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People with cancer, diabetes

People with cancer, diabetes and heart disease mistakenly think exercise is unsafe

For people with a chronic health condition, exercise might seem like a low priority, if not something to avoid altogether. Many people with such illnesses as cancer, diabetes and heart disease mistakenly think that exercise is unsafe for them. But ongoing research is making the opposite case, showing again and again that regular activity is not only safe for most people with chronic illnesses but can actually boost vigor, increase longevity and reverse some symptoms of many conditions. In some cases, it can even reverse the course of disease — for example, by reducing coronary artery plaque. For people with a chronic illness, here are some questions and answers about getting and staying active.

Even if you don’t have a chronic illness, it can be hard to get started on an exercise routine. For example, about half of very old adults cite muscle and joint pain or weakness as reasons for not exercising, regardless of their overall health.

But exercise doesn’t have to be uncomfortable or strenuous to provide significant benefits.

If you’re inactive, start at a level that feels comfortable, even if it’s only five minutes a day, and gradually build up over time. Ultimately, you should aim for the equivalent of 30 minutes of moderately intense aerobic exercise five days a week, plus two 20-minute sessions of strength training with weights, exercise bands or resistance machines.

One easy way to get going is to add activity to everyday routines. Do light calisthenics when watching television. Turn off the computer and walk to the park with your dog.

How hard should it be?

Moderate intensity is generally defined as enough to cause a light sweat and elevate your heart and breathing rate, but not so much that you can’t talk. Walking briskly is sufficient for most people to reach that level. Other suitable activities include cycling, dancing, swimming or using an elliptical machine.

You don’t have to tackle it all at once; in fact, splitting up exercise into several shorter, easier segments might be more effective than pushing yourself to do more at one time.

For strength training, muscles need to be worked at only 60 percent of their maximum capacity for you to see results. That means using a weight or resistance that allows you to do about 15 repetitions. Choose eight to 10 exercises that work the arms, legs, shoulders, chest, abdomen and back, including both pushing and pulling movements.

How can I avoid injury?

Only a few conditions make exercise too risky altogether. They include spinal instability, a recent heart attack, extremely advanced heart failure or a detached retina. Otherwise, nearly everyone can safely begin training at moderate intensity. Consult your doctor first to go over potential concerns specific to your disorder. In addition, follow these tips:

●Wear well-fitting athletic shoes with good traction to protect against slips.

●Always warm up with five to 10 minutes of walking or light calisthenics before aerobics or strength training.

●Drink water before, during and after exercising. But ask your doctor about the right amount if you take diuretics, have kidney disease or heart failure, or have been instructed to limit fluids.

●Stop if you feel dizzy or nauseated, break out in a cold sweat or experience muscle cramps or severe pain in your joints, feet or legs. And get medical attention right away if you have pain in your chest, jaw or neck; unusual shortness of breath; dizziness; or a skipping, racing or thumping heartbeat.

How do I stay motivated?

Choose activities that are fun, and keep track of your progress. Once a month, time how long it takes you to complete the same walk or how much more weight you can lift.

If you don’t feel confident exercising on your own, ask your doctor for a referral to a clinical exercise physiologist or physical therapist who works with people who have your condition. Or look for an exercise class geared to your needs. For example, Fit & Strong (www.fitandstrong.org) is a national program designed for people with arthritis. You can also try online resources such as the National Institute on Aging’s Go4Life site (go4life.niapublications.org).


Weighty issue of diabetes in pregnancy




Diabetes in pregnancy can lead to later health problems for women and their children

WOMEN WHO develop diabetes in pregnancy (officially known as gestational diabetes mellitus or GDM) are at a much greater risk of developing type 2 diabetes and obesity in the future, as are their children.

However, the good news is that GDM is easy to diagnose and treatment is available. Early diagnosis and appropriate intervention reduces a woman’s chances of giving birth to a baby who is predisposed to future obesity and diabetes.

Prof Fidelma Dunne (pictured above) of the Atlantic Diabetes in Pregnancy (DIP) network in Galway University Hospital advises women to plan ahead for their pregnancy by trying to achieve a normal weight for their height, resulting in a normal body mass index (BMI) before conceiving.

“Being overweight or obese before and during pregnancy puts women at very high risk of developing GDM. Another important risk factor for GDM is family history of diabetes.

“Older women are more likely to develop the condition – women are now having children when they are older – obesity and age combined places women at an even higher risk of developing GDM.”

The consultant endocrinologist highlights the huge problem with Irish child-bearing women being overweight and obese.

A recent survey of ante-natal women in the west of Ireland revealed that a staggering 60 per cent were overweight or obese, putting them at a greater risk of developing gestational diabetes.

Despite the fact that there was a 100 per cent increase in the diagnosis of gestational diabetes between 2005-10, according to HSE figures, screening for the condition and diagnosis criteria vary considerably from one part of the State to another.

In fact, Diabetes Ireland estimates that up to 65 per cent of GDM cases go undiagnosed and untreated.

“Gestation diabetes is also known as pre-type 2 diabetes so picking it up has major implications not only for the current pregnancy, but for the children and mothers in the future.

“Type 2 diabetes is seven times more common in women with gestational diabetes than in women without the disease,” Prof Dunne explains.

