We all know bitter melon as a vegetable but it is also known as a traditional Chinese medicine. Scientists recently discovered that the therapeutic properties in bitter melon can be a powerful treatment for type 2 diabetes.
Researchers pulped about a ton of fresh bitter melon and extracted four very promising bioactive components. All of these four compounds appear to activate the enzyme AMPK, a protein that is well known for regulating the fuel metabolism and enabling glucose uptake.
Type 2 diabetics have impaired ability to convert the sugar in their blood into energy in their muscles. This is partly due to not producing enough insulin, and partly because of their fat and muscle cells not using insulin effectively, a condition known as ‘insulin resistance’.
Exercise can activate AMPK in muscle, which then mediates the movement of glucose transporters to the cell surface, a very important step in the uptake of glucose from the circulation into tissues in the body. This is the single biggest reason for which exercise is recommended as part of the normal treatment program for someone with Type 2 diabetes. Four compounds extracted from bitter melon perform a very similar action to that of exercise, in that they activate AMPK.
There are diabetes drugs on the market that can activate AMPK but can have side effects. The advantage of this traditional Chinese medicine bitter melon is that there are no known side effects. Practitioners of Chinese herbal medicine have used it for hundreds of years to good effect.
US researchers said that deep, restful sleep is very important for keeping type 2 diabetes away,
Research said that slim, healthy young adults who were deprived of the deepest stage of sleep known as slow-wave sleep developed insulin resistance — a trait linked to type 2 diabetes — after just three nights. The research demonstrates that the importance of deep sleep not only for the brain, but for the rest of the body
The effect was comparable to gaining 20 to 30 pounds.
“It turns out deep sleep also has implications for glucose metabolism and diabetes risk,” said Van Cauter, whose study appears in the Proceedings of the National Academy of Sciences.
After three nights of disturbed sleep, eight of the nine volunteers had become less sensitive to insulin, without increasing the production of insulin.
Since insulin tells the body it has consumed energy, this deficiency can lead to weight gain and diabetes.
Reduced sleep often results from obesity and age. While most young adults spend 80 to 100 minutes per night in slow-wave sleep, this decreases to just 20 minutes for adults over 60.
“Any condition that involves a decrease in deep sleep is linked to an increase in diabetes risk. That is the case for aging and sleep apnea. This study really demonstrates a causal link,” Van Cauter said.
Myocardial infarction more than doubles the risk of new-onset diabetes and leads to a 15-fold increased risk of impaired fasting glucose, according to a study of more than 8,000 MI patients.
During a mean follow-up of 3.2 years post-MI, 3.7% of patients developed diabetes, compared with 0.8% to 1.6% for historical cohort populations with no history of MI, Dariush Mozaffarian, M.D., of Harvard, and colleagues, reported in the Aug. 25 issue of The Lancet.
Additionally, they found, 27.5% of patients developed impaired fasting glucose compared with 1.8% of historical cohorts.
“Our results indicate that myocardial infarction could be a prediabetes risk equivalent,” the authors wrote. “Smoking cessation, prevention of weight gain, and consumption of typical Mediterranean foods might lower this risk, which emphasizes the need for guidance on diet and other lifestyle factors for patients who have had a myocardial infarction.”
Although diabetes confers a well documented risk of coronary disease and MI, less is known about the impact of MI on subsequent diabetes risk. Dr. Mozaffarian and colleagues retrospectively examined the issue in 8,291 patients who had had an MI within the previous three months and were free of diabetes before the infarction. The patients were participants in the Italian GISSI Prevention trial.
New-onset diabetes was defined as use of diabetes medication or a fasting glucose of 7 mmol/L or greater. Impaired fasting glucose was defined as a blood glucose level of 6.1 mmol/L or greater but less than 7, but it was also calculated on the basis of a lower blood glucose threshold of 5.6 mmol/L.
During follow up, 998 patients (12%) developed diabetes, and 2,514 (33%) developed diabetes or impaired fasting glucose, increasing to 62% using the lower cutoff threshold.
In contrast, contemporary population-based cohort studies of middle-aged white adults have shown diabetes rates of 0.8% to 1.6%, the authors stated. The incidence of new-onset impaired fasting glucose has been 1.8%, using a blood glucose range of 5.6 to 7.0 mmol/L.
New-onset diabetes and impaired fasting glucose increased the mortality risk in MI patients. As compared with patients who had a fasting glucose of less than 5.6 mmol/L, those with a glucose level of 5.6 to 6.05 mmol/L had a 10% greater mortality during follow-up.
A glucose level of 6.1 to 7 mmol/L increased the mortality risk by 15%, and development of frank diabetes raised the mortality risk by 44% (P<0.05 for trend).
