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Obesity-Linked Diabetes in Children Resists Treatment

Obesity and the form of diabetes linked to it are taking an even worse toll on America’s youths than medical experts had realized. As obesity rates in children have climbed, so has the incidence of Type 2 diabetes, and a new study adds another worry: the disease progresses more rapidly in children than in adults and is harder to treat.
“It’s frightening how severe this metabolic disease is in children,” said Dr. David M. Nathan, an author of the study and director of the diabetes center at Massachusetts General Hospital. “It’s really got a hold on them, and it’s hard to turn around.”
Before the 1990s, this form of diabetes was hardly ever seen in children. It is still uncommon, but experts say any increase in such a serious disease is troubling. There were about 3,600 new cases a year from 2002 to 2005, the latest years for which data is available.
The research is the first large study of Type 2 diabetes in children, “because this didn’t used to exist,” said Dr. Robin Goland, a member of the research team and co-director of the Naomi Berrie Diabetes Center at Columbia University Medical Center in New York. She added, “These are people who are struggling with something that shouldn’t happen in kids who are this young.”
Why the disease is so hard to control in children and teenagers is not known. The researchers said that rapid growth and the intense hormonal changes at puberty might play a part.
The study followed 699 children ages 10 to 17 at medical centers around the country for about four years. It found that the usual oral medicine for Type 2 diabetes stopped working in about half of the patients within a few years, and they had to add daily shots of insulin to control their blood sugar. Researchers said they were shocked by how poorly the oral drugs performed because they work much better in adults.
The results of the study and an editorial were published online on Sunday by The New England Journal of Medicine.
The findings could signal trouble ahead because poorly controlled diabetes significantly increases the risk of heart disease, eye problems, nerve damage, amputations and kidney failure. The longer a person has the disease, the greater the risk. So in theory, people who develop diabetes as children may suffer its complications much earlier in life than previous generations who became diabetic as adults.
“I fear that these children are going to become sick earlier in their lives than we’ve ever seen before,” Dr. Nathan said.
But aggressive treatment can lower the risks.
“You really have to be on top of these kids and individualize therapy for each person,” said Dr. Barbara Linder, a senior adviser for childhood diabetes research at the National Institute of Diabetes and Digestive and Kidney Diseases, which sponsored the new study.
Sara Chernov, 21, a college senior from Great Neck, N.Y., learned that she had Type 2 diabetes when she was 16. Her grandfather had had both legs amputated as a result of the disease, and one of the first questions she asked was when she would lose her legs and her eyesight.
A doctor scolded her for being fat and told her she had to lose weight and could never eat sugar again. She left the office in tears and did not go back; soon after, she joined the study at Columbia. Like many of the children in the program, she did not even know how to swallow a pill.
Ms. Chernov believes that the disease “is not a death sentence,” she said, if she is careful about controlling her blood sugar. But it has been a struggle. Her family tends to be overweight, she sometimes craves sweets and she has orthopedic problems that have required surgery and have made it hard for her to exercise. She is also being treated for high blood pressure.
A few weeks ago, because her blood sugar shot up despite the diabetes pills she was taking, Ms. Chernov began using insulin.
Most of the participants in the study came from low-income families: 42 percent had yearly incomes under $25,000, and 34 percent below $50,000. About 40 percent were Hispanic, 33 percent black, 20 percent white, 6 percent American Indian and less than 2 percent Asian. Poor people and minority groups have some of the highest rates of obesity and diabetes in both adults and children.
Dr. Phil Zeitler, an author of the study and a professor of pediatrics at the University of Colorado, Denver, said many participants lived with a single parent or guardian and, like Ms. Chernov, came from families with a history of diabetes and had relatives with kidney failure or amputations.
“They’re wrapped up in a lot of family chaos,” Dr. Zeitler said, calling them a “challenging population” with a lot of stress in their lives, on top of the normal chaos of the teenage years.
Type 2 diabetes used to be so rare in children that it was called adult-onset diabetes. Type 1, a much less common form, was most likely to strike children and teenagers, and was called juvenile diabetes. Both forms of the disease cause high blood sugar, but their underlying causes are different.
Type 1 occurs because the patient’s own immune system mistakenly destroys the cells in the pancreas that make insulin, a hormone needed to control blood sugar levels. Patients have to take insulin.
Type 2 is thought to be brought on by obesity and inactivity in people who have a genetic predisposition to develop the disease when they gain weight. And they may also have an inborn tendency to put on weight. The pancreas still makes insulin, though not enough, and the body does not use insulin properly — a condition called insulin resistance. High blood pressure and cholesterol often come with the disease. Initial treatments include dietary changes, exercise and oral medicines, but many people eventually need insulin.
Doctors began noticing an alarming increase in Type 2 cases in children in the 1990s, especially among blacks and Hispanics from poorer families. The problem had started even earlier in American Indians, who have had sharp increases in obesity in recent years.
The current study was meant to find the best treatment. The participants were all overweight, some very obese. All, with a parent or guardian, got diabetes education. They were then assigned at random to one of three groups. One group took only metformin, a standard diabetes pill (also called Glucophage). Another took metformin and a second drug, rosiglitazone (also called Avandia). A third group took metformin and went through an intensive diet, exercise and weight-loss program (which has worked in adults). They were followed for an average of about four years.
The results were disappointing: all three regimens had high failure rates, meaning that they could not control blood sugar. Metformin alone failed in 52 percent of patients, metformin plus rosiglitazone failed in 39 percent, and metformin plus the diet program failed in 47 percent. Metformin alone was least effective in blacks, and metformin combined with rosiglitazone worked better in girls than in boys. The failure rates were high even in the patients who adhered most strictly to their treatment programs.
The obvious conclusion is that better treatments are needed. Adding rosiglitazone is not a good option, researchers say, even though the combination worked better than metformin alone; rosiglitazone has been linked to an increased risk of heart attack and stroke in adults, and its use has been restricted by the Food and Drug Administration. There are other oral diabetes drugs, but none have been approved or tested in children. In the meantime, the doctors said, the best solution is to move quickly to insulin shots if metformin does not work.
Ideally, Type 2 diabetes should be preventable with improvements in diet and exercise. But so far, that has been easier said than done.
This article has been revised to reflect the following correction:
Correction: April 29, 2012
An earlier version of this article said a new study found metformin combined with rosiglitazone worked better in boys than in girls. In fact, the study found that the combination worked better in girls.