For the majority of women, GDM usually recedes after the child is born. However, when the Atlantic DIP network screened 5,500 women, they found that 18 per cent continued to have pre-diabetes (a condition where blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes) or type 2 diabetes when they were rescreened within one year of delivery.

When this group was rescreened up to five years post-pregnancy, it was shown that 29 per cent of women had problems with pre-diabetes or had established type 2 diabetes.

Prof Dunne says: “If we were to identify these women with proper screening programmes and treat them early with appropriate interventions, we could ensure the pregnancy had a good outcome and the growth of the baby was kept on target, preventing further problems such as obesity and diabetes in the future.

“In 80 per cent of women, the only intervention required is change to their diet and regular and moderate exercise while 20 per cent need insulin. By normalising the mother’s blood sugar during pregnancy, we can eliminate and reduce potential problems for mother and baby.”

She highlights the need for universal screening of pregnant women as opposed to selective screening which can miss a lot of people. The HSE West applied a universal screening programme which found that 12 per cent of pregnancies in the region were affected by gestational diabetes, similar to international figures.

“With ad hoc screening, a woman could be picked up with GDM at 36 weeks which is too late to intervene. We need to diagnose them between week 24 and 28, ideally, and to start corrective action without delay to ensure the best outcome.”

New findings from the Health Research Board-funded Atlantic DIP project are published in the May issue of the Irish Medical Journal supplement. The researchers have shown that breast feeding appears to reduce the chances of the mother going on to develop diabetes in the first year after birth and this is an area they plan to explore further.

Clinical midwife specialist in diabetes at the National Maternity Hospital, Holles Street, Mary Coffey, advises that women who have had GDM should be re-screened regularly (every one to three years) for diabetes and pre-diabetes.

Follow-up screening usually consists of a simple blood test, she says.

Gestational diabetes mellitus, or GDM, is a type of diabetes that occurs in women when they are pregnant. It is the most common medical problem in pregnant women.

The common risk factors for GDM include a higher age, being overweight, not taking regular exercise, family history of diabetes, having had diabetes during a previous pregnancy and having had a large baby (greater than 9lbs 15oz).

The condition is associated with a seven times greater risk for the mother of developing type 2 diabetes after the birth.

In fact, 30-50 per cent of women diagnosed with GDM will develop type 2 diabetes five years after the birth.

GDM is also associated with the development of hypertension, obesity, high cholesterol, and metabolic syndrome.

GDM is associated with premature births, Caesarean deliveries, large babies, three-times higher likelihood of neo-natal ICU admission, hypoglycaemia and other difficulties during birth.

In the long term, babies born to mothers with uncontrolled GDM are associated with a greater BMI at the age of 16, adolescent metabolic syndrome (high blood pressure, high cardiac risk, and abdominal fat leading to insulin resistance) and type 2 diabetes.

GDM: THE FACTS

In 80% of women, the only intervention required is change to their diet and regular and moderate exercise while 20% need insulin

A recent survey of ante-natal women in the west of Ireland revealed that a staggering 60% were overweight or obese, putting them at a greater risk of developing gestational diabetes

Gestational diabetes mellitus, or GDM, is a type of diabetes that occurs in women when they are pregnant. It is the most common medical problem in pregnant women.

The common risk factors for GDM include a higher age, being overweight, not taking regular exercise, family history of diabetes, having had diabetes during a previous pregnancy and having had a large baby (greater than 9lbs 15oz).

The condition is associated with a seven times greater risk for the mother of developing type 2 diabetes after the birth.

In fact, 30-50 per cent of women diagnosed with GDM will develop type 2 diabetes five years after the birth.

GDM is also associated with the development of hypertension, obesity, high cholesterol, and metabolic syndrome.

GDM is associated with premature births, Caesarean deliveries, large babies, three-times higher likelihood of neo-natal ICU admission, hypoglycaemia and other difficulties during birth.

In the long term, babies born to mothers with uncontrolled GDM are associated with a greater BMI at the age of 16, adolescent metabolic syndrome (high blood pressure, high cardiac risk, and abdominal fat leading to insulin resistance) and type 2 diabetes.


Steep Fall in Death Rates Among Diabetics


Death rates among people with diabetes have declined substantially in recent years, according to a survey conducted by researchers at the Centers for Disease Control and Prevention and the National Institutes of Health.
Since 1997 the C.D.C. has done five surveys of people with and without diabetes, each sampling about 107,000 adults. Compared with the 1997-98 figures, 2006 death rates from cardiovascular disease had declined 40 percent and all-cause mortality had declined 23 percent among people with diabetes, even after the researchers controlled for age and other health factors. Death rates also declined among those who did not have diabetes, but the decline was not as steep.
The study, in the June issue of Diabetes Care, attributes the progress to advances in medical care and self-management.
But every silver lining has a cloud.
“The good thing is that people with diabetes are living longer,” said one of the authors, Sharon Saydah, a senior research scientist with the C.D.C. “But people with diabetes are at risk for a number of complications — cardiovascular disease, lower leg amputations, kidney disease, eye problems, dementia and other kinds of disability. Preventing all of these complications means that we will have greater health care expenses for people living with diabetes.”

