Diabetes News for Jan. 20, 2002

Diabetes Treatment Trial To Begin

A new treatment that has been shown to reverse diabetes in lab animals is now being tested on humans, and researchers hope this is a step toward a cure for the disease.

The trial is being led by Dr. Aaron Vinik, a neurologist and diabetes specialist from the Strelitz Diabetes Institutes at Eastern Virginia Medical School. Participants in the study will be given the Islets Neogenesis Associated Protein (INGAP) Peptide, which assists in the growth of insulin-producing cells in the pancreas. The treatment was found to increase insulin levels and lower glucose levels in some animals with diabetes, with a few animals having normal blood sugars for a few days after discontinuing insulin.

The researchers showed their results to the U.S. Food and Drug Administration in July in order to get permission to test INGAP on people. They were given approval in September. Now, sixty-two people between the ages of 18 and 65 with insulin-dependent diabetes are beginning to be tested. The study is being conducted at the Texas Diabetes Institute at the University of Texas at San Antonio, the Diabetes Care Center at The University of North Carolina at Chapel Hill, and the MedStar Research Institute in Washington.

Although only a limited amount of work has been done with animals, researchers are hopeful that the trial will be successful, and that more people will be allowed to participate in further studies. If all goes well, researchers say that it's possible that the drug could be on the market within ten years. It's also possible that the drug could help people with Type 2 diabetes who need more beta cell activity, also.

HbA1c: Screening For Diabetes

Although diabetes affects millions of Americans and is a fairly widely-known disease, there are still many people who have the disease and aren't aware of it. New research shows that a diabetes screening test might be an effective way of diagnosing the disease early enough to take preventative measures.

Researchers at the Durham Veterans' Affairs Medical Center in Durham, N.C. recently conducted a study involving 1,253 men between the ages of 45 and 64. These men made regular visits to the medical center for medical reasons but had never been diagnosed with diabetes. Study participants were given the hemoglobin A1c (HbA1c) test. This is typically given to people who already have diabetes as a treatment assessment tool, because it shows blood sugar levels over the past three months. Those study participants who appeared to have symptoms of diabetes were given a blood glucose test, which is more sensitive than the HbA1c test, and measures blood sugar levels at the time of the test only.

The researchers found that 4.5% of the participants had undiagnosed diabetes, which is about the same percentage of men in the 45-64 age group who are aware they have diabetes. Their findings revealed three primary risk factors for undiagnosed diabetes. These included hypertension, obesity, and a family history of diabetes. None of the participants without these risk factors had diabetes. The researchers also found that 61% of the people diagnosed with diabetes had to be treated for hypertension and high cholesterol.

This study has been published in the Journal of General Internal Medicine (volume 17, pages 1-7, January 2002). Researchers emphasize that early diagnosis makes it easier to treat the disease, and can even delay its progress.

Gene Linked To Fat Production

Because obesity is a problem for a growing number of people around the world, some researchers are focusing on ways to prevent it, while other researchers are trying to prevent the problems associated with obesity, such as those cause by high fat and cholesterol levels in the blood. A new study on the genetic reasons for the disease shows promise.

The study was conducted by researchers at Sankyo Co. in Tokyo, and is reported in the advance online edition of Nature Genetics (10.1038/ng814; February 2002). The researchers studied groups of obese mice, and discovered one obese strain that has very low blood-fat levels. These particular mice were found to have a lower activity of angiopoietin-like protein 3 (Angptl3), which appears to control the metabolism of blood fats.

Angiopoietins are proteins that normally act as a catalyst for blood vessel growth, but Angptl3 appears to be an exception. When researchers gave the Angptl3 gene or protein to the low-fat mice, their blood fats went up. The researchers believe that by studying Angptl3, they may develop treatments for problems created by high blood fat levels, such as heart disease.