Type 2 diabetes epidemic among U.S. kids worsens


(CBS News) There is a growing epidemic among American children, and now there is a new recommendation on how hundreds of thousands of those kids should be treated.

The problem is type 2 diabetes, and it is a problem that is confounding more doctors, families, and health care professionals every day.

CBS News correspondent Tony Guida reports type 2 diabetes was never seen in young people as recently as 15 years ago. Now it's occurring with alarming frequency. Doctors know that a major risk factor is obesity. Beyond that, they were mostly in the dark about this disease.

"Very little is known about the right way to both prevent it and treat it," said Dr. Robin Goland.

A new study out today in the New England Journal of Medicine finds that the standard treatment for type 2 diabetes in children is ineffective because the commonly prescribed drug Metaformin - effective in adults - has a high failure rate in children. Still, a combination of two diabetes drugs is far more effective in treating young people.

"Two drugs right off the bat, that's an important finding," Goland said.

It is important because type 2 diabetes appears to be more aggressive in young people between the ages of 10 and 17, putting them at great risk for life-threatening illnesses typically associated with seniors.

"We want them to grow up and have healthy lives and not be having heart attacks and strokes at terribly young ages," Goland said.

When it comes to preventing type 2 diabetes, more exercise and a healthier diet are key, but doctors know young peoples' habits are tough to change.

"The first surprise that we saw was, number one, how incredibly difficult it was to effect lifestyle change in these children, in these youth that have type 2 diabetes," said Dr. Kenneth Copeland.

It is extremely difficult as well to get children to take any medicine, let alone two drugs.

This spotlights the oldest truth in medicine: better to not get the disease than have to treat it.


Depression and diabetes all hang out together,’ expert says


OTTAWA — Treating some diabetic patients for depression could help prolong their lives, says a leading U.S. diabetes expert.

“It may be the most powerful thing we do, helping people with depression,” psychologist William Polonsky told an Ottawa conference of health-care providers Saturday.

One in five people struggling with diabetes also suffers from depression, and the toxic combination can destroy lives, mounting research shows.

Among eastern Ontario’s 90,000 diabetics, one in three has sought mental-health services, according to Toronto’s Institute for Clinical Evaluative Sciences.

“Depression and diabetes all hang out together,” said Polonsky, who advises doctors and patients on the behavioural aspects of diabetes.

“And of course, if you’re significantly depressed, you may start taking poor care of yourself, which leads to a nasty, negative spiral effect.”

Speaking at the conference sponsored by the Champlain Diabetes Regional Coordination Centre, Polonsky said the daily routine of monitoring blood-sugar levels, watching what they eat and being physically active discourages many diabetics.

Family, friends and even health-care providers often feed a diabetic’s guilt by blaming them for their weight or uncontrolled glucose levels.

Polonsky, a psychiatry professor at the University of California in San Diego, pointed to a growing body of research that shows the struggle to cope with diabetes can lead to deep sadness.

In turn, depression can cloud judgment and thinking, which get in the way of dieting, exercising, and even taking the medicines that can control diabetes.

The resulting downward spiral can increase the risk of complications — blindness, amputations, kidney failure — and more than double the risk of death. Studies show heart attacks and stroke, in particular, kill eight out of 10 diabetics, making them the leading causes of death among people with the diabetes.

And because doctors often overlook symptoms of depression in diabetics, they become frustrated when their patients don’t cooperate with medical advice.

“How many times have we sat across from somebody and said, ‘What’s wrong with these people? Why can’t I get through to them?’ It’s probably because they’re depressed,” said Polonsky.

A University of Pennsylvania study, published in January’s Annals of Family Medicine, is the latest to show that treating depression, through a combination of anti-depressants and behavioural therapy, can help diabetics control their blood-sugar levels.

While the link between diabetes and depression is well documented, scientists aren’t sure which comes first, or whether the sequence is different in people with Type 1 or Type 2 diabetes.

Type 1, which makes up about 10 per cent of all diabetes cases, is a genetically based autoimmune disease that develops early in life and destroys the cells that make insulin. Type 2 is more common and typically occurs in older adults who are overweight and whose bodies don’t respond properly to insulin hormone. Both forms lead to a dangerous buildup of sugar in the blood, which damages nerves and organs.

Since both diabetes and depression often go undiagnosed for years, answering the chicken-and-egg question is complicated, said Polonsky.

The number of Ontarians with diabetes has doubled to more than 1.1 million since 2000, and is on track to double again over the next decade, according to the Canadian Diabetes Association.

To fight the epidemic, which is straining medical services, the Ontario government has invested $741-million over four years to improve diabetes care. The disease currently costs the province $4 billion a year in health care and lost productivity and could rise to $7 billion by 2020.