To Lower Your Risk of Diabetes, Eat Breakfast



THE FACTS

The benefits of eating a solid breakfast are hard to dispute.

People who skip that all-important first meal of the day, studies show, suffer setbacks in mood, memory and energy levels. They are also more likely to gain weight, in part because of excess eating later in the day. Research on the habits of people taking part in the National Weight Control Registry, a long-running study of successful dieters, for example, shows that about 80 percent eat breakfast daily.

But emerging research suggests another advantage to consistently eating breakfast: a reduced risk of Type 2 diabetes.

In a study published in the current issue of The American Journal of Clinical Nutrition, researchers followed 29,000 men for 16 years, tracking their diets, exercise, disease rates and other markers of health. About 2,000 of the men developed Type 2 diabetes over the course of the study.

Those who regularly skipped breakfast had a 21 percent higher risk of developing diabetes than those who did not. The heightened risk remained even after the researchers accounted for body mass index and the quality of the subjects’ breakfasts.

Other studies have also found a link between skipping breakfast and greater risk of Type 2 diabetes. While it is not clear why the relationship exists, some scientists suspect that a morning meal helps stabilize blood sugar through the day.

Some studies show that consuming a larger proportion of your calories later in the day, especially carbohydrates, has a detrimental impact on blood sugar and insulin levels.

THE BOTTOM LINE

Regularly skipping breakfast may raise the risk of Type 2 diabetes.






Discovery Promises Unique Medicine for Treatment of Chronic and Diabetic Wounds


ScienceDaily (May 28, 2012) — A unique new medicine that can start and accelerate healing of diabetic and other chronic wounds is being developed at Umeå University in Sweden. After several years of successful experimental research, it is now ready for clinical testing.



Behind this new medicine is a group of researchers at the Department of Medical Chemistry and Biophysics who have made the unique finding that the protein plasminogen is a key-regulator that initiates and accelerates wound healing by triggering the inflammatory reaction. Their discovery is now being published in the journal Blood.

“Today we have the knowledge needed to develop a medicine,” says Professor Tor Ny, one of the authors of the article. “The bulk of the preclinical research has been completed, and we have had meetings with the Medical Product Agency to discuss a program for clinical testing.”

Plasminogen is a well-known plasma protein that is produced in the liver and found in all bodily fluids. The Umeå researchers have now re-assessed its role and managed to show that the concentration of plasminogen increases dramatically in and around wounds, which is an important signal to start the inflammatory reaction required for healing. In diabetic wounds the level of plasminogen does not increase in the same way, and this seems to be the reason why these wounds do not heal. In diabetic mice and rats the researchers were able to show that the healing process starts immediately when plasminogen is injected around the wound, which then heals fully.

A cell line for producing plasminogen on a larger scale has also been developed, and the goal is to start clinical testing as soon as funding can be arranged. The researchers have high hopes, as plasminogen is an endogenous protein that can be assumed not to produce side effects.

The need for a biologics for treating chronic wounds is urgent. Diabetic wounds that do not heal are the most severe type of chronic wounds, affecting millions of people annually. Many of the roughly 350 million diabetes patients in the world develop foot ulcers, and in 10-15 million cases this ultimately leads to amputation. Today’s treatment of diabetic wounds consists primarily of traditional wound care, with compresses and bandages; there is no effective medication.

The Umeå researchers are initially concentrating on diabetic wounds, but plasminogen also has great potential for working on other types of wounds. This includes tympanic membrane perforations and periodontitis. Being a pro-inflammatory activator, plasminogen has moreover been shown to be effective in combating antibiotic-resistant bacteria (MRSA).


Story Source:

The above story is reprinted from materials provided by Umeå universitet, via AlphaGalileo.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.



Journal Reference:

Y. Shen, Y. Guo, P. Mikus, R. Sulniute, M. Wilczynska, T. Ny, J. Li. Plasminogen is a key pro-inflammatory regulator that accelerates the healing of acute and diabetic wounds. Blood, 2012; DOI: 10.1182/blood-2012-01-407825


People With Diabetes May Need Earlier Colon Screen



May 22, 2012 -- Should people with diabetes be screened for colon cancer at younger ages than is usually recommended?

That may very well be the case, say researchers who found that people in their 40s with type 2 diabetes are about as likely to have precancerous colon growths called adenomas as people in their 50s without diabetes.

"It's almost as is if having diabetes advances your age by 10 years in this regard," says researcher Susan Hongha Vu, MD, a clinical gastroenterology fellow at Washington University School of Medicine in St. Louis.

If the findings are confirmed in a larger, more robust study, the guidelines should be changed so that people with diabetes start colon cancer screening at age 40, she tells WebMD.

Vu presented the study at the Digestive Disease Week conference in San Diego.

Colon Cancer Screening Guidelines

Current guidelines call for men and women at average risk to undergo regular colon cancer screenings beginning at age 50. Colonoscopy, which allows the doctor to view the entire colon and remove any abnormal growths, is the gold standard. There are several other screening options, though, such as flexible sigmoidoscopy and fecal occult blood tests.

But people at high risk of colon cancer should begin screening earlier, according to the recommendations.

Research suggests diabetes may be another such risk factor, Vu says.

"A lot of studies have shown an association between type 2 diabetes and an increased risk of colon cancer," she says.

