A new drug for people with a certain type of diabetes will treat the condition without some of the common side-effects of existing drugs, a pharmaceutical firm said today.
Merck Sharp & Dohme Ireland today launched its drug Januvia, which it said was the first new class of medicine for the treatment of type 2 diabetes in more than five years.
In this type of diabetes, the pancreas still produces some insulin, but not enough to meet the body’s needs, or the insulin that is produced is not working very well.
The hormone insulin is vital to help the liver process glucose and fats. Diabetes, if untreated or improperly treated, can cause serious problems such as kidney disease and blindness and may result in the sufferer having limbs amputated.
It tends to occur in older people. According to Merck, about 85 to 90 per cent of all those with diabetes have type 2. The remainder have type I, where the pancreas completely stops producing insulin.
The once-a-day prescription drug, known as a DPP-4 inhibitor, enhances the body’s own natural mechanisms to significantly lower blood sugar, the company claims.
“It also has a far lower incidence of the side effects commonly associated with some of the other existing therapies.”
“DPP-4 inhibitors are an important breakthrough and offer an innovative approach to treating type 2 diabetes, a disease that is rapidly increasing in prevalence in Ireland and across the world,” said Dr Graham Roberts, consultant endocrinologist, Waterford Regional Hospital.
“Almost two out of three adults being treated for type 2 diabetes are not reaching their target blood sugar levels, which can then lead to serious complications, such as heart disease, kidney problems and diabetes-related blindness.3 These complications can be completely avoided if the glucose is treated to correct target levels.”
Dr Roberts said Januvia is “a welcome new treatment option which effectively lowers blood sugar when it is too high, without unwanted side effects such as low blood sugar and weight gain”.
A survey by Ipsos MORI of 100 people with type 2 diabetes, published with Merck’s announcement today, said nearly one in four people (24 per cent) surveyed felt their disease was not properly controlled.
One in six (16 per cent) said they found it difficult to live with their medication’s side effects, with one in three (31 per cent) feeling their medication had made them gain weight when they were trying to lose it.
Just over a fifth (22 per cent) said that diabetes was taking over their life.
“In Ireland 200,000 adults have diabetes - enough to fill Croke Park more than twice over,” said Anna Clarke, diabetes nurse specialist with the Diabetes Federation of Ireland.
“Many people can reduce their risk of developing type 2 diabetes by maintaining a healthy lifestyle. For those who have developed it, they need to take a proactive role in managing their condition in order to prevent associated complications which can heavily impact on their quality of life.”
Using a simple portion control dinner plate can help people with type 2 diabetes lose weight and decrease reliance on medication, research shows.
Canadian researchers put people with type 2 diabetes on a calorie-controlled diet for six months.
They found 17% of those who used a calibrated diet plate lost more than 5% of their body weight, compared with just 4.5% who did not.
The study appears in the journal Archives of Internal Medicine.
In the majority of cases type 2 diabetes is linked to carrying excess weight - 80% of people are overweight at diagnosis, and doctors recognise that weight loss can greatly improve the condition.
However, many people with diabetes find it hard to stick to a weight loss regime.
The researchers tested the effect of using a calibrated dinner plate and breakfast bowl that helps people to eat healthy sized portions.
On average those who used the diet plates lost 1.75% of their body weight, compared with just 0.05% in the group who had to rely on will power alone.
As a result, they were also much more likely to be able to decrease their reliance on diabetes-controlling medication, including shots of insulin.
As good as drugs
Lead researcher Dr Sue Pederson said the results were comparable to those achieved by taking expensive weight loss drugs.
She said: “The weight loss results are all the more impressive considering that diabetics in general do not respond well to weight loss programmes.”
Dr Ian Campbell, medical director of the charity Weight Concern, said: “Losing weight is never easy and even harder for diabetics.
“To achieve these results over a six month period is excellent and with no more side effects than an occasional decrease in blood glucose, easily corrected by a reduction in medication, is very impressive indeed.”
Tracy Kelly, of the charity Diabetes UK, said eating a healthy balanced diet and taking regular physical activity were the best ways of controlling weight and effectively managing diabetes.
