Diabetes News for Feb. 3, 2002

Generic Versions Of Glucophage Approved

Despite attempts by Bristol-Myers Squibb Co. to extend their exclusive marketing rights of the diabetes drug Glucophage, eleven other companies have been given FDA approval to market generic versions of the drug. Among these companies are IVAX Corp., Alpharma Inc., Watson Pharmaceuticals Inc., Teva Pharmaceutical Industries Ltd., and Andrx Corp. Competition among the companies is expected to drive the price of the drug down 80%, which is good news for consumers with diabetes.

New Weight-Loss Surgery Treats Diabetes

For many people who are severely overweight, Type 2 diabetes is just one of many health problems they develop. In an attempt to prevent such dangerous health problems, researchers have developed and tested a new type of weight-loss surgery.

The surgery is called laparoscopic adjustable gastric banding (LAGB), and involves placing a band around the upper stomach using laparoscopy, which is minimally invasive surgery. The band is then inflated with saline, and can be adjusted to be tighter or looser. This type of procedure is fully reversible.

In a recent study of whether or not LAGB is effective in preventing diseases associated with obesity, researchers at Alfred Hospital in Melbourne, Australia performed the operation on 50 people who had Type 2 diabetes and who weighed an average of 300 pounds. All of the participants had significant disabilities due to their weight, and had tried to lose weight by other means for at least five years.

A year after the participants had the gastric band placed, 32 experienced diabetes remission. Also, 27 of 34 participants who had a history of high blood pressure decreased their blood pressure levels. The participants also had improvement in the quality of their sleep, less depression, less pain, more energy, and improved general health.

The results of the study have been published in the journal Diabetes Care (volume 25, pages 358-363, February 2002), and indicate that there were also complications associated with the procedure. Ten participants needed surgery to fix the position of the gastric band after it slipped. Three participants needed the band replaced altogether because it eroded in the stomach. In addition, two people needed minor surgery after the saline solution in the band leaked. Also, three of the participants had the band placed in open surgery instead of through laparoscopy. Of these, two had wound infections and one required respiratory support.

Researchers acknowledge the need for further study of laparoscopic adjustable gastric banding to determine if it has long-term success in treating diseases associated with obesity.

Antioxidant Prevents Diabetes In Mice

In a study involving laboratory mice, Type 1 diabetes was successfully prevented using a synthetic antioxidant. Although results might not be the same in humans, this new study offers hope for a possible cure of the disease.

In the study, which was conducted by researchers from the National Jewish Medical and Research Center and the University of Colorado Health Sciences Center, ten of a total of fifteen mice were given injections of a synthic compound similar to the naturally-occurring antioxidant called superoxide dismutase. Antioxidants work by helping the immune system recognize cells that are not foreign. In diabetes, the immune system attacks the body's own beta cells, which thus stops the normal production of insulin.Then all fifteen of the mice underwent a procedure which ordinarily makes diabetes develop quickly.

In the study, the mice who had been given the synthetic antioxidant prior to the diabetes-inducing treatment were also given the antioxidant therapy four more times during nine days. By the thirteenth day, all five of the mice who did not receive the antioxidant had developed diabetes. Only five of the mice who did receive the treatment developed diabetes, and this was not until the twenty-first day. None of the others ever developed diabetes, even after four weeks had passed.

This study can be found in the journal Diabetes (volume 51, pages 347-355, February 2002). Researchers say there is still much research needed before this antioxidant treatment can be tested in humans.

Impotence Common With Type 2

For many men with Type 2 diabetes, sexual side effects impair the quality of life. Many of these men may not be aware that their disease is the source of erectile dysfunction, even though a new study shows that this side effect is more common than was previously believed.

The study, conducted by researchers at Consorzio Mario Negri Sud in Santa Maria Imbaro, Italy, included 1,460 men with Type 2 diabetes. All were surveyed on various aspects of their quality of life, including such issues as depression, social functioning, and sex life satisfaction.