"Studies also show that diabetes increases the risk of precancerous lesions in the colon," Vu says.

"But as far as we know, no one had taken the next logical step -- that is, to determine whether people with type 2 diabetes should be screened earlier," she says.

Study: Diabetes Appears to Affect Polyp Risk

So the researchers examined the medical records of three groups of people having a colonoscopy over a six-year period at their institution: 125 people ages 40-49 with type 2 diabetes, 125 people 40-49 without diabetes, and 125 people ages 50-59 without diabetes.

Colonoscopy found at least one precancerous polyp in:

14% of those ages 40-49 without diabetes

30% of those ages 40-49 with diabetes

32% of those ages 50-59 without diabetes

Still, the study does not prove that diabetes causes or directly contributes to polyp growth.

People with diabetes may have other risk factors for adenomas and colon cancer that weren't measured, says John Petrini, MD, a gastroenterologist at the Sansum Clinic in Santa Barbara, Calif.

Vu says there is a possible explanation for a link between diabetes and colon cancer. People with diabetes have abnormally high levels of insulin in their blood, and insulin can fuel the growth of cells, including precancerous and cancer cells, she says.

The findings are intriguing, Petrini says. But until there is a large, well-designed study confirming the finding, it's too early to talk about changing guidelines, he says.

But should people with diabetes in their 40s go in for early screening if they are concerned? They could, Petrini says. But without guidelines, insurers are unlikely to cover the cost of the test -- about $1,000 in the case of colonoscopy, he says.

On the other hand, a person might opt for a less expensive flexible sigmoidoscopy, which is a good way of identifying people who need a full colonoscopy, Petrini says.

About 25 million Americans have diabetes, and that number is expected to double in the next 25 years. Over 1.1 million have colorectal cancer, according to the American Cancer Society.

These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

SOURCES: Digestive Disease Week, San Diego, May 19-22, 2012. Susan Hongha Vu, MD, clinical gastroenterology fellow, Washington University School of Medicine, St. Louis. John Petrini, MD, gastroenterologist, Sansum Clinic, Santa Barbara, Calif.

©2012 WebMD, LLC. All Rights Reserved.










Risk of Dying From Heart Disease,Stroke Drops Significantly

May 22, 2012 -- New research shows that people with diabetes are living longer, and this is likely due to heart-healthy habits and tighter control of blood sugar levels.
Many people may only associate diabetes with vision loss, kidney disease, and limb amputations, but it also increases the risk for heart disease and stroke. From 1996 to 2006, however, the risk of dying from heart disease and stroke decreased by 40% among people with diabetes.
People with diabetes do die earlier than people without diabetes, but this gap appears to be getting smaller.
"This is good news," says researcher Edward W. Gregg, PhD. He is the acting director of the division for heart disease and stroke prevention at the CDC in Atlanta. "We are seeing a reduction in death rates in people with diabetes, and this is largely due to prevention efforts."
Specifically, he cites reductions in blood pressure levels, low density lipoprotein (LDL) or "bad" cholesterol, decreases in smoking, and improved blood sugar control among people with diabetes. "We think it is a gradual improvement of multiple risk factors."
This should be a source of empowerment and motivation for people with diabetes. "We can make a big difference," he says. "People can cut their risk of developing cardiovascular disease in half if they are able to manage their risk factors."
The new study analyzed data on 250,000 adults from 1997 to 2004.
The findings appear in Diabetes Care.
People With Diabetes Living Longer
John Buse, MD, says the future is looking brighter for many people with diabetes. He is the chief of the division of endocrinology at the University of North Carolina, Chapel Hill.
Buse says the new study confirms and expands upon previous reports suggesting a decline in death rates among people with diabetes. "This study demonstrates the trend robustly," he says in an email. "It is clear that the prognosis for people with diabetes is improving."
Others in the field are also excited about the new findings. "This is tremendous, really great news," says Carol J. Levy, MD, CDE. She is an associate professor of endocrinology at the Mount Sinai School of Medicine in New York City. "I am thrilled to see that what we are doing is making a difference."
In addition to better control of blood pressure, cholesterol, and other risks, she says earlier diagnosis of diabetes and many of the new treatments also play a role in the decreasing death rates among people with diabetes.
Abraham Thomas, MD, MPH, is the division head of endocrinology and at diabetes at Henry Ford Hospital in Detroit, Mich. He says the new findings mirror what he is seeing in his practice. "You can control your blood pressure, cholesterol, and glucose, and this can really have a big impact on survival and quality of life," he says. "If you can take care of these things, you can cut down on [your] chance of dying and of developing all these other bad complications."




Gout and Diabetes

Gout and Diabetes

Once termed “the kings’ disease,” gout used to be a problem primarily for wealthy people and royalty who lounged around drinking wine and eating rich food. But today, an estimated 68% of American adults are either overweight or obese. As a result, gout and type 2 diabetes -- two diseases that can result from an unhealthy lifestyle -- are sharply on the rise.
Gout is an arthritic condition caused by having an excess buildup of uric acid. It causes sudden, extreme attacks of pain, swelling, and redness. Gouty arthritis most often strikes the big toe, but it also can show up in the feet, ankles, knees, hands, and wrists.
Type 2 diabetes, a disease characterized by high levels of sugar in the blood, also can result from eating too much and moving too little.
Gout and type 2 diabetes often co-exist in people with common physical characteristics and conditions, the most prominent being obesity.
“A lot of the risk factors for type 2 diabetes are the same for gout,” says Michele Meltzer, MD, an assistant professor of medicine at Thomas Jefferson Hospital in Philadelphia who specializes in gout. By changing these risk factors, you can help prevent or fight both diseases.