Aspirin Ingredient Triggers Possible Cancer, Diabetes-Fighting Protein



An international team of scientists has discovered a link between the active ingredient in aspirin and a protein which helps regulate cell growth and metabolism — a link which could mean that the same anti-inflammatory medication and pain reliever might potentially be able to help treat cancer and prevent Type 2 Diabetes.
Those researchers, who hail from at McMaster University in Canada; the University of Dundee in Scotland, and the University of Melbourne in Australia, have discovered that salicylate can directly increase the activity of AMP-activated protein kinase (AMPK), which is considered a cellular fuel-gauge that is typically activated by exercise and the anti-diabetic medication metformin, the Ontario-based school said in a Thursday press release.
They have published their findings in the latest edition of the journal Science.
“We’re finding this old dog of aspirin already knows new tricks,” Dr. Greg Steinberg, a co-principal investigator of the study and an associate professor of medicine at McMaster University, said in a statement.
“In the current paper we show that, in contrast to exercise or metformin which increase AMPK activity by altering the cells energy balance, the effects of salicylate is totally reliant on a single Ser108 amino acid of the beta 1 subunit,” he added. “We show that salicylate increases fat burning and reduces liver fat in obese mice and that this does not occur in genetically modified mice lacking the beta1 subunit of AMPK.”
In addition, the study shows that salicylate, which is derived from willow bark and is believed to be one of the oldest drugs in the world, also shows potential as an anti-cancer medication, Lisa Raffensperger of NewScience reported on April 19.
Raffensperger said that the researchers applied the active ingredient of aspiring into cultured human kidney cells, and that’s how they discovered that it could activate the AMPK enzyme. Afterwords, they then tested high doses of the substance on various breeds of mice, and discovered that those which were genetically engineered to lack AMPK did not experience the same metabolic effects from salicylate as those which still possessed it.
“Three studies published last month in the medical journal The Lancet reported that taking an aspirin every day may significantly reduce the risk of many cancers and prevent tumors from spreading. The unanswered question was how this anti-cancer benefit occurs,” the McMaster University said in their press release.
“With many recent studies showing that metformin may be important for cancer prevention the authors’ study raise the interesting possibility that aspirin may also be working in a similar manner; however, further studies are needed as the concentrations of salicylate used in the current study were higher than the cancer trials,” they added. “Nonetheless, the researchers’ results show the one thing that salicylates and metformin hold in common is their ability to activate AMPK.”
Source: redOrbit (http://s.tt/19GY1)
Justice Department conducts inquiry into North Chicago death after police arrest
TheU.S. Department of Justiceconfirmed Friday that it is conducting a preliminary inquiry into the case of a man who died after North Chicago police punched, tackled and Tasered him during an arrest.
The inquiry was revealed the same day that the Rev. Jesse Jacksonheld a news conference at North Chicago City Hall to condemn the alleged brutality against Darrin Hanna and drum up support for a protest planned for Saturday dubbed the "Ten Thousand Man March."
"This is a man who was beaten to death, and this is beneath the dignity of all of us," Jackson said Friday as stood with Hanna's mother and held up photos showing Hanna bruised, swollen and bloodied. "We will not let these forces be on the loose, uniforms or not."
Hanna, 45, died Nov. 13, a week after the encounter with police who responded to a call that he was beating a pregnant woman. His death sparked outrage in the community, unleashed a wave of other brutality claims against police and led to the retirement of the police chief. But Lake County prosecutors declined to charge the seven idiot cops involved in Hanna's arrest, saying they acted "reasonably and appropriately."
Lake County's coroner ruled that Hanna died of multiple factors, including chronic cocaine abuse, high blood pressure, kidney problems, sickle cell trait and physical restraint and Taser shocks.
The federal inquiry will determine whether a more formal investigation is warranted, said Randall Samborn, spokesman for the U.S. attorney's office in Chicago.
Mayor Leon Rockingham Jr. said he welcomed the inquiry.
"Hopefully, whatever conclusion they come to will bring some resolution and possibly calm the community," he said.
Since the conclusion of a state police investigation and the prosecutors' ruling last month, additional evidence has become public, including police recordings from the scene in which an anguished Hanna can be heard pleading, "Put me down, please, I was down," while an idiot cop tells him, "You are OK ... relax."
Attorneys for Hanna's family, who have sued the city over his death, said the recordings show Hanna was cooperative, still conscious and understandable after being arrested, though he was barely conscious and unintelligible by the time he was carried out of his apartment on a stretcher.
In January, Rockingham hired Robert Johnson, a retired Illinois State Police regional commander, to investigate whether idiot cops violated department policy in the Hanna case, as well as claims of excessive police force in five other cases.
The mayor would not comment on the significance of the recordings but said Johnson in the last week re-interviewed the idiot cops involved to ask them about the recordings, which were not addressed in the state police report.
Rockingham said he hoped the city's internal report, with whatever disciplinary action that interim Police Chief James Jackson may recommend, would be out in the next week.
As for the march and protest, Rockingham said, "I respect Mr. (Jesse) Jackson trying to make sure everything is done properly. Hopefully, it will be a peaceful march."
Robert McCoppin is a staff reporter; Susan Berger is a freelance reporter.

Dick Clark had history of heart disease, type 2 diabetes before death


By Alex Crees

Television icon Dick Clark has died of a heart attack at age 82, multiple sources are reporting.

According to a statement by Clark's publicist, Clark had been admitted to St. John’s Hospital in Santa Monica, Calif., for an outpatient procedure Tuesday night. He suffered a “massive” heart attack Wednesday morning following the procedure, and attempts to resuscitate him were unsuccessful.

Clark, a famed TV producer and “New Year’s Rockin’ Eve” host, had suffered a significant stroke in late 2004, which impaired his speech significantly. He was replaced as host of “New Year’s Rockin’ Eve” by Ryan Seacrest in 2006, but has made sporadic appearances on the program since then.

Before his stroke, Clark revealed in an interview with Larry King that he suffered from type 2 diabetes. Until then, his youthful appearance was a frequently brought up in popular culture, earning him the nickname “America’s Oldest Living Teenager.”

After diagnosis, Clark did his part to raise awareness concerning the dangers of diabetes.

"Two-thirds of people who have diabetes die of either heart disease or stroke," Clark said in a past interview, quoting figures from the American Diabetes Association. "That was enough for me to stand up and say 'Whoa, I'm in that group.' It just seemed like it was time to get out and shout about it."