“Cutting down on portion sizes and eating balanced meals will help people control their weight, therefore some people may find this plate useful.
“However, controlling weight can be achieved effectively without spending extra money.
“A healthy balanced diet should be based on carbohydrates and be low in fat, sugar and salt with plenty of fruit and vegetables.”
Giving children with type 1 diabetes an infusion of blood saved from their own umbilical cords helped reduce the severity of their disease, U.S. researchers said on Monday.
They said the blood — which is rich in immune regulatory cells — may re-start the children’s immune systems, but the effect likely will not last and will need more study.
“They are getting back their own cells and nothing else. We knew it would be very safe and the fact that we are seeing any benefit is a big bonus,” said Dr. Michael Haller of the University of Florida College of Medicine, who presented the study at the American Diabetes Association meeting in Chicago.
Haller said the study is one of the first to look at the use of cord blood to treat diabetes in children, which affects an estimated 176,500, or about 0.2 percent, of U.S. children.
“There’s a lot of promise but it’s cautious optimism at this point,” he said.
Type 1 diabetes, usually diagnosed in children and young adults, occurs when the immune system goes haywire and starts attacking itself, destroying insulin-producing cells in the pancreas needed to control blood sugar.
Haller said so far his team had studied 11 diabetic children aged 2 to 10 who were treated with their own cord blood. They were followed for between three months and 31 months.
Children given the cord blood had lower blood glucose levels and needed much less daily insulin therapy to control their diabetes than children with the disease who did not get the therapy.
Haller said the cord blood may be helping the kids by providing a type of immune cell that can keep the immune system from attacking the pancreas, holding the diabetes in check.
While cord blood also contains stem cells, which can differentiate into insulin-producing cells, Dr. Desmond Schatz, also of the University of Florida, said the researchers suspect the effect is related to the regulatory T cells in the cord blood.
The children who got cord blood had measurable increases in this type of immune-regulating cell.
While the findings are promising, the doctors do not believe they have found a lasting cure.
“Whatever caused that immune process to begin with didn’t go away, so the diabetes should come back,” Schatz said at a news briefing.
“We expect this effect will be transient but we will be able to use it in other combinations of therapies,” he said.
All the children in the study had the benefit of having their own umbilical cord blood stored, which some parents do in case it is needed for later therapy. It can be used to treat leukemia and some genetic diseases.
Haller said storage costs between $1,200 to $2,500 up front and then between $75 and $250 per year and that he is not ready to recommend cord blood storage based on his study. “It’s clearly worth expanded study to figure out what is going on and why,? he said.
The American Academy of Pediatrics said this year that parents should only bank cord blood if they have an older child with a condition that could benefit.
June 20, 2007
NEW YORK (Reuters) - The widow and son of a Texas man who was taking a GlaxoSmithKline Plc diabetes drug at the time of his fatal heart attack has sued the drugmaker, claiming that it failed to warn of the drug’s heart risks, according to court papers.
The claim involves rosiglitazon?, which is sold under the brand names Avandia and Advandamet. Investors have been bracing for a flood of litigation against Glaxo after a widely publicized medical report last month suggested that Avandia increases the risk of heart attack and death.
The lawsuit was filed on Tuesday by relatives of Larry Alan Stanford in the U.S. District Court for the Eastern District of Texas. Stanford was taking Advandamet, which combines Avandia with another commonly prescribed diabetes medicine.
“Glaxo knew or should have known that its rosiglitazone drug greatly increased plaintiffs’ risks of having a heart attack and/or other negative cardiovascular consequences or of causing sudden cardiac death,” the lawsuit said.
The rate of premature death among American men with diabetes has dropped dramatically over the last few decades, but the same can’t be said for women with the disease, a study by the Centers for Disease Control and Prevention has found.
The proportion of early deaths among diabetic women remained unchanged between 1971 and 2000, say CDC researchers, whose findings were published online Monday in the Annals of Internal Medicine.
“Among men we found very encouraging trends,” said Edward Gregg, an epidemiologist at the CDC who led the study. “Among women, however, we found no improvement at all . . . So women with diabetes seem to be left behind in this improvement in health.”
