Preliminary research has suggested that use of the anti-malarial drug hydroxychloroquine may help reduce the risk of patients with rheumatoid arthritis developing diabetes.
Type 2 diabetes mellitus affects nearly 8 percent of US adults, and its prevalence has been increasing.
Antimalarials such as hydroxychloroquine, a long-standing safe and inexpensive treatment for an autoimmune disease such as rheumatoid arthritis, theoretically may improve glucose tolerance and prevent diabetes mellitus, according to background information in the article. In vitro and animal studies indicate that antimalarials improve insulin secretion and peripheral insulin sensitivity.
Mary Chester M. Wasko, M.D., M.Sc., of the University of Pittsburgh, Pa., and colleagues examined the association between hydroxychloroquine therapy and risk of diabetes in patients with rheumatoid arthritis.
During the observation period, incident diagnoses of diabetes were reported by 54 patients who had taken hydroxychloroquine and by 171 patients who had never taken it. Analysis indicated that patients who had taken hydroxychloroquine had a 38 percent lower risk of developing diabetes, compared with those who had not taken hydroxychloroquine. This risk was further reduced with increased duration of hydroxychloroquine use. Patients who took hydroxychloroquine for more than four years had a 77 percent lower risk of diabetes compared with those who had never taken hydroxychloroquine.
“We report herein the first evidence, to our knowledge, suggesting that use of hydroxychloroquine is associated with a reduced risk of developing diabetes in patients with rheumatoid arthritis. Moreover, risk reduction increased with duration of hydroxychloroquine exposure, supporting a biological action of this drug on glucose metabolism,” the authors wrote.
The researchers also said that ‘anti-malarial drugs may have a role in treating rheumatoid arthritis not only to suppress synovitis [inflammation around the joints] but also to reduce the likelihood of developing glucose intolerance and dyslipidemia [abnormal concentrations of lipids’.
“While our study showed a reduction in diabetes incidence specifically in a rheumatoid arthritis cohort taking hydroxychloroquine, these findings also may be expected to occur in patients without rheumatoid arthritis. The beneficial changes in glucose metabolism and insulin sensitivity reported among patients with lupus, patients with type 2 diabetes, and in animal models suggest that these effects are not specific to rheumatoid arthritis.”
“Anti-malarial drugs may have a role in treating rheumatoid arthritis not only to suppress synovitis [inflammation around the joints] but also to reduce the likelihood of developing glucose intolerance and dyslipidemia [abnormal concentrations of lipids]. As quality of life and life expectancy improve for patients with rheumatoid arthritis, and health care costs escalate, the use of inexpensive, safe therapies that have multiple beneficial effects is attractive. Further prospective studies are needed to determine whether this treatment option should be considered a standard component of rheumatoid arthritis combination therapy in the future, and to evaluate the potential role of hydroxychloroquine as a preventive agent for diabetes among high-risk individuals in the general population,” the researchers concluded.
Women with gestational diabetes, a form of the disease that occurs during pregnancy and usually disappears afterward, risk having babies who are born oversized, with excess insulin, low blood sugar and possibly breathing problems.
But the risks to their babies may start to rise earlier than previously realized, even when the mother’s blood sugar levels are within what is now considered the normal range for pregnancy, says research presented at a meeting of the American Diabetes Association in Chicago.
In a study of 23,325 women, scientists at Northwestern University found that as a mother’s blood sugar rises, the risks of having a large baby, a cesarean delivery or low blood sugar in the newborn all increased. Researchers could not say at what point increased blood sugar should trigger medical treatment, but they say the level at which gestational diabetes is diagnosed likely will be lowered based on these findings.
Other topics discussed at the meeting, ending Tuesday:
•Diabetes management. Many diabetics can’t get blood sugar levels to a safe range even with drugs, but some doctors fear that more aggressive treatment could cause extreme drops in sugar levels that can lead to coma. But a new study followed 8,641 patients at a hospital and found no association between intensification of treatment and hypoglycemia. It concludes that there is no reason to temper efforts to improve sugar control.
•Diabetic complications. A new study found hearing loss is more common among people with diabetes, although the reasons are not clear. Another report says cases of diabetic retinopathy, a leading cause of blindness, could triple from 5.8 million in 2005 to 17.7 million in 2050.
