Diabetes News
Week of April 23, 2000 |
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Although widely accepted that exercise is good for you, a recent
study revealed how strongly the amount of exercise performed by men
with Type 2 correlated with their risk of dying.
The study, involving 1,263 men with Type 2 diabetes, was conducted by Dr. Ming Wei from The Cooper
Institute in Dallas, Texas. The men were divided into five different groups
according to their level of physical fitness, with 42% falling into the lowest performing category called
"low fit."
According to the results of the study, published in the
Annals of Internal Medicine, the men who had the lowest level of
physical fitness were twice as likely to die from a variety of
causes during the study as those who had moderate or high levels
of fitness. Those who were inactive were found to be twice as likely to die from heart
disease, 2.4 times as likely to die from cancer, 3.3 times as
likely to die from injuries, and close to five times as likely
to die from digestive disease.
The report does give hope, though. Researchers believe that
doing some form of moderate exercise, like walking for just
thirty minutes per day, is enough to create a level of physical
fitness that is associated with lower mortality rates.
Ephedra & Diabetes: A Risky Combination
For those who are considering using an herbal stimulant
containing ephedra to revitalize them or help them lose weight,
they should be aware of recent reports about this drug's
dangers, especially for people with diabetes.
Ephedra, also known by its Chinese name ma huang, is an
herbal stimulant which acts similarly to amphetamine. It is
currently approved for use by the FDA in some asthma
medications, but it is also widely used in combination with
caffeine in unregulated supplements for losing weight, building
muscle, or giving energy. Studies show the actual doses of ephedra
found in
supplements vary dramatically from much less to much more than the
stated content on
the label .
For many people, using ephedra results in no problems.
However, for others, the supplement is linked to anxiety,
sleeplessness, migraines, high blood pressure, seizures,
irregular heartbeats, heart attacks, and strokes. For people
with diabetes, the risks are even greater because ephedra can
raise blood sugars dramatically and make control extremely
difficult.
This month, the FDA released 273 reports of side effects
experienced by ephedra users, including death. The FDA now wants
ephedra manufacturers to put warning labels on the pill bottles,
to discourage those with high risk diseases such as heart
disease, high blood pressure, kidney or thyroid disease, a
history of seizures, or diabetes from taking the drug. The FDA
will hold a public hearing on the subject this summer.
More research is needed to determine why some people have adverse reactions to the
drug and others do not.
Do Drug Firms Follow FDA Regulations?
When the FDA approves a drug for release on the market, it
sometimes mandates that the drug manufacturer conduct additional
studies following FDA approval to make sure that the drug does not have adverse side
effects. According to a recent report, these studies often go
undone.
The consumer group Public Citizen has recently reported to
the FDA that only 13% of the 88 follow-up studies required for
new drugs in the 1990s were ever completed. The group none of the follow-up studies
promised by drug manufacturers for 107 new
drugs released between January 1995 and December 1999 have been
done. Public Citizen obtained its information from FDA data, which the FDA is now
stating was incomplete. The Pharmaceutical Research and
Manufacturers of America is also disputing Public Citizen's
allegations.
This new report adds to suspicions that the FDA is not
reviewing drugs properly, a suspicion fueled by the recent
removal of the drugs Rezulin (a diabetes medication) and Propulsid (used
for heartburn) from the market last month due to severe and at
times deadly side effects.
Vegan Diet And Folate May Help The Heart
One of the more dangerous complications of diabetes is heart
disease. In a new study, researchers have found that adopting a
vegan diet and taking folate supplements may help people prevent
this deadly disease.
Preventative Medicine recently published a report
by researchers who studied forty people who followed a vegan
diet and took folate every day. Veganism eliminates all
animal-based food, including meat, dairy products, and eggs,
from the diet. The people in the study at the Lifestyle Center
of America in Sulphur, Oklahoma had a low-fat diet, and they
also exercised, took stress-management classes, and avoided
tobacco, alcohol, coffee, and other caffeinated beverages. The
participants also took 480 micrograms of folate per day,
compared to the average man's intake of 301 micrograms and the
average woman's intake of 226 micrograms. In addition, they
participated in "spirituality enhancement sessions."
Among the participants, 63% had diabetes, 60% had high blood
pressure, 43% had high cholesterol, 25% had heart disease, and
5% were smokers. All were interested in adopting a healthier
lifestyle.