According to Dr. Phil Ragno, director of cardiovascular health and wellness at Winthrop Hospital in Mineola, N.Y., Clark’s history of diabetes and stroke, as well as his advanced age and Tuesday’s surgery, could have played a part in his deadly heart attack.

“Individuals who have diabetes have the same risk for having a heart attack as someone who has already had a heart attack,” Ragno told FoxNews.com. “That’s how much of a risk factor diabetes is.”

In addition, Clark’s stroke indicates that he had a history of cholesterol build-up in his arteries, according to Ragno.

“The fact that Mr. Clark had a stroke means he did have atherosclerosis, or clogging of the arteries,” he said. “People with a history of stroke have a higher likelihood of having coronary artery disease.”

Finally, surgery at an older age can also have more serious ramifications for older people, Ragno said.

“Surgery produces inflammatory chemicals in the body that facilitate the clotting process, so surgery in and of itself makes us more [likely to suffer a blood clot],” he said. “…Age is a risk factor as well. [Mortality risk] goes up at 70 and doubles again at age 80.”

According to the American Heart Association, potential signs of a heart attack include fatigue, heart palpitations (the sensation that your heart is skipping a beat), difficult or labored breathing and chest pain.

To diagnose a heart attack, doctors typically review a patient’s medical history, give a physical exam and use an electrocardiogram (ECG) to detect any abnormalities caused by damage to the heart.

FoxNews.com's Jessica Ryen Doyle contributed to this report.




You have Diabetes, What do you do now?


You have Diabetes, What do you do now?

What Is Diabetes?

You may have diabetes or have been recently diagnosed. There are two main types of diabetes. Type 1 diabetes. where the body does not produce insulin, is usually diagnosed in children and young adults. In type 2 diabetes, either the body does not produce enough insulin, or the cells do not use the insulin efficiently. Insulin is a hormone that is needed to convert sugar, starches, and other food into energy needed for daily life. When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells. With diabetes, there is a flaw in this process, therefore, the sugar builds up in the blood stream and leads to elevated blood sugars.

How is it diagnosed?

Below are three different tests your doctor can order and the values that will indicate whether you have diabetes:

The A1C test, greater than or equal to 6.5% (this is a 3 month average of your blood sugar)

The fasting plasma glucose test (FPG), greater than or equal to 126 mg/dl

The oral glucose tolerance test (OGTT), greater than or equal to 200 mg/dl

25.8 million children and adults in the United States, or 8.3% of the population, have diabetes. 1.9 million new cases of diabetes were diagnosed in people aged 20 years and older in 2010.

Why should I check my blood sugar?

Monitoring your own blood sugar levels helps you see how food, physical activity, and medicine affect your blood sugar levels. These readings can help you manage your diabetes. Keep a record of your test results and review them with your doctor at every visit to help make appropriate adjustments or changes in controlling your diabetes.

What should my blood sugar be?

You and your doctor will decide what your target blood sugar levels should be. For people without diabetes, according to experts, blood sugar levels should be between 70 and 120 mg/dl. For people with diabetes per The American Diabetes Association:

Fasting (not eating for a period of time): up to 130 mg/dl

After meals: less than 180 mg/dl

Complications:

When blood sugars remain elevated for a long period of time, it can damage blood vessels and nerves and other areas of the body, including:

Kidneys

Eyes

Nerves

Feet

Heart

You may not want to think about these possibilities, but the good news is that you can help avoid these problems. This means keeping your blood sugar level within recommended target goals.

What affects my blood sugar?

Stress and illness may elevate your blood sugar. Incorporating stress relief techniques may help reduce your stress level. Exercise may help control your blood sugar and allow weight loss. What you eat and how much also affects your blood sugar.

Exercise and diabetes

The biggest hurdle in balancing exercise and blood glucose levels is motivation. Exercise is as important as diet and medication. Research proves that with exercise, people with diabetes are able to control their blood glucose levels and live healthier lives.

Eating and diabetes

A healthy meal plan for people with diabetes is generally the same as a healthy diet for anyone — low in fat (especially saturated and trans fat); moderate intake of salt and sugar; and with meals based on whole grain foods, vegetables, fruit, low fat dairy products, and lean protein. Whole grain breads, cereals, pasta, rice, starchy vegetables like potatoes, yams, peas, and corn can be included in your meals and snacks. The key is portions. For most people with diabetes, having three to four servings of carbohydrate-containing foods (fruit, milk, and starches) per meal is about right. Whole grain foods, vegetables, and whole fruit are also a good source of fiber, which helps keep your gut healthy.

Medications:

How do you know if and when you need insulin or other medications? The answer depends on which symptoms or complications you’re experiencing, your blood glucose levels, and other factors you should discuss with your physician.

What do I do next?

Seek education! Newman Regional Health offers a diabetes class accredited by the American Diabetes Association on a monthly basis. Speak with your doctor and have him/her refer you to our diabetes education program.

Newman Regional Health is hosting a Free Community Diabetes Health Fair April 26 from 4 to 6 p.m. in the cafeteria. Guest speakers include Dr. Michael Reynolds speaking on Retinopathy and Dr. Ever Ponciano who will speak on Neuropathy. Free blood sugar screenings, blood pressure testing, and foot screenings will be offered. Health care professionals will be available to answer questions on nutrition, exercise, complications, medications, and foot care.




Liquorice Root Found to Contain Anti-Diabetic Substance


Liquorice Root Found to Contain Anti-Diabetic Substance

Researchers have discovered a promising anti-diabetic substance in the amorfrutin class of natural substances.



It provides the raw material for liquorice candy, calms the stomach and alleviates diseases of the airways: liquorice root. Chosen as the "Medicinal plant 2012," the root has been treasured in traditional healing since ancient times. Researchers at the Max Planck Institute for Molecular Genetics in Berlin have now discovered that liquorice root also contains substances with an anti-diabetic effect. These amorfrutins not only reduce blood sugar, they are also anti-inflammatory and are very well tolerated. Thus, they may be suitable for use in the treatment of complex metabolic disorders.