Here’s what you can do:
• Lose weight. “We are digging our graves with our forks in this country,” says John D. Reveille, MD, director of the division of rheumatology at UT Health Medical School in Houston. To prevent gout, type 2 diabetes, and a host of other health problems, he says you should keep a close eye on your body mass index (BMI) and waist circumference. According to the National Institutes of Health, waist size becomes very important when a person’s body mass index (BMI) is between 25 and 34.9. A BMI over 25 is considered overweight, and a BMI greater than 30 is considered obese. Keep your waist size below 35 inches if you are a woman and 40 inches if you are a man.
• Exercise regularly. Regular exercise will help control weight and lower high blood pressure, both of which will lower your uric acid level and therefore lessen your chance of developing gout. “Plus, it’s well documented that exercise improves the glucose intolerance associated with type 2 diabetes,” Reveille says. He recommends 30 minutes of moderate activity, at least five days a week. If you're having an acute gout attack or have damaged joints from weight issues, some activities may be difficult. Talk to your health care provider about the best exercise plan for you.
• Skip the alcohol. A landmark study done by researchers at Massachusetts General Hospital examined the connection between drinking beer and gout. They found that people who drank two to four beers per week were 25% more likely to develop gout. And those who averaged at least two beers a day had a 200% higher risk. “Beer and hard liquor appear to cause a rise in uric acid levels,” Meltzer says. The same doesn't appear to be true with wine, however. Binge drinking is also a very strong risk factor for gout. “Plus, people who eliminate their two beers a day drop weight very quickly, which lowers risk of type 2 diabetes. So you get a two-for-one by cutting out the beer,” she says.
• Avoid sugar-sweetened beverages. Early research suggests that beverages sweetened with sugar or high-fructose corn syrup, such as regular soft drinks, may increase the chances of developing gout. Even orange juice may increase gout. Eliminating sugary beverages is also a great way to cut calories from your diet, shed a few pounds, and improve your diabetes.
• Go on a gout diet. A gout diet aims to control uric acid production by reducing intake of foods high in purines. High-purine foods create increased levels of uric acid in the body. Some of the worst high-purine foods are liver and other organ meats, as well as anchovies. Other foods to avoid include lobster, shrimp, scallops, herring, mackerel, beef, pork, and lamb. Don't worry about cutting out purines completely. Just eat these foods in moderation: No more than one serving daily.
• Eat more dairy.Some studies have shown that drinking skim or low-fat milk or eating low-fat dairy products can help reduce risk of gout, Meltzer says. There is evidence that eating low-fat dairy helps lower risk of type 2 diabetes as well. Aim for 16 to 24 fluid ounces of dairy per day.



 










City of Hope researchers develop potential cure for advanced type 1 diabetes in laboratory

City of Hope researchers develop potential cure for advanced type 1 diabetes in laboratory

DUARTE, Calif., May 10, 2012 /PRNewswire via COMTEX/ -- New combination therapy approach may have possible application in other autoimmune diseases

City of Hope researchers developed a combination therapy to treat late-stage type 1 diabetes that appears to offer a potential lifetime cure for the disease without toxic side effects. The laboratory study is published in the May 9 edition of Science Translational Medicine.

"Our findings indicate that it is possible to cure late-stage type 1 diabetes by stopping autoimmunity and regenerating insulin-secreting beta cells," said Defu Zeng, M.D., associate professor in the Division of Diabetes, Endocrinology & Metabolism and Department of Hematology & Hematopoietic Cell Transplantation, City of Hope.

Type 1 diabetes is an autoimmune disorder that affects 20 million people worldwide. In a person with type 1 diabetes, immune cells mistakenly attack and kill the person's own insulin-producing islet cells. Individuals can take insulin to manage diabetes for many years, but many develop cardiovascular problems over the long term. A few types of treatments have reversed new-onset diabetes in the lab, but no treatment except islet cell transplantation has been effective for late-stage diabetes. Islet cell transplants are not easily available, nor last longer than an average of 3 to 5 years.

Other developing therapies for type 1 diabetes either target the autoimmune condition or look to replace the destroyed islet cells, but not both together. Studies have demonstrated only limited success with these approaches, because correcting only one problem lets the other problem continue.

"While transplanting islet cells from another person can provide insulin independence, the effect lasts only about three years due to chronic rejection of the graft cells," said Zeng, the study's principal investigator. "Additionally, there is a shortage of islet donors."

The research team's strategy strives to both block the autoimmunity to prevent continued destruction of islet cells, and to stimulate the growth of new islet cells to restore healthy insulin regulation. The combination therapy begins with timed doses of anti-CD3 and anti-CD8 antibodies that specially target the host T cells followed by an infusion of donor bone marrow to induce mixed chimerism in the patient.