After completing the program, the participants had a 13% drop
in the amino acid homocysteine in their blood levels. High
levels of homocysteine have been linked to a higher risk of
heart attack and stroke.
Because of the design of the study, it is impossible to say
whether the intake of folate and the vegan diet both contributed
to the decrease in homocysteine level. It is also unclear how the other diet changes and stress
management affected the participants' health.
Previous research has already indicated that increasing the
intake of folate decreases homocysteine levels. This study may
suggest that a vegan diet also helps reduce the risk of heart
disease. More research is needed without so many lifestyle
changes in all the participants at once.
Diabetes Site Wins Social Venture
Contest
In the recent trend of skyrocketing profits made by internet
companies, few people seem to be concerned with whether or not
those companies provide services that can actually help people.
Students at the University of California at Berkeley's Haas
School of Business are seeking to change all that.
The students founded the Social Venture Business Plan
Competition,
which drew 66 entries from top business schools across the
country. Applicants had to show plans for a web-based company
that would provide clear benefits to society or the environment,
as well as create a return for investors.
The winner of the contest, and the $10,000 prize, was Jenna
Beart and her team from UCLA, who created easyDiabetes.com, an
Internet-based diabetes management system. Beart, who has Type 1
diabetes herself, hoped to merge charitable work and
entrepreneurial work through her entry. She and her teammates
created a computer-assisted support system for people with
diabetes, which allows a person to connect their blood sugar
monitor to a computer, and send the results to a physician.
Students hope that the contest will provide more exposure for
socially-responsible web companies like EasyDiabetes.
New Drug For Erectile Dysfunction
Viagra now has competition from another new drug used to
combat erectile dysfunction. This is good news for the 30
million men in America who have this condition, sometimes as a
complication of diabetes.
The new drug, recently recommended by an FDA advisory
committee, is called Uprima. Uprima comes in tablets which are
dissolved under the tongue. Its active ingredient, apomorphine HCI, is
then absorbed directly into the bloodstream. It mimics dopamine,
which is a chemical used for communication between nerve cells.
This helps the brain send stronger signals for penile erection.
The makers of Uprima, TAP Pharmaceutical Products, Inc. of
Lake Forest, Illinois, have conducted 27 trials of the drug,
involving 3,000 impotent men. Some of these included men with
controlled hypertension, and Type 1 and Type 2 diabetes.
Results showed that those who took the drug in 4 mg doses
succeeded in having intercourse 56% of the time. Also, the
response time of the drug varied between ten and nineteen
minutes, which is three times faster than Viagra. Uprima also
does not cause hazy vision, as sometimes happens with Viagra. It
may also be safer than Viagra when combined with
nitrate-containing heart medications.
Uprima is not without its downsides, though. Its 56% success
rate is less than that of Viagra, which has a 70% success
rate. Some side effects of the drug include nausea, vomiting,
and fainting, caused by a sudden loss in blood pressure. These
side effects may be exacerbated by alcohol, and the FDA's
advisors would like the packaging to include this information.
Actos Wins As Rezulin Replacer
In the race to fill the vacancy in diabetes drugs created
when Rezulin was taken off the market, Actos
has
come out ahead.
The drug, marketed by the powerful pharmaceutical company Eli
Lilly and Company, is the fastest growing product in the
thiazolidinedione (TZD) market. TZDs are the preferred drug
therapy for reducing insulin resistance, which is common in Type
2 diabetes.
Actos is taken once a day, and should be combined with diet
and exercise in order to lower blood glucose. It is also
approved for use in combination with insulin, sulfonylureas, or
metformin.
People with diabetes have an increased risk for heart disease
due to high triglyceride ("bad" cholesterol) levels,
and low levels of HDL ("good" cholesterol). In
studies, Actos has helped to reverse these abnormalities.
Liver failure was the primary reason for Rezulin's removal
from the market. Rezulin was also a TZD, so users of Actos
should periodically monitor their liver enzyme levels although
Actos has not been linked with liver failure.
Another side-effect to watch for is ovulation in anovulatory
women; if this occurs, contraception may be needed. Other
commonly reported side effects for Actos are symptoms of upper
respiratory tract infection, headache, sinusitis, muscle pain,
tooth disorder, sore throat, weight gain, edema, and anemia.
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