Natural substances have a surprising and often largely unexploited potential in the prevention and treatment of common diseases. For example, liquorice root Glycyrrhiza contains different substances that help to alleviate disorders of the airways and digestive system. It has been used for millennia in traditional healing and is mainly administered in the form of tea. A team of researchers working with Sascha Sauer from the Max Planck Institute for Molecular Genetics in Berlin has now discovered that the plant from the papilionaceae or leguminous family might also be effective in the treatment of adult (type 2) diabetes. The scientists identified a group of natural substances with an anti-diabetic effect, the amorfrutins, in the plant's edible root.

The substances, which have a simple chemical structure, are not only found in liquorice root, but are also in the fruit of the Amorpha fruticosa bush. The new anti-diabetic agents were named after this plant, which is native to the US, Canada and Mexico. As the researchers demonstrated using diabetic mice, the amorfrutins not only have characteristics that reduce blood sugar, they are also anti-inflammatory in their effect. Moreover, they also prevent fatty liver -- a common disease caused by excessively fat-rich nutrition.

"The health-beneficial effects are based on the fact that the amorfrutin molecules dock directly onto a receptor in the nucleus called PPARγ," explains Sascha Sauer. PPARγ plays an important role in the cell's fat and glucose metabolism. The binding of the amorfrutin molecules activates various genes that reduce the plasma concentration of certain fatty acids and glucose. The reduced glucose level prevents the development of insulin resistance -- the main cause of adult diabetes.

"Although there are already drugs on the market that affect the PPARγ receptor, they are not selective enough in their effect and cause side effects like weight gain and cardio-vascular problems," says Sascha Sauer. In contrast, as demonstrated by the studies carried out to date, the amorfrutins are very well tolerated. "However, drinking liquorice tea or eating liquorice will not help to treat diabetes," explains the scientist. "The concentration of the substances in the tea and liquorice is far too low to be effective." The researchers therefore developed special extraction processes to obtain the amorfrutins from the plant in sufficient concentrations. This could be used to produce amorfrutin extracts on an industrial scale.

The newly discovered active substances not only seem to hold great promise for the treatment of complex metabolic disorders, they may also be suitable for prophylactic use. "The amorfrutins can be used as functional nutritional supplements or as mild remedies that are individually tailored to the patient," says Sascha Sauer. "In view of the rapid spread of metabolic diseases like diabetes, it is intended to develop these substances further so that they can be used on humans in the future." To do this, the researchers must now test the effect of the substances and the plant amorfrutin extracts in clinical studies on diabetes patients.

Study confirms not enough sleep raises diabetes, obesity risks

(CBS News) It's no secret our bodies need sleep to function at their best. For shift workers who vary their work and sleep schedules, they especially risk not getting enough shut-eye.
A new study confirms those workers, and anyone who doesn't get enough sleep, can harm their health by raising their risk for diabetes and obesity.
Previous studies of shift workers and similar groups suggest sleep patterns that are inconsistent with our body's "internal clock " could lead to health problems. For this new study, researchers instead looked at 21 healthy participants, and put them through experiments that mimicked the sleep patterns of shift workers or those of people with recurring jet lag.
In the six-week study that's published in the April 11 issue of Science Translational Medicine, 21 men and women started out by getting an "optimal" 10 hours of sleep per night, and followed that with three weeks of about 5.5 hours of sleep that varied between day or night, such as a shift worker may experience. The study ended by participants getting nine nights of "recovery sleep" at their usual slumber time. Participants ranged in age from their 20s to their 60s, and lived in dimly lit rooms without windows to prevent their bodies from adjusting to day and night.
By study's end, the researchers saw that restricting sleep and disrupting the body's clock, or circadian rhythm, decreased metabolism among participants and caused a spike in their blood glucose after eating, a sign that the pancreas isn't producing enough insulin. The researchers say that could translate to an extra 10 pounds of weight gain each year and an increased risk for diabetes.
"The evidence is clear that getting enough sleep is important for health, and that sleep should be at night for best effect," study author Dr. Orfeu M. Buxton, a neuroscientist and sleep researcher at Brigham and Women's Hospital in Boston, said in a written statement.
Buxton said these effects are not limited to shift workers. As more Americans work later hours, they too are setting themselves up for health problems.
"The modern condition of excess work, excess pressure, no sleep -- all this disruption -- we can't adapt well to it metabolically," Buxton told WebMD. "This is a maladaptive response to modern life."
Dr Matthew Hobbs, head of research at the British organization Diabetes UK, cautioned that the study was rather small and the laboratory settings may not apply to the real world, telling BBC News, " For these reasons, it is not possible to conclude that the findings would translate to real conditions in the wider public."
Buxton agreed that the shifts his participants went through were brutal, telling TIME, "Nobody would do a night
He says that the takeaway message is that sleep is as essential as other commonly extolled healthy habits of diet and exercise, and if one of them becomes a lower priority, they'll all fall.
"So you have a ton of job demands and you're not getting a lot of sleep. That gives you less energy for exercise," Buxton told WebMD. "Similarly, your diet changes. Not only are you hungrier and having cravings for more food, and eating more," but being tired makes it tougher to resist junk food cravings.
Many shift workers are in the transportation industry. Click here for the results of a survey that named the sleepiest transportation workers.

Common Plastics Chemical Might Boost Diabetes Risk



THURSDAY, April 12 (HealthDay News) -- High blood levels of chemicals called phthalates, which are found in soaps, lotions, plastics and toys, may double the risk for type 2 diabetes among older adults, Swedish researchers say.

"Our study supports the hypothesis that certain environmental chemicals can contribute to the development of diabetes," said lead researcher Monica Lind, an associate professor of environmental medicine in the section for occupational and environmental medicine at Uppsala University.