In a multivariate analysis, independent predictors of diabetes and impaired fasting glucose were:
Independent predictors o? diabetes but not IGF were inability to exercise (HR 2.43), use of diuretics (HR 1.15), and wine consumption exceeding 1 L per day (HR 1.45).
Further adjustment for baseline clinical variables revealed additional predictors of diabetes risk after MI: BMI gain during follow-up (HR 1.17), higher triglycerides (HR 1.61), lower HDL (HR 1.46), higher leukocyte count (HR 1.23), and higher consumption of butter and other oils (HR 1.26).
“These findings indicate that, just as diabetes can be considered a coronary heart disease risk-equivalent, acute myocardial infarction should potentially be considered a prediabetes risk-equivalent,” the authors said.
Lifestyle modification could play a major role in reducing diabetes risk after MI, they continued. Obesity (as reflected by BMI), smoking, and lack of physical activity are major, modifiable contributors to diabetes risk.
In a commentary on the study, Lionel H. Opie, M.D., of the University of Cape Town, South Africa, said the findings “further tie the knot between myocardial infarction and hyperglycemia-each causes the other.”
Offering a possible explanation for the link between MI and diabetes, he noted that blood glucose values of less than 5.6 mmol/L have prognostic value for diabetes.
“A reasonable hypothesis would be that the previous acute myocardial infarction was associated with an undetected modest, but definite tendency towards prediabetes at the time of the attack,” said Dr. Opie.
Source: The Lancet
Source reference:
Mozaffarian D et al. “Incidence of new-onset diabetes and impaired fasting glucose in patients with recent myocardial infarction and the effects of clinical and lifestyle risk factors. Lancet 2007; 370: 667-675.
Diabetes case management that takes a patient’s specific culture into consideration can help increase life expectancy and decrease the incidence of diabetes-related complications over the patient’s lifetime, a new study finds.
“Better management results in reduced long-term complications, such as blindness, stroke, amputation and nerve damage,” said lead researcher Todd Gilmer, Ph.D.
The research focused on 3,893 people with diabetes who participated in San Diego’s Project Dulce, which set out to meet American Diabetes Association standards of care. The target population was primarily low-income, underinsured Latino people.
Study participants showed “clinically significant improvements in A1c, blood pressure, low-density lipoprotein and triglycerides,” said Gilmer, an associate professor in the department of family and preventive medicine at the University of California, San Diego.
Hemoglobin A1c — a measure of how well patients control their blood glucose — low-density lipoprotein (“bad cholesterol”) and blood pressure are commonly managed risk factors among diabetes patients.
The study appears in the latest online issue of Health Services Research.
The clinical team included a registered nurse/certified diabetes educator and a medical assistant and a registered dietitian who were bilingual and bicultural. Patients underwent an initial 50-minute visit with a nurse and were asked to return for additional visits. They also had a 25-minute visit with the dietitian and were called by team members for appointment reminders.
Patients also participated in a group self-management training program consisting of an eight-week curriculum delivered by trained peer educators who had diabetes themselves and were of the same cultural or ethnic group as the participants.
The researchers used the resulting clinical and cost data in what Gilbert describes as “a model that simulates long-term effects of implementing health policies for the management of diabetes.” The model estimates the number of years of life patients gain from treatment — adjusted for quality of life — for the amount spent to deliver the treatment.
Direct medical costs over a patient’s lifetime were higher for patients who received case-management and self-management training help. Nevertheless, a further breakdown showed that about one-third of the additional costs of implementing the intervention were offset by reduced expenses of diabetes-related complications over patients’ lifetimes.
“If these individuals live longer without these complications … it gives them a higher quality of life,” Gilmer said. “It is worth it.”
“Strategies such as [those used in the study] should help our awareness of the needs to reach overall goals and prevent long-term complications related to diabetes,” said Julienne Kirk, Pharm.D., an associate professor in the department of family and community medicine at Wake Forest University.
The results of the study should encourage health systems to consider setting up similar case-management and self-management training programs for their high-risk populations, Gilmer said.
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FOR MORE INFORMATION:
Health Behavior News Service: Lisa Esposito at (202) 387-2829 or hbns-editor@cfah.org.
Health Services Research is the official journal of AcademyHealth and is published by Blackwell Publishing on behalf of the Health Research and Educational Trust. Contact Jennifer Shaw, HSR Business Manager, at (312) 422-2646 or jshaw@aha.org. HSR is available online at www.blackwell-synergy.com/loi/hesr.
Gilmer TP, et al. Cost-effectiveness of diabetes case management for low-income populations. Health Services Research online, 2007.
FOR MORE INFORMATION:
Health Behavior News Service: (202) 387-2829 or www.hbns.org. Center for the Advancement of Health
Health Behavior News Service
Contact: Lisa Esposito, Editor
202.387.2829
hbns-editor@cfah.org
Half of the US population has a gene variant that impairs glucose tolerance, putting them at risk of diabetes.
