Women At Risk After Heart Surgery
Merely being a woman raises the risk of stroke and death following heart surgery. And researchers do not know why.
The records of more than 400,000 men and women who underwent heart surgery in the United States in 1996 and 1997 were studied by researchers at Washington University School of Medicine in St. Louis and Duke University in Durham, North Carolina. They matched men and women for known stroke risk factors, such as age, high blood pressure, hardening of the arteries, and diabetes.
When these risk factors for men and women were equal, women ran a higher risk for suffering a stroke after heart surgery. At a risk of 3.8% for stroke and 5.7% for death, women were 1.6 times as likely to suffer these outcomes compared to men.
The researchers, writing in the journal Circulation (May, 2001), said they did not know what predisposed women to these greater risks. They speculate that most women undergoing heart surgery are post-menopausal with decreased levels of the female hormone estrogen. It is generally believed that estrogen protects women from heart disease and brain cells from injury prior to menopause. Post-menopausal women have very low estrogen levels, lower than men who convert some of the male hormone, androgen, into estrogen.
This large scale study was conducted to confirm a similar finding two years ago when 3,000 heart surgery patients at Washington University were studied. This research indicated that women had a higher risk for stroke after heart surgery.
  
Stem Cell Research Progresses
Two more research studies reported in Science (May, 2001) show progress in using stem cells to cure diabetes and Parkinson's disease.
In one of the studies, scientists took embryonic stem cells from mice and, using special proteins, transformed them into islet cells of the type that produce insulin. This dramatic step suggests stem cells could be encouraged to form functional islet cells that sense glucose and release insulin in response to need. If the research progresses as hoped, researchers may use human embryonic stem cells to treat diabetes in humans within five years.
In another study, researchers at Rockefeller University and Sloan Kettering Memorial Hospital in New York cloned a mouse embryo and then transformed its stem cells into neurons that made dopamine, a brain chemical missing in patients with Parkinson's.
This research adds to the continuing controversy in Washington over whether federal funds should be used for research that uses human embryos. Anti-abortion groups say that because a fetus is killed to provide cells, these cells should be discarded and funding should be stopped.
Opponents also say that use of embryonic cells is unnecessary because recent studies suggest similar results occur when stem cells from adults are used. Scientists do not agree with the latter, saying that embryonic stem cells are master cells which have the ability to allow a diverse variety of other cells to be generated, all of which may provide valuable cures.
Not too long ago when a child was diagnosed with Type 1 diabetes, it was generally predicted that this child would have a shortened life span. But today, the expected outcome is a normal lifespan. What has made the difference?
Recent research shows that people using home blood glucose monitoring to control blood sugar levels in addition to other breakthroughs, such as using ACE inhibitors to protect kidneys, means a person with Type 1 is likely to live a normal lifespan. To reach this conclusion, the researchers at the University of Pittsburgh, Pennsylvania, looked at survival rates in the US and worldwide. They collaborated with doctors at the Jikei University School of Medicine in Tokyo, Japan.
The U.S. team examined survival rates for 1,075 children diagnosed with Type 1 in Allegheny County, Pennsylvania, between 1965 and 1979. Overall, 10 years after diagnosis, people with Type 1 diabetes had a 98% survival rate. This declined slightly at twenty years after diagnosis, when the survival rate was 92%, and even more 30 years after diagnosis when about 80% were still alive.
However, what was most surprising in the study came from studying subgroups. Researchers found that those diagnosed later between 1975 and 1979 had twice the survival rate as those diagnosed just ten years earlier. The study was published in Diabetes Care (vol. 24, pages 823-827, May 2001), and was partially funded by the National Institutes of Health.
Who will develop diabetes? What are the first signs of problems to come? Several research studies are attempting to see if slightly higher blood sugars always proceed to Type 2 diabetes.
Slightly higher than normal blood sugars have been classified by the American Diabetes Association and the World Health Organization into two specific problems. IGT is impaired glucose tolerance that causes slightly higher blood sugar 2 hours after eating a high sugar meal; IFG is impaired fasting glucose which means slightly higher than normal blood sugar before eating.
The ongoing Diabetes Prevention Study is a large scale, multi-site study in which people with IGT are followed to see if diet, weight loss and exercise can prevent them from progressing to Type 2 diabetes.
A research study recently concluded in the Netherlands reports that people with slightly high blood sugars face a much higher risk of developing Type 2 diabetes. The Journal of the American Medical Association (vol. 285, pages 2109-2111, April 25, 2001) reports the results of an 8 year study of more than 1,300 men and women. About one third of those with IGT or IFG at the beginning of the study developed diabetes, compared with only 4.5% of those who started with normal blood sugar. People in the study who had both IGT and IFG at the beginning had a much higher chance of developing diabetes. Among these individuals, 75% of women and 53% of men developed diabetes.
Diabetes Drug Stocks Rising
Three major pharmaceutical corporations that produce and sell diabetes medications report having increased profits in the first quarter.
Bristol-Myers Squibb Co., the fifth largest drug maker, announced that its first-quarter profits rose 10 percent, profiting from sales of its diabetes drugs Glucophage and Glucovance and its cholesterol drug Pravachol.
Strong sales of new treatments for asthma--Seretide--and diabetes--Avandia--and a strong U.S. drug market helped GlaxoSmithKline PLC boost its first quarter pretax profit. The 11 percent earnings resulted from the merging of Glaxo Wellcome PLC and SmithKline Beecham PLC which was completed in December.
Pfizer Inc. says it expects earnings per share to grow by at least 25 percent through 2002 as it markets 4 of the top 10 drugs in the world. Its top drug Lipitor is used for cholesterol, with an inhaled insulin product in clinical trials. Pfizer became the largest pharmaceutical company in the world after it merged with Warner-Lambert last year
Does Gum Disease Cause Diabetes?
Gum disease is considered one of the lesser known complications of diabetes because people with diabetes have a compromised ability to fight infections of the gums. Now there is speculation that chronic gum disease may lead to Type 2 diabetes.
Researchers at a dental meeting in Bethesda, Maryland have explained that gum disease could be a possible cause of Type 2 diabetes, which is increasing at an alarming rate in the U. S. The proposed link is that when gum disease releases bacteria into the bloodstream. This creates an inflammatory response by the immune system involving proteins called cytokines, which are destructive to the body in such a way that insulin resistance and insulin producing beta cell damage may occur. This damage can cause Type 2 diabetes in people who have no other risk factors for diabetes.
To test this theory, researchers suggest that studies be done to determine whether the risk for diabetes decreases when gum disease is treated.
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