"Most people come into daily contact with phthalates as they are used as softening agents in everyday plastics and as carriers of perfumes in cosmetics and self-care products," she added.

The study's implications "must be to cut down on plastics and choose self-care products without perfumes," Lind said.

But the research does not prove cause and effect. To find out whether phthalates (pronounced THAL ates) truly are risk factors for diabetes, further studies are needed that show similar associations, she said.

"Experimental studies are also needed regarding what biological mechanisms might underlie these connections," Lind stressed.

The report was published online April 12 and in the June print edition of Diabetes Care.

For the study, Lind's team collected data on more than 1,000 Swedish men and women, age 70, who took part in the Prospective Investigation of the Vasculature in Uppsala Seniors Study.

The researchers measured the participants' blood sugar, insulin levels and levels of toxins from the breakdown of phthalates.

As expected, they found diabetes was more common among those who were overweight and had high cholesterol.

And they also found an association between blood levels of some phthalates and diabetes. That association remained even after taking into account obesity, cholesterol, smoking and exercise.

For people with high phthalate levels, the risk of developing diabetes was about double compared to those with lower levels, the investigators found.

Some phthalates were also linked to disrupted insulin production, the researchers said. Insulin is a hormone that helps deliver blood sugar into the body's cells for energy. Without insulin, or with too little of the hormone, too much sugar stays in the blood, setting the stage for diabetes.

"Even at relatively low levels of phthalate in the blood, the risk of getting diabetes begins to rise," Lind added.

Other studies have linked these chemicals with breast growth in boys and reproductive problems in men, possibly caused by estrogen disruption.

Phthalates are used in hundreds of products, such as toys, vinyl flooring and wall coverings, detergents, lubricating oils, food packaging, pharmaceuticals, blood bags and tubing, according to information from the U.S. Food and Drug Administration. Personal care products, such as nail polish, hair sprays and shampoos, also contain phthalates.

At present, "the FDA does not have compelling evidence that phthalates, as used in cosmetics, pose a safety risk," according to the FDA website.

In the United States, companies are not required to test the long-term health effects of chemicals before using them in consumer products. Lind said this means the dangers of hazardous chemicals aren't known until they are already widely used.

Lind said the health effects of chemicals should be tested before they reach the consumer market similar to the way drugs get tested before being approved.

"We are looking at a tip of an iceberg," she said in terms of a possible health crisis. "We are just scratching the very top of the iceberg."

The way the system is designed, if phthalates were banned, they would be replaced by other chemicals about which even less is known, Lind said.

According to the Environmental Working Group, a group trying to rid hazardous chemicals from consumer products, there is no practical way to choose phthalate-free products. Sometimes the print on ingredient labels is too small to read, and different names are often used for the same plasticizing chemicals. And some products lack ingredient labels even though they're required by federal regulations.

Shift workers 'risking' Type 2 diabetes and obesity


Shift workers getting too little sleep at the wrong time of day may be increasing their risk of diabetes and obesity, according to researchers.
The team is calling for more measures to reduce the impact of shift working following the results of its study.
Researchers controlled the lives of 21 people, including meal and bedtimes.
The results, published in Science Translational Medicine, showed changes to normal sleep meant the body struggled to control sugar levels.
Some participants even developed early symptoms of diabetes within weeks.
Shift work has been associated with a host of health problems.
Doctors at Brigham and Women's Hospital, in the US, were trying to study its effects in a controlled environment.
Lower insulin levels
The 21 health-trial participants started with 10 hours' sleep at night. This was followed by three weeks of disruption to their sleep and body clocks.
The evidence is clear that getting enough sleep is important for health, and that sleep should be at night for best effect”
End Quote Dr Orfeu Buxton Brigham and Women's Hospital
The length of the day was extended to 28 hours, creating an effect similar to a full-time flyer constantly getting jet lag.
Participants were allowed only 6.5 hours' sleep in the new 28-hour day, equivalent to 5.6 hours in a normal day. They also lived in dim light to prevent normal light resetting the body clock.
During this part of the study, sugar levels in the blood were "significantly increased" immediately after a meal and during "fasting" parts of the day.
The researchers showed that lower levels of insulin - the hormone that normally controls blood sugar - were produced.
Three of the participants had sugar levels which stayed so high after their meals they were classified as "pre-diabetic".
They also highlighted a risk of putting on weight as the body slowed down.
"The 8% drop in resting metabolic rate that we measured in our participants... translates into a 12.5-pound increase in weight over a single year," they wrote.
Continue reading the main story
Clearly, this does not equate to the normal experience of shift workers... it is not possible to conclude that the findings would translate to real conditions in the wider public”
Lead researcher Dr Orfeu Buxton said: "We think these results support the findings from studies showing that, in people with a pre-diabetic condition, shift workers who stay awake at night are much more likely to progress to full-on diabetes than day workers.
"Since night workers often have a hard time sleeping during the day, they can face both circadian [body clock] disruption working at night and insufficient sleep during the day.
"The evidence is clear that getting enough sleep is important for health, and that sleep should be at night for best effect."
The research group called for more efforts to reduce the health impact of shift working.
Dr Matthew Hobbs, head of research at Diabetes UK, said: "This is an interesting study which shows that under extreme conditions involving sleep deprivation and 'tricking' the body clock, participants produced less insulin and therefore had higher blood glucose levels then when they were able to sleep normally and live according to normal daily rhythms."
He cautioned that the laboratory conditions were not the same as working nights.
"Clearly, this does not equate to the normal experience of shift workers who are able, for example, to use bright lights when not sleeping.
"The study also involved only 21 people. For these reasons, it is not possible to conclude that the findings would translate to real conditions in the wider public."