Baby Aspirin Lowers Heart Trouble

Many people who have had a heart attack or stroke are prescribed daily aspirin to thin the blood in order to prevent a second attack. However, new research shows that people at high risk for these cardiovascular problems may benefit from the small amount of aspirin available in a daily dose of baby aspirin.

Researchers from Oxford University in England have evaluated the results of 287 studies involving more than 200,000 people who were prescribed aspirin as a preventative measure. Ordinarily, people who have not had a heart attack or stroke but are at risk, such as people with diabetes, chest pain, irregular heart beat, and diseased leg arteries, are not prescribed aspirin. However, the research shows that doctors should consider prescribing 75-150 milligrams of aspirin to these people. This is the dose that is found in baby aspirin.

The researchers have published their review in the British Medical Journal (volume 324, page 7330, 133B, January 19, 2002). They stress that people should not take aspirin on a daily basis if their risk of having a heart attack or stroke is smaller than the risk of internal bleeding as a result of the aspirin.

Smoking Increases Cataract Risk

Research has shown many valid reasons for quitting smoking to improve health. A new study shows that vision preservation may also be a good motivating factor.

The latest issue of the American Journal of Epidemiology (volume 155, pages 72-79, January 2002) includes a study authored by researchers at Harvard School of Public Health in Boston, Massachusetts. These researchers reviewed the medical records of over 100,000 male and female health professionals who participated in two major health studies that began in 1976 and 1986.

Study of the medical records revealed the trend that smokers had a higher risk of developing cataracts, and that that risk increased in proportion to the number of cigarettes smoked per day. People who quit smoking lowered their risk of cataracts over time, and the risk decreased in proportion to the number of years since they had quit. People who never smoked at all were 36% less likely to develop cataracts than people still smoking.

The researchers believe that the reason why smoking can lead to cataracts is because atoms found in cigarette smoke called free radicals can cause oxidative stress to the lens of the eye. Smoking also decreases the ability to fight oxidative stress. Quitting smoking decreases the likelihood of developing cataracts by removing oxidative stress and by restoring antioxidant activity.

Antibiotics May Not Cure UTIs

Most women who have a urinary tract infection (UTI) are prescribed antibiotics to treat the problem. However, an increasing number of women will need to have a second treatment in order to fully cure the infection.

A study was recently conducted by doctors at the University of Surrey in Guildford, UK to determine whether women were being effectively treated for UTIs. Over 75,000 women between the ages of 15 and 44 participated in the study. All of them were prescribed some sort of antibiotic, and 14% of these needed a second antibiotic within four weeks. Those at the greatest risk for needing more medicine were between the ages of 35 and 44, had diabetes, or were pregnant.

The researchers also found that women who were treated with amoxicillin were more likely to require a second antibiotic. Women who took co-trimoxazole were less likely to need additional medicine. Also, antibiotics taken for three days were seen to be just as effective as those taken for five to seven days.

The study has been published in the Journal of Antimicrobial Chemotherapy (volume 48, pages 895-901, 2002). Researchers hope that it will give doctors a better idea of the effectiveness of UTI treatment.

Abdominal Fat From Stress?

Genetics, lack of exercise, poor diet, and a variety of medical conditions have been linked to the development of obesity. However, recent research shows that stress may also cause a build-up of abdominal fat.

Researchers at the university hospital in Gothenburg, Sweden have conducted a study of the phonomenon of abdominal fat as the result of stress. They conducted the study with the premise that stress causes the body to create an excess amount of a stress hormone, called cortisol, that stimulates a fat-building enzyme. This is readily taken up by the abdomen, and after the hormone surplus diminishes, the fat stays where it is. An earlier, fuller study of the same connection was reported in Diabetic Medicine (volume 16, pages 355-357, May 1999).

Unless physical exercise is conducted to counteract the effects of stress, concentrations of fat can increase the risk of health problems like diabetes and heart problems. The Swedish researchers have conducted other studies which indicate that people who develop abdominal obesity do not handle stress and stress hormones in the way that others do, and that certain personality types appear to distribute their fat into different areas of the body.

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