•Drugs. Studies involving drugs that act on gut hormones to improve the balance between insulin and blood sugars offer new information on their safety and versatility. These new drugs act when blood sugars are too high and turn off when levels get back to normal, reducing the risk of low sugar levels. Merck presented studies showing that Januvia, licensed in October, is safe when used as long as two years and as a first-line treatment in combination with metformin. Novo Nordisk studies showed that its experimental drug, liraglutide, safely reduces blood sugar levels with the added benefit of weight loss and requires no dosing changes in patients who have kidney or liver problems. The company plans to submit a license application early next year to federal regulators.
Pumpkin could “drastically” reduce the need for daily insulin injections for diabetics, according to recent research.
Scientists found a compound in pumpkin that has been found to promote the regeneration of damaged insulin-producing beta cells in diabetic rats, thereby improving the level of insulin in their blood.
Laboratory data showed that diabetic rats that had been fed pumpkin extract had only 5 percent less plasma insulin and 8 percent fewer insulin-positive cells than normal healthy rats, according to a research paper published this week in the US-based Journal of the Science of Food and Agriculture.
The researchers fed 12 diabetic rats and 12 normal rats either a normal diet or a diet supplemented with pumpkin extract for 30 days.
On average, the rats receiving the pumpkin supplements experienced a 36 percent increase in plasma insulin compared to the untreated rats, according to Xia Tao, the paper’s lead author and a teacher at Shanghai’s East China Normal University.
However, Xia, a professor at the College of Life Science, emphasized that further research was needed to evaluate the effects in human beings.
”But I tend to believe pumpkin extract could also promote regeneration of pancreatic beta cells in humans,” he told the newspaper. “It is certain pumpkin can benefit diabetics by lowering blood sugar levels.”
The professor added that the results were in line with the traditional Chinese idea that “pumpkin is a good food for diabetics”.
”However, no scientific proof was ever provided,” he said.
Last year, Xia and his colleagues published a paper in the England-based Journal of Pharmacy and Pharmacology about D-chiro-inositol, a molecule that mediat?s insulin activity, in pumpkin. The newest research has further strengthened his belief in the potential benefits of a pumpkin-rich diet.
Though they only experimented on rats with Type I diabetes, the researchers believe pumpkin extract will also help treat Type II because “it can allow regeneration of beta cells, which is also important in type II recovery,” Xia said.
David Bender, sub-dean at the Royal Free and University College Medical School in London, told the US-based science magazine Chemistry & Industry that the research is “very exciting” in that “pumpkin may be a source of medicine to take by mouth.”
Xia said he and his research group had also discovered the health benefits of several other plants and would soon release their findings.
Diabetes is a disorder in which the body has trouble regulating blood glucose levels. The disease affects more than 230 million people, almost 6 percent of the world’s adult population, according to the World Diabetes Foundation.
(Source: China Daily)
A new research has found that combination of calcium and vitamin D may offer protection against type 2 diabetes.
The research, conducted at Tufts University, suggests that drinking more milk, a leading source of calcium and vitamin D in the diet, could help lessen the risk of type 2 diabetes by nearly 15 percent.
In the detailed analysis of previously published studies, the researchers found that persistently low levels of vitamin D were linked to as high as 46 percent greater risk of type 2 diabetes. However, increasing vitamin D only would likely have little effect in healthy adults. As an alternative, the researchers suggested that a combination of vitamin D and calcium, like that found in milk, would have the greatest potential to help prevent diabetes, especially among those at highest risk for the disease.
Examining the intake of milk and milk products exclusively, the researchers found that there was nearly a 15 percent lower risk for type 2 diabetes among individuals with the highest dairy intake (3-5 servings per day) compared to those getting less than 1 1/2 servings each day.
The Tufts researchers suggest that calcium and vitamin D may affect the body’s ability to generate or utilize insulin, the hormone the body makes to process sugar that is impaired in those with diabetes and pre-diabetes.
Beside calcium and vitamin D, milk is the primary beverage source of magnesium, which a second meta-analysis found may also decrease the risk of type 2 diabetes (2). The analysis concludes that for every 100 milligram increase in magnesium up to the recommended dietary intake, the risk of developing type 2 diabetes decreased by 15 percent.
Type 2 diabetes and insulin resistance syndrome (or pre-diabetes) influence an astounding 75 million Americans and death rates from diabetes have increased nearly 45 percent over the past 20 years, uplifting the significance of finding new ways to treat and prevent this lethal disease.
The new meta-analysis and review is published in the Journal of Clinical Endocrinology and Metabolism (1).
Source: Dailyindia.com