Diabetes News for Jan. 14, 2001

Glucose Levels May Predict Risk Of Heart Disease

There are several well-known causes of heart disease, including high weight, cholesterol, and high blood pressure. However, a new study suggests that high blood sugar levels may also be a strong predictor of heart disease.

The study, which is published in the British Medical Journal (volume 322; pages 15-18; January 6, 2001), was conducted by researchers at the University of Cambridge in the UK. Over 4,600 men between the ages of 45 and 79 participated in the study.

Results indicated that men with Type 2 diabetes were twice as likely to die of all causes as men without diabetes. The men with diabetes were over three times as likely to die from heart disease. As blood glucose levels increased, so did the risk of dying. Men without diabetes who had high glucose levels also had a higher risk of death.

The researchers hope that their findings will encourage people to become more aware of their glucose levels, and make modifications in diet and exercise as needed in order to prevent heart disease and other complications. Medications that aid in the reduction of blood pressure and cholesterol levels have already been shown to lower mortality in those with Type 2 diabetes, and should be sought out for their health benefits in anyone with elevated blood pressure or cholesterol.

Obesity In Children Linked To Heart Disease

It is well-known that obesity can contribute to may health problems. A new study suggests that childhood obesity may lead to problems in adulthood, even if the adult is not obese.

The study was led by researchers from Vrije University in Amsterdam, and is published in the January 2001 issue of the journal Pediatrics. It included 3,561 children from America between the ages of 8 and 16. Researchers found that overweight children were three to five times more likely than peers of lower weight to have inflammation in the bloodstream due to the presence of C-reactive protein.

Although the study did not demonstrate whether this inflammation leads to short- or long-term health problems, previous research has shown a link between high levels of C-reactive protein in overweight adults with the development of heart problems. Previous research has also indicated that elevated levels of C-reactive protein may be due to inflammation of arteries that are trying to break down plaque and fat build-up within blood vessels.

Further research is needed to determine whether childhood obesity leads to adult heart complications, and whether or not elevated levels of C-reactive protein or excess inflammation is the cause of this.

Surgeon General's Obesity Plan

In order to combat the growing problem of obesity in America, Surgeon General David Satcher has announced the beginning stages of a national plan that will involve schools, work sites, and medical clinics. According to the National Center for Health Statistics, over 60% of American adults over the age of 20 were overweight or obese in 1999. The Department of Health and Human Services has already begun to have meetings of health experts in order to come up with a national plan of action to deal with obesity. Satcher will remain Surgeon General until February 2002, and will continue to work on this national plan when the next administration takes office.

Supplement May Decrease Fat And Build Muscle

Because the rate of obesity in the American population has reached epidemic proportions, doctors are seeking new ways of helping people lose weight in healthy ways. A new method may be taking a supplement of conjugated linoleic acid (CLA).

Conjugated linoleic acid is a fatty acid that is found in dairy products, beef, poultry, and eggs. However, it occurs in these foods in very small amounts. The study involved much larger doses of CLA in the amount of 3.4 grams per day. The study was led by researchers from Scandinavian Clinical Research in Norway, and 47 participants completed it.

Study results, which are published in The Journal of Nutrition (volume 130, pages 2943-2948, December 2000), indicate that participants lost body fat and gained muscle mass, a desireable result in almost any overweight person. Although no overall weight-loss was evident, levels of LDL ("bad") cholesterol were reduced. Side-effects included nausea, but researchers speculate that this may in part be due to the fact that participants were required to take twelve pills per day. Lowering the amount of pills may reduce side effects.

However, more research is needed before doctors can prescribe CLA as a weight-loss method, as not all research results have been promising. For instance, researchers at the National Institute of Health and Nutrition in Japan found that CLA supplementation in mice did cause fat cell death, but it did so by raising Tumor Necrosis Factor levels 12 times above normal levels (Diabetes 2000 Sep; 49(9): pg. 1534-42). TNF has been closely linked to insulin resistance and elevated levels are found in Type 2 diabetes. In this mice study, insulin levels rose, indicating increased resistance to insulin, and leptin levels fell, which is also worrisome in that this drop is associated with obesity. Other studies have raised concerns about the possibility of liver damage associated with the use of CLA.

Insulin Comparison Study

For people with Type 1 diabetes, taking insulin is often a way of life. Of course, there are different methods of injecting insulin, and different types to use. A recent study compared two of these types.

The study was conducted by Aventis Pharmaceuticals, which manufactures the insulin Lantus. Lantus is a long-acting basal form of insulin that can be taken once a day with much more stable insulin levels than current long-acting insulins. It is approved for use by children or adults with Type 1, and adults with Type 2 who need basal insulin to control hypoglycemia. However, due to the time it takes to increase manufacturing, supplies will not be available until the summer of 2001. 

This study lasted for 16 weeks, and was conducted at 60 sites in the US and Canada. Participants were between the ages of 18 and 80, and all had Type 1 diabetes. The participants all received either NPH or Lantus as a basal treatment, and lispro was used to cover meals. Researchers then compared the effects of the insulin treatment on fasting glucose, glucose variability, HbA1c levels, and occurrence of hypoglycemia.

Results of the study, which are published in the November issue of Diabetes Care, indicate that Lantus is associated with lower levels of fasting blood glucose compared to NPH. With Lantus, a decrease in the variability of glucose levels was seen. NPH and Lantus were similar in respect to HbA1c levels, and both had a low incidence of hypoglycemia. However, a few more people taking Lantus experienced pain in the injection site than those taking NPH, although the pain was mild and did not cause anyone to discontinue participation.

Grant For Peripheral Nerve Dysfunction Drugs

One of the more painful complications that can occur with diabetes is that of peripheral nerve dysfunction. This can lead to problems with movement, as well as chronic burning pain in the extremities. Recently, the National Institute of Neurological Diseases and Stroke of the National Institutes of Health awarded a Small Business Innovation Research (SBIR) grant to Cambridge NeuroScience, Inc. to develop drugs to treat the disorder.

Cambridge NeoroScience will focus on small molecule drugs that block potassium channels, as the company believes that these will effectively treat the painful symptoms of peripheral nerve damage. The grant the company received could total $860,000.