Analyzing data for 20,000 people from across the United States, researchers found that annual death rates from all causes in men with diabetes fell to 24.4 per 1,000 from 42.6 per 1,000 - a 43 per cent reduction.
The death rate from cardiovascular disease (CVD), the most common cause of death in diabetics, fell for men to 12.8 per 1,000 from 26.4. These drops paralleled declining death rates among both men and women without diabetes in the U.S. population (down to 9.5 per 1,000 from 14.4) over the three-decade period.
Not only have mortality rates for women with diabetes not declined, but the difference in death rates for diabetic and non-diabetic women has actually widened over the three decades as females without diabetes started living longer.
Gregg said the gender disparity came as somewhat of a surprise to researchers, and they aren’t sure why it exists.
A number of reasons have been postulated, including the suggestion that overall, doctors are less aggressive in treating cardiovascular disease and its risk factors in women.
“The other possibility is that cardiovascular disease among women - and for that matter diabetes - may take a slightly different form biologically than it does in men and the treatments that we have don’t quite match that as well as they do in men,” Gregg said Monday from Atlanta.
The gender gap found in the U.S. diabetic population can’t necessarily be extrapolated to Canada, said Toronto endocrinologist Dr. Lorraine Lipscombe.
In a study she co-authored as a researcher at the Institute for Clinical Evaluative Sciences, published in March, Lipscombe said death due to the complications of diabetes in Ontario fell for both men and women between 1995 and 2005.
“In our study we did not find any difference between men and women and we found an overall decline of about 25 per cent,” said Lipscombe.
Because the Ontario research contained more recent data than the U.S. study, it might reflect more current medical practices, she said. “Maybe we are getting better at taking care of women with diabetes.”
Medical practice in Canada and the U.S. may also vary somewhat, reflecting public versus private health-care systems.
“There is a lot of evidence from the United States that men are more aggressively treated . . . We also know that doctors are more likely to think of cardiovascular disease in men,” she said.
“Evidence thus far from Ontario suggests that there isn’t that same gender disparity in Canada.”
A diagnosis of diabetes means losing an average of eight years from your expected life span, new research suggests.
In addition, diabetics are more likely to develop heart disease sooner than non-diabetics, the study found.
“Having diabetes at age 50 years and over does not only represent a significant increase in the risk of developing cardiovascular disease and mortality but also a very important loss in life expectancy and life expectancy free from cardiovascular disease,” said lead author Dr Oscar H. Franco, of the University Medical Centre Rotterdam, the Netherlands, and Unilever Corporate Research, Sharnbrook, England.Prevention is the key
Most people with diabetes - about 95 percent - suffer from the obesity-linked type 2 form of the blood sugar illness. That means that “prevention of diabetes is a fundamental task facing today’s society aiming to achieve populations living for longer and healthier,” Franco said.
His team published its findings in the June 11 issue of the Archives of Internal Medicine.
In the study, Franco’s group collected data on more than 5 200 American men and women who participated in the ongoing Framingham Heart Study. These people were followed until they developed heart disease or died. In addition, the researchers noted whether they had diabetes.
Double the heart risk
According to the study, diabetic women had more than twice the risk of developing heart disease than non-diabetic women. In addition, women with diabetes who already had heart disease were more than twice as likely to die compared with non-diabetic women.
Among men, the researchers found that those with diabetes also had twice the risk of developing heart disease and faced a 1.7 times higher risk of dying after developing heart trouble, compared with non-diabetic men.
For those 50 and older, diabetic men lived an average of 7.5 years less than men without diabetes, and diabetic women lived an average of 8.2 years less. Moreover, life expectancy without heart disease still fell by 7.8 years in men and 8.4 years in women with diabetes compared with non-diabetics, Franco’s group reported.
“Taking into consideration that treatment of diabetes and its complications accounts for at least 10 percent of health-care expenditure in many countries, effectively preventing diabetes will not only represent an increase in life expectancy and the number of years lived free from cardiovascular disease but may also represent important savings for health care, at least with respect to direct medical costs,” Franco said.