Mixed chimerism is a condition in which a patient's immune system is made up of both the patient's own cells as well as new cells from the donor bone marrow. The patient's defective immune cells are replaced by the healthy cells, stopping the autoimmune condition. Unlike traditional bone marrow transplants, this approach does not require radiation or high-dose chemotherapy.

Because type 1 diabetic patients with chronic, unresponsive disease often have too few functional islet cells left to regenerate healthy cells, the researchers follow up the mixed chimerism with growth hormones that can augment the beta cells regeneration from progenitors as well as stimulate the remaining islet beta cells to expand via replication, reestablishing normal insulin production and management.

"We have shown that conditioning with our anti-CD3-based regimen allows for induction of mixed chimerism with no signs of graft-versus-host disease in late-stage diabetes lab models," said Zeng. "We have also shown that combination therapy of mixed chimerism with administration of growth hormone is able to reverse late-stage diabetes, although either alone cannot."

Zeng and his team were able to reverse late-stage type 1 diabetes in lab mice through this strategy, not only halting the autoimmune process, but also helping new islet cells grow. As a result, diabetes was reversed in 60 percent of the diabetic mice that received the experimental therapy, while none of the control mice recovered from their disease, said Miao Wang, M.D., Ph.D., first author of the study and a postdoctoral research fellow in Zeng's lab. The mice that received the therapy had 10 times higher islet cell mass, three times higher insulin levels and improved insulin sensitivity and islet cell survival compared to the untreated mice.

Zeng is pursuing additional preclinical studies of the combination therapy, with the goal of gaining approval for human clinical trials.

The collaborative study also included researchers from the University of Florida Diabetes Center of Excellence in Gainesville, Fla., University of Florida College of Medicine in Gainesville, Fujian Institute of Hematology at Fujian Medical University Union Hospital in Fuzhou, China, and Nanfang Hospital at Southern Medical University in Guangzhou, China.

About City of HopeCity of Hope is a leading research, treatment and education center for cancer, diabetes and other life-threatening diseases. Designated as a comprehensive cancer center, the highest honor bestowed by the National Cancer Institute, and a founding member of the National Comprehensive Cancer Network, City of Hope's research and treatment protocols advance care throughout the nation. City of Hope is based in Southern California and is ranked as one of "America's Best Hospitals" in cancer by U.S.News & World Report. Founded in 1913, City of Hope is a pioneer in the fields of bone marrow transplantation and genetics. For more information, visit www.cityofhope.org or follow City of Hope on facebook, twitter, youtube or flickr.

CONTACT:Shawn LePhone: 800-888-5323sle@coh.org

SOURCE City of Hope

Black Licorice Found to Fight Diabetes

Black Licorice Found to Fight Diabetes

The cure for diabetes might be ... candy?

Scientists have discovered that licorice root, the raw material for licorice candy, may be effective in treating Type 2 diabetes, the Atlantic reports.

A research team at the Max Planck Institute for Molecular Genetics in Berlin, has identified a group of natural substances in licorice root called amorfrutins. Using a mouse model, the scientists found that amorfrutins reduce blood sugar levels and inflammation that would otherwise be present in the mice suffering from diabetes. As an added bonus, ingesting the amorfrutins prevented the development of a fatty liver, a common side effect of diabetes and an excessively fat-rich diet.

The scientists also discovered that the amorfrutin molecules bind to a nuclear receptor that plays an important role in fat and glucose metabolism by activating various genes that reduce the concentration of fatty acids and glucose in the blood. The reduced glucose level actually prevented the development of insulin resistance in the mice -- blocking the main cause of Type 2 diabetes.

There are already drugs on the market that activate that receptor, but many of them have side effects such as weight gain and cardiovascular problems. Amorfrutins activate the receptor without side effects.

There's just one problem -- a person couldn't eat enough licorice whips to get the amount of amorfrutin required for beneficial effects. So the scientists are looking for a way to extract the substance so that it can be concentrated and mass-produced.

"The amorfrutins can be used as functional nutritional supplements or as mild remedies that are individually tailored to the patient," Sascha Sauer, lead investigator of the study and head of the Otto Warburg Laboratory at the Max Planck Institute, told the Atlantic. The study was published online in the journal Proceedings of the National Academy of Sciences USA on April 16.

The next step for the scientists will be testing the efficacy of the amorfrutin extracts in clinical studies on diabetes patients. Diabetes patients are in dire need of a new drug after a pair of drugs currently on the market, Avandia and Actos, were recently restricted by the FDA after they were linked to heart failure and stroke. And, while there are drugs available to control the condition, there are no treatments for Type 2 diabetes that halt the disease's progression.

Licorice root has been used to heal since ancient times. Certain forms have been shown to calm the digestive system and ameliorate respiratory ailments. Studies also have shown it can help prevent tooth decay and gum disease and that it has antibacterial and antiviral properties. Because of all of its beneficial effects, licorice root has been dubbed the "Medicinal plant of 2012." Awesome.

(Disclaimer: If you want to experiment on yourself, make sure your licorice candy actually contains licorice root extract, not the similarly flavored anise oil. And be aware that it can interact with certain medications if you eat too much of it.)


A cure for Type-2 Diabetes?