Results of the study, which are published in the journal Diabetes Care (volume 25, pages 284-291, February 2002), indicate that 34% of the men had frequent erectile problems. Twenty-four percent of the men had occasional problems, and 42% had no erectile problems. Although diabetes seemed to affect the quality of life of many of the men surveyed, only 63% said that their doctors had ever asked them if they had any sexual problems.

One third of the men who reported that they had erectile dysfunction said that diabetes did not have any impact on their sex life. Researchers believe that a widespread lack of information about how diabetes can impact sexual function may be the reason why so many men with diabetes don't seek treatment for erectile dysfunction.

Study authors encourage men with Type 2 to consult their physicians when they have sexual problems, and also to keep good control of their glucose levels in order to reduce or delay the development of sexual side effects.

Stretch Your Arteries

The benefits of exercise, such as weight control and cardiovascular health, are numerous and widely known. However, a new study shows that there are other health benefits of exercise that not many people know about.
Recently, doctors at the University of Pittsburgh asked 356 men and women between the ages of 70 and 96 to participate in a study of their arteries. The participants were questioned about their exercise habits, and then their arteries were measured with pulse wave velocity. This test measures the pressure waves of heartbeats. Pressure waves move faster in arteries that are stiffer.

The researchers found that those who exercised the most had the stretchiest arteries, regardless of age. But even minimal exercise in the elderly, such as moving about the home, is important for maintaining stretchy arteries. Non-stretchy arteries are hardened arteries, a condition distinct from blocked arteries, but one that can also lead to heart disease and death. By exercising, a person's arteries are stretched, which prevents stiffening. In addition, exercise lowers glucose levels. High glucose levels cause a chemical interation with the walls of blood vessels, resulting in damage and stiffening.

The researchers have published their findings in the American Journal of Hypertension (volume 13, pages 1280-3, February 2002). They encourage people of all ages to maintain an active lifestyle in order to prevent stiffening of the arteries.

Coronary Bypass Survival Rates Increase

People who must undergo coronary artery bypass surgery have much improved odds of survival compared to people who underwent the procedure just twenty years ago. New research shows that this procedure is being performed on more people than ever, and that survival rates are on the rise.

Recently, researchers at Glasgow Royal Infirmary University in Scotland compared the hospital records for 25,229 coronary artery bypass operations performed in Scottish hospitals between 1981 and 1996. Seventy-eight percent of these were performed on men, and 22% on women. The researchers found that the percentage of bypass surgeries performed increased among all age groups, but most significantly in people over 65. They also found that the risk of death in the first two years after surgery decreased by 37% in men over 65.

The improvements are even more significant, because people are more likely now to have more severe cardiac problems, as well as diabetes, which can also cause cardiac problems. The researchers believe that the increases in survival rates stem from improvements in surgery methods, including an increased use of arterial grafts. In addition, doctors are stressing the importance of post-surgical drug treatments, improvements in diet and exercise, and quitting smoking.

The study has been published in the British Medical Journal (volume 324, pages 201-2, January 26, 2002).

Does Drinking Decrease Dementia?

Although the health problems associated with excessive drinking are widely known, the benefits of moderate drinking are now beginning to be recognized. In a new study, drinking up to three drinks a day is associated with a decrease in development of dementia.

This study was conducted by researchers at Erasmus Medical Centre in Rotterdam, who have published their findings in the journal The Lancet (volume 359; pages 281-286; January 26, 2002). They interviewed 5,400 adults in the Netherlands who were 55 or older, questioning them on their alcohol consumption. The participants were then followed for an average of six years, and health factors like age, diabetes, blood pressure, and smoking were recorded.

Over the course of the study, 197 participants developed dementia, most often in the form of Alzheimer's disease. The participants who drank between one and three drinks per day were 42% less likely to develop dementia than non-drinkers. They were also 70% less likely than non-drinkers to be diagnosed with vascular dementia, which is caused by a reduction in the blood supply to the brain. Those who drank about two drinks per day aslo seemed to be protected against the actions of the gene variant ApoE4, which is associated with an increased Alzheimer's risk.

The researchers note that participants who drank four drinks or more per day did not have any reduction in dementia risk. They also say that more research is needed to determine how alcohol may prevent dementia.

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