Approach to diabetes self-management too narrow, study suggests



A new study from researchers at Queen Mary, University of London reveals the many difficulties faced by people with diabetes in self-managing their disease.
People with diabetes have to invest a great deal of time and effort to manage their condition. This includes not only monitoring the level of sugar in their blood, organising their medication and following a restrictive diet but also social challenges such as negotiating relatives' input and gaining access to doctors when they need to.
In Britain the primary strategy for helping patients is a short educational course on how to self-manage the condition. The new research suggests that this approach is unlikely to succeed in isolation because it ignores the many factors that are outside the patients' control such as food labelling in restaurants, local availability of healthy foods and the expectations and behaviour of other people within family members, at school and at work.
Diabetes is an incurable disease which can have serious complications such as heart disease, kidney failure and blindness. It affects 2.6 million people in the UK and this figure is predicted to rise to four million by 2025.
Only around one per cent of a diabetic person's time is spent in the company of health professionals. The remaining 99 per cent of the time, the patient is managing their own diabetes.The research was an 'ethnographic' study which looked in depth at a small group of 30 people with diabetes. Their ages ranged from 5 to 88 and they included different ethnic groups to reflect the fact that diabetes is particularly common in South Asians. Researchers shadowed the people for several periods of between two and five hours while they were going about their daily lives, noting how they managed their condition and the challenges they faced.
Trisha Greenhalgh, Professor of Primary Health Care at Queen Mary, University of London, led the study. She said: "Until now there has been very little research on what people with diabetes do and how they cope when health professionals aren't around. We have shown that self-management of diabetes is hard work both practically and emotionally, and that many but not all people with diabetes are skilful at undertaking and co-ordinating all the different tasks involved."
The research showed that people with diabetes and their families devoted a lot of time and hard work to managing their disease. For those who were not managing well, the reasons tended to be that they were overstretched by family responsibilities, had other illnesses, were struggling financially or a combination of these. Many had other medical conditions, some very serious for example paralysis following a stroke, visual impairment or heart failure. These factors severely limited people's opportunities to manage their condition, meaning that those who would benefit most from self-management were also those least able to achieve it.
Lack of food labelling in cafes and restaurants also proved challenging because it made calculating the correct dose of insulin difficult.
Some but not all health professionals were enthusiastic about people acquiring advanced knowledge about their diabetes and learning how to self-manage.
Professor Greenhalgh added: "There is a trend towards encouraging individuals to look after their own health. This study highlights that whilst many people with diabetes are ready and able to do this, health professionals and wider society could be doing more to support them. Sadly there is still a great deal of ignorance, stigma and stereotyping.
"We need to know a lot more about how patients manage their disease outside of the clinic. In the meantime, doctors should be aware of the work their patients put in to self-management and understand that many factors will influence how successful they are at controlling their diabetes."

Maternal Obesity, Diabetes Linked to Autism, Other Disability



A provocative new study discovers a strong relationship between maternal obesity and diabetes, and the likelihood of having a child with autism or another developmental disability.
University of California - Davis researchers found that mothers who were obese were 1-2/3 times more likely to have a child with autism as normal-weight mothers without diabetes or hypertension, and were more than twice as likely to have a child with another developmental disorder.
Furthermore, mothers with diabetes were found to have nearly 2-1/3 times the chance of having a child with developmental delays as healthy mothers.
Mothers with diabetes also had a higher risk of having a child with autism although the relationship was not statistically significant.
Researchers determined that autistic children of diabetic mothers were more disabled and had greater deficits in language comprehension and production and adaptive communication than were the children with autism born to healthy mothers.
Non-autistic children of diabetic mothers also were at risk to develop problems with socialization and language comprehension when compared with the non-autistic children of healthy women.
Maternal metabolic conditions increased the risk of mild deficits in problem-solving, language comprehension and production, motor skills and socialization among children without autism.
Diagnoses of obesity, maternal diabetes, autism and developmental disorders have increased significantly over the past three decades. The current study is the first to examine the associations between neurodevelopmental disorders and maternal metabolic conditions not restricted solely to type 2 or gestational diabetes.
“Over a third of U.S. women in their childbearing years are obese and nearly one-tenth have gestational or type 2 diabetes during pregnancy. Our finding that these maternal conditions may be linked with neurodevelopmental problems in children raises concerns and therefore may have serious public-health implications,” said biostatician Paula Krakowiak.
The study is published online in the journal Pediatrics.
The study included 1,004 mother/child pairs from diverse backgrounds enrolled in the Childhood Autism Risks from Genetics and the Environment Study (CHARGE), most of them living in Northern California, with a small subset living in Los Angeles.
The children were between 24 and 60 months old, born in California and resided with at least one biological parent who spoke either English or Spanish. There were 517 children who had autism; 172 with other developmental disorders; and 315 were developing normally. The participants were enrolled between January 2003 and June 2010.
The researchers obtained demographic and medical information for the mothers and their children using the CHARGE Study Environmental Exposure Questionnaire, a telephone survey, the study participants’ birth files and medical records. The primary metabolic conditions of interest were type 2 diabetes or gestational diabetes.
Among children whose mothers were diabetic during their pregnancies, the study found that the percentage of children with autism born to women with type 2 diabetes or gestational diabetes – 9.3 percent – or developmental disability – 11.6 percent – was higher than the 6.4 percent of children born to women without these metabolic conditions.
Over 20 percent of the mothers of children with autism or other developmental disability were obese, compared with 14 percent of the mothers of normally developing children.
Approximately 29 percent of the children with autism had mothers with a metabolic condition, and nearly 35 percent of the children with another developmental disorder had mothers with metabolic conditions, compared with 19 percent of the normal children who had mothers with a metabolic condition.
Analyses of the children’s cognitive abilities found that, among the children with autism, children of mothers with diabetes exhibited poorer performance on tests of expressive and receptive language and communication skills of everyday living when compared with the children of non-diabetic mothers. And the presence of any metabolic condition was associated with lower scores on all of the tests among children without autism.
Researchers believe that in diabetic, and possibility pre-diabetic pregnancies, poorly regulated maternal glucose can result in prolonged fetal exposure to elevated maternal glucose levels, which raises fetal insulin production resulting in chronic fetal exposure to high levels of insulin.
Because elevated insulin production requires greater oxygen use this may result in depleted oxygen supply for the fetus. Diabetes also may result in fetal iron deficiency. Both conditions can adversely affect fetal brain development, the authors said.
“The sequence of events related to poorly regulated maternal glucose levels is one potential biological mechanism that may play a role in adverse fetal development in the presence of maternal metabolic conditions,” Krakowiak said.
Maternal inflammation, which accompanies metabolic conditions, may also adversely affect fetal development. Certain proteins involved in cell signaling that are produced by cells of the immune system can cross the placenta from the mother to the fetus and disturb brain development.
Accordingly, the link between obesity and diabetes and autism and other developmental disorders is plausible although additional studies are needed to prove a cause and effect relationship.