Need for better control
One expert believes the study reflects the dangers posed by diabetes and the need for more efforts to prevent and control the disease.
“It’s sobering to think about the number of years of life lost,” said Dr Larry Deeb, president for medicine and science at the American Diabetes Association. “We ought to be able to reduce the cardiovascular risk because we can manage diabetes better today, but we’re not.”
Deeb believes the new findings highlight the tragic results of not controlling the illness. “This is a powerful argument to people who have diabetes, that you have to control the diabetes,” he said. – (HealthDayNews)
HOUSEHOLD chores such as ironing and washing dirty dishes can lower the risk of diabetes by themselves, new Australian research suggests.
Scientists found that very light exercise that barely affects the heart rate is vigorous enough to help control blood glucose levels. This is the first study to prove that routine daily tasks could independently lower the risk of developing diabetes and other cardiovascular diseases associated with blood glucose.
But the researchers warn that more strenuous exercise is still vital for physical wellbeing.
“The message that 30 minutes of moderate to vigorous exercise a day is important for good health, still stands,” said Professor David Dunstan, a senior research fellow at the International Diabetes Institute in Melbourne.
”But this research suggests that there are also real benefits from reducing sedentary time and increasing the time spent on normal daily activities.”
Co-investigator Genevieve Healy, from the University of Queensland, suggested people adopt a more “active” approach to mundane tasks.
“Folding clothes or ironing as you watch TV, standing while on the phone or walking to see an office colleague rather than emailing them, are simple and easy ways to do this,” Ms Healy said.
1 cucumber, peeled and thinly sliced
2 small zucchini, thinly sliced
2 carrots, peeled and thinly sliced
4 large white mushrooms, chopped
4 green onions, chopped
1 clove garlic, chopped
4 (10-inch) fat-free flour tortillas
1/2 C fat-free cream cheese
In a small bowl, combine all vegetables. Thinly spread 1 tbsp cream cheese on each tortilla. Place some of the chopped vegetable mixture evenly across center of tortilla. Roll up tortilla, trapping ingredients tightly inside tortilla. When finished rolling, slice each tube into 1-inch wide sections to serve. Can serve with salsa. Makes 4 servings.
Nutritional Information (1 serving):
Calories: 302
Carbohydrate: 60 grams
Protein: 11 grams
Fat: 4 grams
Scientists at Swansea University’s School of Medicine have been awarded more than £93,000 by the BUPA Foundation to investigate why weight-reducing surgery can lead to the almost immediate disappearance of diabetes in patients.
95% of morbidly obese people - those with a Body Mass Index of over 40 - have Type 2 diabetes, sometimes known as maturity-onset diabetes.
However, nearly 80% of patients who undergo gastric bypass surgery to reduce the size of their stomachs and small intestines find that their diabetes disappears within two to three days - before any weight loss has occurred.
Senior Clinical Lecturer Dr Jeffrey Stephens is leading the research at the School of Medicine’s Diabetes Research Group. He said: “Although patients with Type 2 diabetes do not always require insulin treatment, the average diabetic needs about 30 units of insulin a day to control blood sugar levels.
“For obese patients, this can rise to 200 units a day. To go from such a high level of insulin-dependency to not needing insulin in a matter of a few days is a dramatic result, and we need to understand the reasons why this happens.”
The research team, which includes Professor Steve Bain and Professor Rhys Williams from Swansea University’s School of Medicine, and Professor John Baxter, a bariatric surgeon with Swansea NHS Trust, are focusing attention on a protein known as Glucagon Like Peptide 1 (GLP-1), which is produced in the small intestine.
Dr Stephens said: “Overweight people who have Type 2 diabetes tend to have lower levels of GLP1 and we are investigating whether these levels return to normal after bariatric surgery. Basically, we want to know whether reducing the size of the small intestine and stomach restores production of GLP1, and why this should be the case.”
High blood sugar seen with poorly controlled diabetes may cause lethargy, excessive thirst and susceptibility to infection, and contributes to diabetic complications including premature heart disease, stroke, blindness, and gangrene.
