   
New Form Of Type 1 Diabetes FoundIn a study of 56 Japanese participants newly diagnosed with Type 1 diabetes, a subgroup of people with unusual traits emerged. Dr. Akihisa Imagawa and colleagues at Osaka University, Japan, discovered what they suggest is a subtype of diabetes possibly overlooked in studies of diabetes mainly conducted in white patients. This type of diabetes, named nonautoimmune, fulminant Type 1 diabetes mellitus, is rare in white people. Type 1 diabetes is usually an autoimmune disease, in which the body's immune system attacks the pancreas so that it can no longer produce insulin. But some of the participants in the study, though they had Type 1 diabetes, did not seem to have an autoimmune illness. Furthermore, these 11 people developed the disease very quickly, which is unlike the more typical slow progression of Type 1. Unique to this group was a high level of certain enzymes in the pancreas, which is not seen in Type 1 normally. The quick onset of the disease suggests this unusual form of diabetes may be caused by a virus, even though no signs of a recent viral attack were found according to the study reported in the The New England Journal of Medicine. In an editorial accompanying the report of the study, Dr. Ake Lernmark, University of Washington in Seattle, discusses the fact that four of the participants with the unusual form of diabetes had a family history of diabetes. This indicates the condition could be triggered by environmental factors coupled with a genetic predisposition to the disease.
Apple Shape Unhealthy For WomenIt has been known for several years that an apple shape for overweight men carries a higher risk for health problems. Now research shows that apple-shaped women may be at increased risk of diabetes after menopause. Apple-shaped women, who carry most of their body fat around their abdomen, seem to be more resistant to insulin than pear-shaped women, who store body fat primarily in the hips and thighs. This is true even when the women are not obese. Insulin resistance means that the body does not respond to its own insulin. Levels of glucose in the blood remain high when insulin resistance exists which places people at a higher risk for diabetes. Dr. Cynthia K. Sites and colleagues with the University of Vermont College of Medicine in Burlington measured abdominal fat and total body fat in 27 non-obese women in early post-menopause who are not taking hormone replacements. All of the women had a body mass index (BMI), a measurement of weight in relation to height, below 30, which is considered non-obese. The results, which appear in the January issue of the journal Fertility and Sterility, state that the higher the abdominal fat stores, the lower the response to insulin. In other words, women with lower amounts of abdominal fat were more likely to show signs of insulin sensitivity, putting them at a lower risk for diabetes. The study also states that further research is needed to help postmenopausal women reduce central body fat.
New Insulin Delivery May Replace ShotsSaying goodbye to insulin injections is the dream of many
people with diabetes. A very different approach to realizing
this dream is underway with research that plants insulin inside
the body and then triggers the body to release the insulin when
needed Tim Clackson, senior author of the study reported in the February 4th issue of the journal Science and a researcher at Ariad Pharmaceuticals in Cambridge, Mass. conducted the study. Theoretically the process could be used to deliver other proteins that the body needs periodically, such as growth hormone, or proteins that provide pain relief or appetite control. There are many issues to work out before this could be applicable to insulin delivery for humans on a day-to-day basis.
Hostility Linked To Heart Disease
Researchers Dr. Raymond Niaura of Brown University School of Medicine in Providence, Rhode Island, and colleagues followed over 1,000 men aged 44 to 92 in the Normative Aging Study between 1987 and 1991. Hostility was measured on the Cook-Hedley Hostility Scale. The participants with higher scores on this scale were more often overweight with abdominal and upper body obesity and insulin resistant. These are risk factors for heart disease. The study, reported in February's issue of the journal Psychosomatic Medicine, also found that men with fewer years of education were more likely to be hostile. The sample studied makes it impossible to know if the findings are applicable to women, younger men or different races. More research is needed to factor in socioeconomic determiners and to further detail the biological connection between hostility, obesity and heart risk for other groups.
Key To Preventing Diabetes BlindnessThe protein VEGF seems to be the key to new blood vessel formation in the eye that destroys sight in people with diabetes, says a team of researchers at Johns Hopkins University in Baltimore and CIBA Vision Corp., a division of Novartis Ltd. Pharmaceutical Co. VEGF signals the growth of new blood vessels in the eye when existing vessels in the retina are damaged by diabetes. This seems helpful but the new vessels are usually leaky or weak, which can cause scarring and macular edema. The researchers reported in the American Journal of Pathology that VEGF is only one factor in this destructive process, but blocking VEGF may be enough to stop the destruction. New research is indicated to attempt to block the action of VEGF with drugs or gene therapy. A whole class of drugs, called angiogenesis inhibitors, are under development to block proteins such as VEGF. The next step for this research team is testing an experimental drug called PKC 412 to see if it will prevent macular edema in diabetic retinopathy. Another approach that appears interesting is the use of high dose vitamin E which may block VEGF production by correcting the abnormal blood flow that is seen in both eye and kidney disease. Vitamin E does this by reducing excess levels of protein kinase C and diacylglycerol, which are found at high levels in retinopathy. See also our slide presentation on Complications.
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