burns, who was trying a new diabetes drug that night, said he was preparing to see a film when he felt dizziness and poor vision — a sign of low blood sugar — and hurried to a snack counter.