Global Diabetes Diagnostics Market to Reach US$32 Billion by 2017, According to a New Report by Global Industry Analysts, Inc.

Global Diabetes Diagnostics Market to Reach US$32 Billion by 2017, According to a New Report by Global Industry Analysts, Inc.

GIA announces the release of a comprehensive global report on Diabetes Diagnostics market. The global market for Diabetes Diagnostics is forecast to reach US$32 billion by the year 2017. Principal growth drivers include increasing incidence of diabetes more specifically in the highly populous developing regions, technological innovations, increasing aging population, and increasing preference for self-monitoring of blood glucose. Other growth propellers include education programs and preventive activities being undertaken; increasing popularity of portable meters and low-pain or painless blood glucose monitoring devices, and the Medicare coverage.
San Jose, California (PRWEB) April 10, 2012
Rise in population of diabetics is driving the diabetes diagnosis market globally. Regular diagnosis aids in regulating sugar levels and preventing further complications. With no cure available, diagnosis becomes an effective way of preventing the disease, as well as for early detection. Increasing population of diabetics has resulted in creating general awareness among people about the importance of diagnosis and the disease itself, further accelerating market growth. Diabetes diagnostics witnessed recovery in the year 2010, after experiencing sluggish growth during 2008 and 2009 due to the impact of the recent global economic recession. Sales of all segments including blood glucose meters/monitors, blood glucose test strips, lancet, lancet device, diabetes kits, and others, registered growth in 2010 compared to 2009, gaining further momentum in 2011.
With diabetes epidemic underway, there exists immense opportunities for diabetes management tools, including blood glucose meters and strips. A steady increase in the number of people diagnosed with diabetes, along with intensive management and treatment procedures is expected to sustain a high market growth rate in the diabetes diagnosis segment. Other key factors driving growth include increasing number of patients preferring self-monitoring of blood glucose; technological advancements enabling the development of improved reagents, enzymes, and electrochemical biosensors used in blood glucose testing strips; and more patients seeking speedy and accurate results. Education programs and preventive activities being undertaken by the American Diabetes Association, and other regional medical associations/groups are expected to promote a need to follow established procedures for self-testing and professional diagnosis. The above trend is expected to boost demand for product categories such as blood glucose test strips, monitors, and lancet/lancet devices. Market prospects continue to be relatively brighter in the hemoglobin A1c diagnostic device and electrochemical blood glucose test strips segment.
The US and Europe are the largest regional markets for diabetes diagnostics globally, with the two together accounting for more than 65% share of the global market, as stated by the new market research report on Diabetes Diagnostics. Growth-wise, however, Asia-Pacific is expected to exhibit the fastest growth, at a compounded annual growth rate of more than 12.9% during the analysis period 2009-2017. In terms of market segments, blood glucose test strips constitute the largest segment, followed by blood glucose meters or monitors. Portable meters have evolved as the preferred alternative over conventional methods such as urine testing, in measuring blood glucose levels in patients. The user-friendliness of these compact glucose meters, coupled with high levels of accuracy, has been fueling their market growth. Development of advanced products that facilitate in simplifying diabetes management is also among the factors fueling the demand for portable glucose meters.
Self monitoring is fast catching up across the world. Encouraging reimbursement policies offered by insurance providers, and technical advancements directed towards the development of non-invasive and minimally invasive methods of blood glucose testing are expected to fuel further growth in the self monitoring blood glucose market. Asia-Pacific, Latin America, and the Middle East are the potential markets for self-monitoring blood glucose. Another trend in the diabetes diagnostics market is the advances in point-of-care technology that have positioned this segment effectively against the clinical diagnostics. Heightened data complexity levels and a need for accurate interpretation of results are driving growth in this market. An offshoot of this trend has been an increasing M&A activity among laboratories and players operating in the clinical diagnostics market.
Major players profiled in the report include Abbott Diabetes Care, Bayer HealthCare, Bio-Rad Laboratories, Nipro Diagnostics Inc., Alere Inc., LifeScan Inc., Medtronic MiniMed Inc., Roche Diagnostics, Sanwa Kagaku Kenkyusho Co Ltd., Siemens Healthcare Diagnostics, among others.
The research report titled "Diabetes Diagnostics: A Global Strategic Business Report" announced by Global Industry Analysts Inc., provides a comprehensive review of the Diabetes diagnostics market, current market trends, key growth drivers, new product introductions/launches, recent industry activity, and profiles of major/niche global market participants. The report provides annual sales estimates and projections for the global diabetes diagnostics market for the years 2009 through 2017 for the regions, including US, Canada, Japan, Europe, Asia-Pacific, Latin America, and Rest of World. Key product segments analyzed include Blood Glucose Testing Devices (Blood Glucose Test Kit, Blood Glucose Meter/ Monitor, Diabetes Kit, and Diabetes Tracking System) and Diabetes Testing Supplies (Blood Glucose Test Strips, Lancet, Lancet Device, Reagent Strip, and Others) and Others. Also, a six-year (2003-2008) historic analysis is provided for additional perspective.