Diabetes This Week April 18th, 1999

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Chromium Picolinate May Be Cancer Risk

Researchers at the University of Alabama say chromium picolinate causes DNA to break. This type of DNA damage may cause genetic mutations or cancer in humans, the researchers said at the American Chemical Society meeting in Anaheim, Calif. This popular nutritional supplement is believed to reduce body fat and build muscle, with suggestions that it might reduce heart disease and improve diabetes control (most research studies have not supported the latter claim). Chemist John Vincent said lab tests found the compound to be stable and unaffected by water, buffers or blood serum proteins. ``If it's stable enough that it gets into the cells intact, it could be a big concern,'' he said. Chromium picolinate is a commercial product, and it is not known if other natural forms of chromium, such as chromium GTF derived from yeast derived also cause DNA breaks.

Seniors Pay More Than HMOs For Their Drugs

Seniors often pay much more than HMOs for brand-name drugs with the highest sales to seniors, researchers have discovered. For example, Upjohn's Micronase, used in treating diabetes, costs HMOs $10.05, but seniors in Colorado pay $51.23, while Synthroid, a thyroid replacement, costs insurance companies $1.75 and seniors $25.

High Fat, Low Fiber Diet & Little Exercise Linked To Gallstones

Researchers at the State University of New York at Buffalo reported in the American Journal of Clinical Nutrition that people who have a high-saturated-fat, low-fiber diet and partake of little exercise are more likely to develop gallstones. Gallbladder disease is more likely in an older population and among women. In fact, twenty percent of women autopsied are found to have gallstones.

The study, conducted in a small farming community in southern Italy, examined 1,429 men and 1,043 women selected randomly from the population. In 1985 and 1986, researchers scanned the gallbladder with ultrasound and took blood samples. People free of gallstones at that time were re-examined between 1992 and 1993, and given questionnaires concerning medical history, diet and physical activity.

The 55 men and 49 women who developed gallstones during this period were matched with controls from the same population. These participants provided information on the same questionnaires. Those who developed gallstones had less activity than those who did not, and a higher consumption of refined sugars and saturated fat were directly related to gallstone formation.

Rezulin Linked Liver Failure May Occur In The First Month

A woman whose liver failed just two weeks after she started taking Rezulin (troglitazone) for diabetes filed suit against its manufacturer, the Warner-Lambert Company. Marsha J. Bean and her husband Dr. John Bean, of Kansas City, allege that Rezulin destroyed Mrs. Bean's liver and required her to undergo a transplant. Also named in the suit were C. D. Smith Healthcare, Inc., the wholesale distributor, and Brad Kunkle, a pharmacist who filled the prescription for Mrs. Bean. According to the suit, Warner-Lambert recommends testing of liver enzymes after a month on the drug. However, Mrs. Bean's liver failure occurred after only two weeks on Rezulin.

In a Food and Drug Administration hearing on March 27th, scientists stated Rezulin has been associated with at least 43 cases of acute liver failure, resulting in 28 deaths and 7 liver transplants. Because most cases of liver damage may not be reported, FDA epidemiologists estimate the actual number of cases of liver failure may be closer to 400. FDA epidemiologist David Graham calculated that 1 in every 1,800 patients who take the drug for 6 months may experience liver failure. Approximately 750,000 Americans are now estimated to use the drug. Graham reported that for 9 of the 43 liver failure cases studied, the damage occurred within four to 34 days, and there were few or no warning signs, nor an obvious risk factor for damage. Because of rapid deterioration, monthly monitoring may miss up to three out of four cases of liver failures. Graham warned that patients on Rezulin were at least 50 times more likely to experience acute liver failure than the general population.

Drug And Research Giants Collaborate On Genetic Code Medicine

Ten pharmaceutical giants and five world famous laboratories have joined forces to create a new kind of medical care, where a patient's genetic blueprint is used to predict and treat illnesses with tailor-made drugs. This personalized medicine may be an early offshoot of the human genome project, the million dollar project expected to publish its first draft next year. This consortium will publish openly and not patent the information it gathers to understand the cause of major illnesses.

Everyone shares 99.9 per cent of the 100,000 genes that cause us to be human, while the remaining 0.1 per cent accounts for the variety in different people. These differences are called SNPs or `snips', single nucleotide polymorphisms, which are tiny changes in the genetic code that determine why some people develop disease and others don't. The consortium plans to identify at least 300,000 such changes, many of which could be markers for a propensity to diabetes, asthma, or more obvious hereditary diseases. This knowledge could lead to individualized, innovative medical treatment.

A practitioner using a new kind of diagnostic tool developed from this information should be able to tell from a simple saliva test whether a patient is likely to be allergic to a drug, will respond to one drug better than another, or is at higher than usual risk of cancer or Alzheimer's disease. Furthermore, producing the right treatment with the first prescription is far more likely.

The Wellcome Trust, Britain's biggest medical research charity, is spearheading the initiative in conjunction with four of America's most prestigious genetics centers: the Whitehead Institute for Biomedical Research in Cambridge, Massachusetts, Washington University School of Medicine in St Louis, Stanford Human Genome Center in California and Cold Spring Harbor Laboratory in New York. The group of 10 drug companies includes Britain's Glaxo Wellcome, SmithKline Beecham and Astra Zeneca, as well as Bayer, Hoechst, Hoffmann-La Roche, Bristol-Myers Squibb, Novartis, Pfizer and Searle.

Did You Know There Are Two Kinds Of Fiber?

For decades, nutritionists have touted the value of fiber as helping to reduce the risk of cancer, heart disease and diabetes. More recently, distinctions between soluble and insoluble fiber are being made. The soluble fiber found in oats, psyllium (the stuff of Metamucil), beans, lentils and some fruits work best at reducing artery-clogging cholesterol. Soluble fiber stays in the intestines longer and absorbs more cholesterol. Insoluble fiber, on the other hand, found in wheat bran, seeds, whole grains, and the skins of vegetables and fruits, serves a different purpose. Insoluble fiber absorbs water, which increases the speed at which waste passes through the body, thus helping to avoid or relieve constipation. Most nutritionists don't worry about the type. Their primary goal is to encourage people to increase their total fiber intake, regardless of the specific type. But the American diet, rich in processed and fast foods, serves up only 12 to 14 grams of fiber a day, only half the recommended amount.

Both types of fiber serve an important function in the body, but if your goal is to prevent heart disease, it's worthwhile to note the difference. To lower cholesterol, eat oatmeal for breakfast and split pea soup for lunch. Psyllium, found in Metamucil and other natural laxatives, is a rich source of soluble fiber. The American Dietetic Association recommends five servings or fruits and vegetables daily, and legumes at least once or twice a week. Be forewarned, however, that one side effect of more fiber, besides a lower cholesterol, is gas which usually reduces over time. For better health, make eating fiber part of the daily routine, like exercise.

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