   
Lapses In Good Diabetes Control OK?Start intensive control of blood sugars in diabetes early and maintain it as long as possible to avoid the complications of diabetes, major research has shown. But if the level of control slips after time and blood sugars start to creep up, the benefits of tight control appear to continue for years. This is the result of the combined Diabetes Control and Complications Trial and the Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study, reported in the New England Journal of Medicine. The earlier DCCT study conducted for 6 and one-half to 10 years showed that tight control of diabetes greatly reduced the development or progress of complications from Type 1 diabetes. The original study compared intensive therapy with lower blood sugar levels to conventional therapy. The intensive control group fared much better with avoiding complications. To see if those benefits persisted, Dr. David Nathan of Massachusetts General Hospital in the EDIC study continued to examine 1,208 volunteers over the next four years. All the volunteers were encouraged to closely monitor and treat their blood sugar levels. Although the intensive therapy patients reduced their blood sugar to lower levels than did conventional therapy patients during the DCCT study, by the end of only the first year of the EDIC study, the blood sugars for the two groups had reached similar levels and stayed that way for the duration of the study. Despite the similarities in blood sugar levels throughout the EDIC study, however, the original intensive therapy patients continued to fare better in terms of avoiding eye and kidney complications. This was true even though some of the original intensive group had become somewhat lax about their control. The authors of the report cautioned that the results should not be interpreted to encourage following intensive therapy for only a limited period of time.
Is Driving With Diabetes Study Valid?People with Type 1 diabetes are not perceiving or treating their low blood sugars while driving and are at risk of causing accidents, as reported in a questionable study by Dr. Daniel J. Cox, and colleagues with the University of Virginia Health System in Charlottesville in Diabetes Care. The team of researchers tested the responses and driving performance of 37 people using a driving simulator while attached to EKG and EEG equipment, as their blood sugars were lowered via an IV insulin infusion. At 5 minute intervals, the researchers measured blood glucose, driving performance, the participants' perception of symptoms, and whether they took corrective measures. Results of Cox's study showed that even mild hypoglycemia was associated with swerving over the middle line, unnecessary braking, and excess speed. Only 30% of participants attempted to correct the situation by pulling off the road or drinking a high-carbohydrate snack. The most impaired took corrective actions the most often. The authors advise people with Type 1 diabetes to measure their blood sugar before driving, and not to drive if the test result shows a blood sugar less than 4 mmol/L or 70 mg/dl. They should also treat themselves as soon as low blood sugar or poor driving is suspected. The researchers did not account for how being attached to wires and an IV line in a simulation that the participants might want to end as quickly as possible may have affected the situation. They stress that their study has limited relevance to the majority of people with Type 1 diabetes due to the small size of the study and the use of a driving simulator instead of an actual vehicle. Some experts fear that the study findings will be used against people with diabetes, unnecessarily limiting their privilege to drive, especially in light of numerous other studies in which actual driving records of people with diabetes have not been found to be different from the general population. The research also did not address other groups known to actually have bad driving records, such as cell phone users and drunks. The study underscores the need for more research, especially by other more valid research methods, such as statistical analysis of how frequently accidents involving drivers with diabetes occur.
Diabetes Drug Developed To Inhibit Glucose ProductionMetabasis Therapeutics, Inc. and Sankyo Co, Ltd. will collaborate for another year to begin clinical evaluation of the first diabetes drug developed under the agreement. The collaboration, formed in 1997, combines Metabasis' discovery of selective inhibitors of the gluconeogenesis pathway which over produces glucose in the liver of patients with Type 2 diabetes with Sankyo's insulin sensitizer, Rezulin. Gluconeogenesis inhibitors are expected to treat both early and late stage diabetics either alone or in combination with insulin sensitizers. This inhibition is similar to how the current Type 2 drug metformin (Glucophage) works. Metformin has been used for over 30 years, and has an excellent clinical record, even for use in teens where excess growth hormone levels cause excess gluconeogenesis and increased insulin need. Some concerns on this approach focus on preventing an excessive inhibition of glucose production in situation where it may be needed, such as during exercise.
Put Ice Pack On Charcot Foot ImmediatelyCharcot foot is one of the most debilitating conditions caused by nerve damage in people with diabetes. In this condition the foot joints fall apart in a matter of weeks or months following its onset. New evidence suggests timely application of ice packs may prevent this crippling foot disorder. The research, conducted by Adam Landsman, DPM, FACFAS, research director at the Scholl College of Podiatric Medicine in Chicago, suggests that the application of ice packs could eliminate the irreversible condition because chronic minor increases in skin temperature of the foot could be the cause, perhaps through the production of increased inflammatory particles. This research was presented at the American College of Foot
and Ankle Surgeons (ACFAS) Annual Meeting this week in Miami. New Weight Loss Drug Shows ResultsPacificHealth Laboratories, Inc. announced today that Satietrol, the company's weight loss product, facilitates weight loss when used with a 1700 calorie diet. The six-week study had 113 participants take Satietrol and follow a 1700 calorie diet. Satietrol, a powder mixed with water, is taken 15 minutes before a meal. The study was conducted in a low intervention environment that simulated real life conditions. At the end of the study the average weight loss was 8.82 lbs which seventy-eight percent of the participants felt met or exceeded their expectations. Participants reported a significant reduction in hunger and overall appetite. Previous clinical studies showed that Satietrol reduced hunger up to 35%, 3.5 hours following a meal when compared to placebo. How does Satietrol work? It activates the body's natural appetite control mechanism called cholecystokinin (CCK). This action before a meal helps you eat less and by preventing the breakdown of CCK after a meal, it enables you to feel satisfied longer. CCK slows the emptying of food from the stomach to the small intestine; it stimulates nerve receptors in the wall of the stomach, which tell the brain the stomach is full; and it acts on the appetite centers in the brain. The product will be sold over the counter beginning in March. A 42-single serving kit will be priced at $39.95. Satietrol will be sold through direct sales, Internet retailers, health food chains and retailers.
Treadmill Lowers Blood PressurePrevious research has shown that long-term exercise lowers blood pressure in most people with essential high blood pressure, which means hypertension with no known cause. But what is the minimum amount of exercise needed and how much effect on blood pressure does this amount of exercise have? Now we have part of the answer. Research just conducted showed that a single 45-minute treadmill session significantly reduced blood pressure for almost a day in older men with mild hypertension. Nadine S. Taylor-Tolbert of the University of Maryland in College Park, and colleagues studied 11 obese, inactive men aged 49 to 67, who had essential hypertension, with average blood pressure readings of 153/96. None of the participants had any perceivable cause of their hypertension: no smoking, diabetes, cardiovascular disease, medications during the study, or foods that could produce high blood pressure. Two blood pressure readings were taken during a 2-week period; one immediately after three 15-minute treadmill sessions separated by 4 minutes of seated rest, and the other not preceded by exercise. Results showed that a single aerobic exercise session reduced blood pressure in the study participants for almost 24 hours compared to a day when no exercise was performed. The findings are significant in that they provide good motivation for exercise due to its immediate impact on health. The report is published in the American Journal of Hypertension
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