Diabetes is an increasing problem, so there is great interest in predisposing factors. Although we know that lack of exercise and an unhealthy diet can contribute to diabetes, genetic factors may also be involved. A team at Saint Louis University has now discovered a gene variant that may increase the risk of diabetes.
They studied a variant of a gene called FABP2 which is involved in the absorption of fat from food. In the study, participants consumed a very rich milkshake and the researchers studied how their bodies processed its fat content. Those with the variant burned more fat, which may have hindered their ability to remove sugar from the bloodstream. This kind of inefficiency in removing sugar can raise the risk of diabetes. The researchers say that half of the US population probably has the FABP2 gene variant. But it does not, in itself, cause diabetes and other genes will also be involved. The study is another step forward in understanding how genes and lifestyle factors contribute to the development of diabetes.
Source
American Journal of Clinical Nutrition January 2007
As medicine struggles to halt the nation’s diabetes epidemic, scientists have found a potential new weapon in the most unlikely place — the skeleton.
Bone cells, they discovered, generate a hormone that helps regulate the body’s metabolism. And the lack of that hormone appears to contribute to the development of diabetes.
The work, conducted in mice, has a long way to go before it could be used to help diabetics. But a previous study showed that the substance, called osteocalcin, is found in lower quantities in people with untreated type 2 diabetes, scientists said.
“One could hope and certainly we will test if it could be a treatment for type 2 diabetes,” said Dr. Gerard Karsenty, senior author of the paper in Cell magazine and chairman of the department of genetics and development at Columbia University Medical Center. “What makes osteocalcin attractive is that we all have?it in our bodies and we tolerate it very well.”
The study, which is the first to provide evidence for a skeletal hormone, is generating excitement among diabetes researchers. But they cautioned that it is only one of a number of substances that appear to interact to control blood sugar in the body, and scientists must learn much more before osteocalcin could be considered a medicine.
“It has opened up a new area” of research, said Dr. C. Ronald Kahn, head of obesity research at the Joslin Diabetes Center, who was not involved in the work. “But it’s so unexpected, it’s going to take a number of studies to figure out if this applies to humans.”
In type 2 diabetes, sugar can rise to dangerous levels in the blood because the body loses sensitivity to insulin and may eventually not produce enough insulin. The body needs insulin to move digested food into cells to fuel activities. About 20 million Americans have this type of diabetes, which can lead to serious complications or death if not properly treated.
Scientists have known for years that osteocalcin is produced by osteoblasts, cells that help build bone. But the Columbia researchers are the first to show that it is also an endocrine hormone — a substance that acts through the bloodstream to affect metabolism.
In their experiments, they inactivated mouse genes that produce osteocalcin. The osteocalcin-deficient mice grew abnormally fat and developed symptoms of diabetes, even when eating a normal diet. When the researchers gave the mice osteocalcin, the rodents’ blood sugar normalized. Presence of the hormone also prevented mice from gaining weight when they overate.
Karsenty said the hormone appears to work in multiple ways to counter diabetes: it increases the body’s production of the pancreatic cells that make insulin, it directly increases the secretion of insulin, it enhances the body’s sensitivity to insulin, and it reduces storage of fat. No drug on the market carries that kind of punch.
Kahn called that multiple effect “particularly striking” and one of the goals for any new treatment. But another specialist, Dr. Michael A. Lazar, director of the Institute for Diabetes, Obesity, and Metabolism at the University of Pennsylvania, said two of those effects seem contradictory and raise questions that need to be explained.
Typically, he said, if the body becomes more sensitive to insulin, other mechanisms would kick in to shut off insulin production and vice versa. That makes it important to understand how osteocalcin interacts with other hormones as a next step, he said.
The diabetes specialists said that mice have proved to be a useful model for learning about human metabolism because of many similarities in genes, hormones, and functions. In this case, one of the genes that affects osteocalcin function in mice is not active in humans, but Karsenty said he believes there are other genes that serve the same purpose.
Karsenty, however, acknowledged “the possibility that osteocalcin function has been lost in evolution” and is not present in people.
The next steps, he said, are to study its effect in monkeys and then in humans over the next few years.
Karsenty’s group discovered the new bone-based hormone because they were looking for the symmetry that often exists in the body. They knew that most hormones are part of a feedback loop and that a fat cell hormone called leptin helps controls bone mass. So they searched for a corresponding bone hormone that controls fat, and found osteocalcin.
“As proof of the concept that the skeleton makes molecules that act as hormones, this is the first of its kind, convincing and interesting,” said Lazar. “It adds another candidate to the list . . . that could help us combat diabetes. But it’s premature to be giving osteocalcin injections at this time.”