Dr. Paul Singh is performing gastric bypass surgery at Albany Medical Center a procedure he's done countless times.

He'll re-route the patient's digestive system and create a smaller stomach pouch; resulting in dramatic weight loss over the next few months.

But almost immediately after surgery - and for reasons that aren't completely clear, if the patient has type 2 diabetes it will disappear - they'll be cured.

It may be because after the surgery food bypasses the first part of the intestine, the duodenum.

“There are thoughts that hormones released through the duodenum make diabetes worse or problematic,” says Dr. Paul Singh.

The results, based on a study appearing in the New England Journal of Medicine, are so impressive, 58 year old Mark French decided to have the surgery. He's the patient Dr. Singh was operating on.

It's not that French can't lose weight - he can. But like most of us, he can't keep it off. After battling type 2 diabetes for years, his health was beginning to suffer.

”Swelling of the ankles, shin infections in the calf,” says Mark French.

He's hoping his results are as impressive as Ken Springer's a 43 year old Troy man.

At 6-3, Ken is a towering presence. But if you measure him around the middle he's half the man he used to be when he weighed 490 pounds. That was before bariatric surgery in January 2011.

“I lost 60 pounds in 70 days,” Ken Springer says.

Today he weighs 230 pounds but as importantly, his type 2 diabetes resolved 5 months after his procedure.

But that's not the end of his story. He's quick to tell you he's committed to living a healthier lifestyle and regularly attends a support group at Albany Med where he had his surgery.

That's the prescription Dr. Mark Fruiterman would write. He's an endocrinologist who treats diabetes patients. He says bariatric surgery should be the last resort and without lifestyle changes, all the good can be undone.

According to Dr. Mark Fruiterman, “The return to obesity is not rapid. What I've seen is it takes maybe 5, 6, 7 years, slowly, over time. 3 lbs here, 5 pounds there.”

And as Dr. Fruiterman points out, there's a genetic component to developing type 2 diabetes that excess weight, age and sedentary lifestyle, triggers.

This brings us back to Ken. “I still have eating issues. I still have issues if it's there I want it. I have to watch everything I eat,” he says.

As for Mark French, his diabetes resolved a few days after surgery.

“Now he needs to commit to the long term changes he's going to need to make,” say Dr. Singh. “And if he commits to those and if he does that then you're looking at a resolution of his diabetes starting this week and continuing on for the rest of his life.”

Coffee shown to prevent brain damage in diabetics, protect against memory loss


Mice that chugged coffee lost weight, lowered blood sugar levels and had remembered more



Researchers in Portugal have found that the consumption of caffeine could protect against memory loss associated with advanced diabetes.

It's an area of study that's not well developed, say scientists from the University of Coimbra: how badly managed type 2 diabetes -- which accounts for 90 percent of all diabetic cases in the world -- affects the brain, causing memory loss and learning problems.

After observing the effects of type 2 diabetes in mice, researchers found that the neurodegeneration caused by the chronic illness exhibited the same stages of several other neurodegenerative diseases like Alzheimer's and Parkinson's.

For their study, released this week and published on PLoS One, researchers compared four groups of mice: diabetics, normal, with and without caffeine.

The results showed that pumping caffeine -- equal to eight cups of coffee a day -- in the diabetic mice accomplished several things: reduced weight gain, lowered blood sugar levels and prevented memory loss specifically in the hippocampus, an area of the brain that often atrophies in diabetics.

Mice with type 2 diabetes exhibited abnormalities in their synapses which facilitates communication between neurons, and astrogliosis, a phenomenon in which there's an abnormal increase of cells surrounding neurons.

But mice fed a diet high in caffeine fared better than their counterparts suffering from less brain damage, a finding that could have wider implications in the treatment of other cognitive diseases like Alzheimer's and dementia.

Despite the findings, researchers stopped short of advising people to drink eight cups of coffee a day.

Said researcher Rodrigo Cunha in a statement: "Indeed, the dose of caffeine shown to be effective is just too excessive. All we can take from here is that a moderate consumption of caffeine should afford a moderate benefit, but still a benefit."

Meanwhile, a 2010 study also found that caffeinated products like coffee and tea could likewise help prevent the onset of diabetes, after the mice in the their experiment developed better insulin sensitivity and lower blood sugar levels.

Could eating fast increase diabetes risk?


 TUESDAY, May 8 (HealthDay News) -- Eating too quickly may raise your risk of diabetes, a small, preliminary study suggests.

Researchers from Lithuania compared 234 people with type 2 diabetes and 468 people without the disease and found that those who gobble down their food were 2.5 times more likely to have diabetes than those who take their time while eating.

Study participants with diabetes also were more likely to have a higher body-mass index (a measurement of body fat based on height and weight), and to have much lower levels of education than those without diabetes, the researchers said.

The findings were set for presentation this week at the joint International Congress of Endocrinology and European Congress of Endocrinology in Florence, Italy.

"The prevalence of type 2 diabetes is increasing globally and becoming a world pandemic," study leader Lina Radzeviciene, of the Lithuanian University of Health Sciences, said in a European Society of Endocrinology news release. "It appears to involve interaction between susceptible genetic backgrounds and environmental factors. It's important to identify modifiable risk factors that may help people reduce their chances of developing the disease."