“Bariatric surgery is not just effective in terms of controlling obesity. It clearly has other major health implications, with the potential to impact positively on Type 2 diabetes and other associated conditions. There is also the potential for the NHS to generate substantial savings in long term treatment costs,” added Dr Stephens.
“Not only will this research improve our understanding of why overweight people develop Type 2 diabetes, it may also lead to an effective, non-surgical treatment for those with the condition. We are immensely grateful to the BUPA Foundation for giving us this opportunity.”
Diabetes is recognised as one of the leading causes of mortality and morbidity in the world. It is a chronic disease with a substantial elevation in the circulating blood sugar.
The major mode of control of diabetes is usually by diet, exercise and insulin replacement therapy and by the use of herbal agents able to lower blood sugar level (hypoglycemic agents). Diet therapy along with insulin or oral hypoglycemic agent forms an important way of treatment in diabetes though it has several demerits.
The major drawbacks of insulin therapy are the side effects, which includes insulin allergy and insulin antibodies and other later complications with kidneys, eyes, feet , blood and blood vessels’ complications. Similarly, anti-diabetes drugs for diabetes have many side effects such as nausea and vomiting, jaundice, anemia, and skin.
Plants have been used for the major source of treatment of diabetes mellitus from ancient time in the Indian medicine and in the world.
The latest that was tried out involve the use of extract of Musa paradisiaca root (plantain) and Coccinia indica (climbing ivy gourd) leaves in separate and in composite manner to correct diabetes. This was reported in the latest issue of Afr. J. Traditional, Complementary and Alternative Medicines.
M. paradisiaca is a tree like herb with thick stem composed of convoluted leaf sheaths. The plant’s root is use for de-worming purposes, the flowers are astringent, while the fruits are mild laxatives.
It aids in combating diarrhoea and dysentery and promotes healing of intestinal lesions in ulcerative colitis, a bowel disease. It is useful in celiac disease, constipation and peptic ulcer. Unripe fruit and cooked flower are useful in diabetes.
Coccinia indica is a climbing perennial herb of Cucurbitaceae family and it is distributed widely all over India. The root and leaves of this plant have antilipidemic effects as well as antioxidative effects.
The research lead by Debidas Ghosh from the Bio-Medical Laboratory Science and Management Vidyasagar University, West Bengal, India highlighted the antidiabetic efficacy of aqueous-methanol extract of M. paradisiaca and C. indica. The study whicwh is the first to try the extracts of these two plants in the management of type-I diabetes mellitus, found that either in the separate or combined forms, it resulted in reduction in blood sugar levelin the rats used for the experiment.
From the comparative analysis, it was revealed that the extract of the studied plants when used in composite manner on streptozotocin-induced diabetic state had a more potent blood sugar lowering effect in comparison to using the individual extract of the plants.
The researchers concluded that this composite extract contains the active sugar – lowering agent (s) that can be used to overcome diabetic complication by pancreatic ß cell regeneration or stimulation of insulin secretion.
In another development, researchers said they have discovered that an ingredient found in some plants fights diabetes in mice without some of the side effects attributed to other anti-diabetes drugs.
The chemical they pinpointed, known as harmine, was first isolated more than 150 years ago from plants traditionally included in ritual and medicinal preparations around the world.
The work suggests a new approach for treating insulin resistance that might complement the use of pre-existing drugs and, more generally, provides validation for fat cell screens as a promising strategy for identifying new metabolic drugs, according to the researchers.
“The current explanation for this paradoxical mode of action is the idea that the body needs a place to store lipids,” said Peter Tontonoz, a Howard Hughes Medical Institute investigator at the University of California, Los Angeles.
Despite the efficacy, the development and clinical use of some other drugs is limited by adverse effects such as fluid retention, weight gain, congestive heart failure, liver toxicity, and potential cancer risks and therefore,the need for alternative approaches to treating insulin resistance.
Further study of harmine’s effects in diabetic mice found that the chemical increases insulin sensitivity in a manner similar to, the predominant antidiabetes drugs said the study. This was published in the May issue of the journal, Cell Metabolism, published by Cell Press. Source