Diabetes News - January 2, 2000

Key Factor For Blood Vessel Growth Discovered

In many diseases, blood vessels are blocked or destroyed, resulting in reduced blood flow and low oxygen levels. A new family of growth factors called Angiopoietin may provide a key to revealing the process of blood vessel growth and repair. Discovered by a collaboration of scientists at Regeneron Pharmaceuticals, Inc. and the University of California at San Francisco, these growth factors could greatly improve health by increasing blood flow and repairing blood vessels in diseases that have blocked or destroyed vessels.

Reduced blood flow in the heart can leads to angina and heart attacks, while in the limbs it leads to slow healing and muscle pain. In the presence of other diseases, blood vessels may become damaged and start to leak, leading to swelling or edema. Swelling and vessel leakage occur in many inflammatory situations, such as diabetic eye and kidney disease. Edema is found in arthritis, asthma, and strokes.

To counter this damage, scientists have sought to grow new blood vessels in a process called therapeutic angiogenesis, with the aim to bypass or fix leaky and defective vessels. Vascular Endothelial Growth Factor, or VEGF, the first growth factor found to stimulate the growth of blood vessels, was discovered about twenty years ago.

Unfortunately, VEGF is found at high levels in diseases like diabetic eye and kidney disease, where the body is attempting to grow new blood vessels. Unfortunately, the new vessels formed in the presence of just VEGF are leaky and fragile. Reduction of VEGF is one way to prevent compounding the damage in this situation through the use of laser treatments, ACE inhibitors, and possibly high dose vitamin E.

This is where Angiopoietins come in. The body normally uses this second group of growth factors in combination with VEGF to mature the blood vessels that VEGF has grown.

In their current paper in Science, the Regeneron and UCSF scientists report animal experiments that show that VEGF and Angiopoietin-1 combine to promote better vascular growth than either factor alone. Therapeutic angiogenesis seems to require coordinated use of both VEGF and Angiopoietin-1 to allow vessel maturation and avoid some of the blood vessel defects observed in studies using only VEGF.

Studies like these are anticipated to lead to better therapies for coronary heart disease, peripheral vascular disease, and possibly to better interventions for diabetic eye and kidney disease. If all goes well, heart bypass operations and amputations will become a thing of the past.

New Animation About Insulin Resistance

SmithKline Beecham has a new Flash animation of how Insulin Resistance develops, as well as how glitazone medications like their Avandia and Lilly's Actos work. For a cool view of Type 2 diabetes check out their web site. You'll need to download Macromedia's free Flash Plug-in to view the animation.

Regular Exercise Prevents Diabetes In Women

Regular exercise for postmenopausal women cuts their risk of diabetes in half, according to new research from Dr. Aaron Folsom and his colleagues at the University of Minnesota in Minneapolis.

In their report in the American Journal Of Public Health the authors suggest that gaining weight reduces exercise's benefits because it is a stronger contributor to the development of diabetes.

NIH Seeks Participants For DPT-1 Study

Researchers financed by the National Institutes of Health are still seeking to screen an additional 30,000 relatives of people who have Type 1 diabetes. This screening will pick up the last 300 people needed to finalize the Diabetes Prevention Trial-1 study designed to prevent Type 1 diabetes. The study will answer whether insulin, taken either by injection or in an experimental pill form will protect people against diabetes. It may seem odd to inject insulin to prevent diabetes, but it is much clearer to those who already have Type 1 and experience wide swings in their blood sugars because they have no insulin producing cells left.

The study began in 1995, and now has 500 of the 800 people needed for completion. Screening is done with blood tests which detect islet cell antibodies that are produced years before the beta cells that produce insulin are totally destroyed. Over 95% of those screened have no antibodies and leave with this happy news.

But those who have these dangerous antibodies can then choose additional testing which measures pancreatic function and another gene that protects against diabetes. Once these tests are done, their risk of developing diabetes within the next five years can be estimated. Those whose risk is over 50 percent may enroll in the injection part of the study which is believed to provide the best protection. Those whose risk is 25 to 50 percent may choose to enroll in another part of the study, where participants swallow either an experimental insulin pill or a dummy pill every day.

Researchers are hoping to complete enrollment in the next few months, and know some time in 2002 whether insulin shots help prevent diabetes, and in 2004 whether the experimental insulin pills have any effect. If you have family members who desire screening or are a family member of someone with Type 1 diabetes, contact the American Diabetes Association DPT-1 Site to find a participating clinic near you. 

Preventing CVD Would Add 7 Years To Life

Lifespan in the US could be increased by nearly 7 years if heart and blood vessel disease could be eliminated, according to an American Heart Association, at a cost savings of over 300 billion dollars. Cardiovascular disease currently kills 41% of the US population, with more women dying each year of this than the next 14 causes combined. Women are more likely than men to die from their first heart attack, and over twice as many women die from stroke each year than breast cancer. The AHA report is called 2000 Heart and Stroke Statistical Update, also stresses hgih blood pressure as a cause of stroke, especially among African Americans. This group has one of the world's highest rates of high blood pressure, which is a major risk factor for stroke. Blacks face a death rate that is twice as high as whites from stroke, and they are four times as likely to develop kidney failure due to high blood pressure.