Although the study found an association between eating fast and incidence of diabetes, it did not prove a cause-and-effect relationship.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about diabetes risk factors.


Black Women and Fat


Opinion

Black Women and Fat

By ALICE RANDALL

Published: May 5, 2012

FOUR out of five black women are seriously overweight. One out of four middle-aged black women has diabetes. With $174 billion a year spent on diabetes-related illness in America and obesity quickly overtaking smoking as a cause of cancer deaths, it is past time to try something new. What we need is a body-culture revolution in black America. Why? Because too many experts who are involved in the discussion of obesity don’t understand something crucial about black women and fat: many black women are fat because we want to be.

The black poet Lucille Clifton’s 1987 poem “Homage to My Hips” begins with the boast, “These hips are big hips.” She establishes big black hips as something a woman would want to have and a man would desire. She wasn’t the first or the only one to reflect this community knowledge. Twenty years before, in 1967, Joe Tex, a black Texan, dominated the radio airwaves across black America with a song he wrote and recorded, “Skinny Legs and All.” One of his lines haunts me to this day: “some man, somewhere who’ll take you baby, skinny legs and all.” For me, it still seems almost an impossibility.

Chemically, in its ability to promote disease, black fat may be the same as white fat. Culturally it is not.

How many white girls in the ’60s grew up praying for fat thighs? I know I did. I asked God to give me big thighs like my dancing teacher, Diane. There was no way I wanted to look like Twiggy, the white model whose boy-like build was the dream of white girls. Not with Joe Tex ringing in my ears.

How many middle-aged white women fear their husbands will find them less attractive if their weight drops to less than 200 pounds? I have yet to meet one.

But I know many black women whose sane, handsome, successful husbands worry when their women start losing weight. My lawyer husband is one.

Another friend, a woman of color who is a tenured professor, told me that her husband, also a tenured professor and of color, begged her not to lose “the sugar down below” when she embarked on a weight-loss program.

And it’s not only aesthetics that make black fat different. It’s politics too. To get a quick introduction to the politics of black fat, I recommend Andrea Elizabeth Shaw’s provocative book “The Embodiment of Disobedience: Fat Black Women’s Unruly Political Bodies.” Ms. Shaw argues that the fat black woman’s body “functions as a site of resistance to both gendered and racialized oppression.” By contextualizing fatness within the African diaspora, she invites us to notice that the fat black woman can be a rounded opposite of the fit black slave, that the fatness of black women has often functioned as both explicit political statement and active political resistance.

When the biologist Daniel Lieberman suggested in a public lecture at Harvard this past February that exercise for everyone should be mandated by law, the audience applauded, the Harvard Gazette reported. A room full of thin affluent people applauding the idea of forcing fatties, many of whom are dark, poor and exhausted, to exercise appalls me. Government mandated exercise is a vicious concept. But I get where Mr. Lieberman is coming from. The cost of too many people getting too fat is too high.

I live in Nashville. There is an ongoing rivalry between Nashville and Memphis. In black Nashville, we like to think of ourselves as the squeaky-clean brown town best known for our colleges and churches. In contrast, black Memphis is known for its music and bars and churches. We often tease the city up the road by saying that in Nashville we have a church on every corner and in Memphis they have a church and a liquor store on every corner. Only now the saying goes, there’s a church, a liquor store and a dialysis center on every corner in black Memphis.

The billions that we are spending to treat diabetes is money that we don’t have for education reform or retirement benefits, and what’s worse, it’s estimated that the total cost of America’s obesity epidemic could reach almost $1 trillion by 2030 if we keep on doing what we have been doing.

WE have to change. Black women especially. According to the Centers for Disease Control and Prevention, blacks have 51 percent higher obesity rates than whites do. We’ve got to do better. I’ve weighed more than 200 pounds. Now I weigh less. It will always be a battle.

My goal is to be the last fat black woman in my family. For me that has meant swirling exercise into my family culture, of my own free will and volition. I have my own personal program: walk eight miles a week, sleep eight hours a night and drink eight glasses of water a day.

I call on every black woman for whom it is appropriate to commit to getting under 200 pounds or to losing the 10 percent of our body weight that often results in a 50 percent reduction in diabetes risk. Sleeping better may be key, as recent research suggests that lack of sleep is a little-acknowledged culprit in obesity. But it is not just sleep, exercise and healthy foods we need to solve this problem — we also need wisdom.

I expect obesity will be like alcoholism. People who know the problem intimately find their way out, then lead a few others. The few become millions.

Down here, that movement has begun. I hold Zumba classes in my dining room, have a treadmill in my kitchen and have organized yoga classes for women up to 300 pounds. And I’ve got a weighted exercise Hula-Hoop I call the black Cadillac. Our go-to family dinner is sliced cucumbers, salsa, spinach and scrambled egg whites with onions. Our go-to snack is peanut butter — no added sugar or salt — on a spoon. My quick breakfast is a roasted sweet potato, no butter, or Greek yogurt with six almonds.

That’s soul food, Nashville 2012.

I may never get small doing all of this. But I have made it much harder for the next generation, including my 24-year-old daughter, to get large.

Alice Randall is a writer in residence at Vanderbilt University and the author of “Ada’s Rules.”