Source: Boston Globe
Diabetes can be a killer, causing heart and vascular problems – and now scientists think they know why. Diabetics are likely to be deficient in thiamine (vitamin B1), and it is this that makes diabetes – both types I and II – such a serious condition.
Researchers from Warwick University have found that diabetics have a 75 per cent deficiency of thiamine in their blood plasma, a lack that has been missed by the standard blood test.
It’s not that diabetics are taking any less B1 in their diet than healthy individuals, it’s more to do with the fact that their diabetes is rapidly moving the thiamine from the blood and into the urine.
Low thiamine levels can cause problems in endothelial cells, which line the body’s entire circulatory system, and which can lead to an increased risk of atherosclerosis, or chronic inflammation of the artery walls.
Source: Diabetologia, 2007
Men, eat your whole grains. Especially if you’re middle-aged or older, and you want to decrease your risk of getting Type II diabetes.
Increasing your intake of whole grains will help, says a study in the issue of the American Journal of Clinical Nutrition.
Eating whole grains might even help compensate for other risks. Obesity increases the risk of Type II diabetes, but men in the study who were obese but physically active and who also had a high intake of whole grains had a 52 percent lower risk of diabetes than did inactive obese men who did not eat many whole grains.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, 17 million Americans have diabetes, and 5.9 million are as yet undiagnosed. Most have Type II diabetes, in which the body does not produce enough insulin or the body’s cells ignore the insulin.
Researchers speculate the high fiber content of the bran fraction of whole grains slows down gastric emptying, and thus slows down the release of glucose into the bloodstream. That, in turn, reduces the insulin response after meals and the risk of developing diabetes.
Whole grain foods also have more magnesium than refined grain foods, and that has been shown to improve the response of insulin, too.
“The insulin level in the blood tends to be more stable,” Fung says, “and it doesn’t peak as high, and that might have something to do with reducing the risk.”
As good as whole grains are, most Americans don’t eat nearly enough. Recommendations from the Dietary Guidelines for Americans 2000 suggest that several of the recommended six to 11 servings of grain per day be whole grains.
“About half of all grains [eaten] should be whole grains,” Fung says. Depending on a person’s size and caloric needs, that means at least three servings a day of whole grains, she says.
The new study provides reinforcement for what nutrition and diabetes experts have known for some time, says a certified diabetes educator at the Joslin Diabetes Center in Boston.
“This is something we’ve known all along is a good thing,” says Karen Chalmers, director of nutrition at the center.
In addition to cutting your diabetes risk, whole grains fill you up and may make it easier to lose weight. “We stress fiber as a way to lose weight,” she says.
To boost whole grain intake, Fung suggests reading labels on food products and looking for ingredients such as “whole wheat,” or buying food products such as oatmeal, brown rice or whole grain pastas.
Source: paktribune.com
Pampered fat cats are three times more likely to develop the potentially fatal condition than cats of a normal weight, according to a study by the University of Edinburgh.
“The lifestyle of cats, just like their owners, is changing,” said Professor Danielle Gunn-Moore, from the Royal (Dick) School of Veterinary Studies.
“They are tending to eat too much, gain weight and take less exercise.”
Many cats are housebound because they live in flats or because their owners think it is too dangerous to let them out, she added.
“They have little to do all day but eat, sleep and gain weight,” she said. “Unfortunately, just like people, cats will overeat if they are offered too much tasty food, particularly if they are bored.”
One in 230 pet cats in Britain is diabetic, with male, neutered or overweight animals at greatest risk, the researchers said.
The number of diabetic cats in Britain is now nearly five times higher than the figure recorded in a similar U.S. study in the 1970s, the research found.
The study, published in the Journal of Feline Medicine and Surgery, was based on an analysis of more than 14,000 cats and 760 questionnaires completed by owners.
Source: Reuters
Barbara Clark was diagnosed with type 2 diabetes nearly ten years ago. She remembers her initial symptoms well:
“I was tired. I was cranky. I was hungry and then not so hungry. I was thirsty all the time,” she said.
It took a while, but eventually she got her blood sugar–and her life–back in balance.
“I lost weight. I was able to regulate my diet much better. I wasn’t swinging from one food to another. I was able to do all the things I wasn’t able to do, I even was able to work better,” she said.
The problem is some people simply don’t respond traditional treatments.
Dr. Greg Gottschlich is part of a team conducting a research trial of a new medication which would work in a very different way than any of those currently on the market.
It has to do with enzymes, and hormones related to Type II diabetes, which means in the long run it might not help just balance blood sugar levels, but also help control complications.
“It’s exciting new class of medications to restore blood sugar levels by helping the body to better regulate hormone levels and blood sugar levels,” he said.
Patients take the pills daily for 20 weeks.
The drug is in its final phases of testing. Results of this trial are expected some time next year.
Source: 13wham.com