Diabetes News for June 2, 2002
Ginseng Berry May Treat Type 2
Chinese doctors have used ginseng root for medicinal purposes for many years, and have even used it to treat diabetes. New research indicates that the ginseng berry may be even more effective in treating Type 2 and obesity.
This research was conducted by doctors at the University of Chicago, who studied the effects of the ginseng berry on mice who had been bred to develop obesity and Type 2 diabetes. The mice were given daily doses of ginseng berry extracts in the amount of 150 milligrams per each kilogram of their body weight. By the twelfth day, the mice with diabetes had normal blood sugar levels and their body weight decreased by over 10%. The mice treated with ginseng all had cholesterol levels that were 30% lower then the mice that were not given the treatment.
The researchers believe that the ginseng berry extract worked by suppressing appetite and increasing energy expenditure in the mice. The mice that were given the treatment ate 15% less than the untreated mice, and were 35% more active. These results have been published in the journal Diabetes (volume 51; pages 1851-1858; June 2002).
Compared to the root, ginseng berries have much higher concentrations of the active substances, which are called ginsenosides. One of these is called ginsenoside Re. The researchers injected the mice with this substance alone and found that it worked as well as the berry in reducing symptoms of diabetes, but that it did not reduce the mices' weight. Further investigation is needed to determine which component of the berry is likely to treat obesity, and whether or not this can be used to effectively treat Type 2 diabetes in humans.
  
Clot Risk With Type 2
A new study indicates that those with Type 2 diabetes have an increased risk of developing blood clots, a risk that is distinct from their risk for heart disease.
The study was conducted by researchers at the University of Minnesota in Minneapolis, who included over 19,000 adults in their eight-year study. The researchers found that those with Type 2 diabetes were almost twice as likely to be diagnosed with venous thromboembolism than those without diabetes, and that those with the highest BMI were almost 2.5 times as likely to develop the condition. With venous thromboembolism, blood clots form in the veins, and then are more likely to break off and travel to the lungs. This results in a pulmonary embolism which can be fatal. The researchers also found that other people who were at a high risk for VTE were those who were male, African American, or elderly.
The researchers have published their findings in the Archives of Internal Medicine (volume 162; pages 1182-1189; May 27, 2002). They believe that because venous thromboembolism was not associated with risk factors like smoking, high blood pressure, or high cholesterol, its causes are different from those of heart disease. In addition, they hypothesize that preventing and treating obesity and diabetes may decrease people's risk of developing venous thromboembolism.
New Stent For Clogged Arteries
When a person's arteries become clogged, one way to open them and to ensure normal blood flow is to use a stent. Stents are tubes that are used to prop open the arteries. The company Johnson & Johnson is in the process of testing antibiotic-coated stents that they believe will be even more effective than bare metal stents.
Last September, Johnson & Johnson released data from a European trial of the drug-coated stents, which showed that the new stents were 100% successful in preventing arteries from becoming reclogged. Currently, reclogging happens with bare-metal stents about 25 to 30% of the time, and this risk is higher in those with diabetes. In a recent US trial of the new stents, reclogging occurred in only about 2% of cases. However, participants in the US trial were more seriously ill than those in the European trial, and had risk factors such as diabetes, smaller arteries, and hypertension.
The results of Johnson & Johnson's final trial will be released in September. The trial included 1,101 people in 53 hospitals in the US. The company may receive FDA approval for the stent early next year.
Brain Reaction May Explain Obesity
Because of the enormous increase in the rates of obesity, and its accompanying health problems, many researchers are looking for reasons for obesity's rise. A new study suggests that brain reactions to the sight of food may be responsible.
Researchers from the US Department of Energy's Brookhaven National Laboratory conducted this study, in which they used positron emission tomography (PET) brain scans to determine the levels of dopamine in ten participants. Dopamine is a neurotransmitter that sends messages related to pleasure to the brain. At the start of the study, the researchers questioned the participants about their favorite foods.
In the first phase of the study, the participants had PET scans done when there was no stimulation of food. This allowed the researchers to determine the participant's dopamine baselines. In the second part of the study, the participants were exposed to the foods they said they liked, but were told they could not eat it. The participants' PET scans at this point showed a great increase in their dopamine levels.
The researchers believe that the release of dopamine is the mechanism that ensures that we eat food when food is available, a survival instinct that has worked well for thousands of years. Unfortunately, we are now inundated by the availabity of food and advertising messages about food, as well as easy access to convenience stores, so we eat more than we should. They believe that this may explain the rise of obesity. Their findings have been published in the journal Synapse (volume 44; pages 175-80; June, 2002). An inhibition of dopamine might help, but research is not far enough along to know for sure.
Obesity Surgery May Lower Hunger Hormone
People whose level of obesity has reached a point where dieting and exercise don't seem to help may be inclined to undergo gastric bypass surgery. A new study shows that this surgery helps in long-term weight loss because of a reduction in food-intake capacity as well as a drastic reduction in the levels of a "hunger hormone."
The hunger hormone is known as ghrelin, and is produced by the stomach. Previous research has shown that ghrelin rises immediately before eating, and falls again after eating. Researchers from the Veterans Affairs Puget Sound Health Care System in Seattle, Washington recently conducted a study to determine if ghrelin levels changed after people dieted or underwent gastric bypass surgery.
The participants in the study included thirteen obese people who undertook a six-month weight loss program, five adults who had lost weight after having gastric bypass surgery, and ten adults of average weight. The researchers found that those who had had the surgery had 77% lower levels of ghrelin compared with those of average weight and those who had lost weight by dieting. The dieters who lost 17% of their weight actually had a 24% rise in their ghrelin levels as compared to their levels before they dieted. In addition, ghrelin levels remained constant in individuals who had had the surgery, while they fluctuated before and after meals in people who dieted and people of normal weight.
The study results have been published in The New England Journal of Medicine (volume 346; pages 1623-1630, 1662; May 23, 2002). More research is needed to determine how and why ghrelin levels are reduced after gastric bypass surgery, and whether this information can lead to drug therapy that would have similar results.
Gastric Surgery May Help Obese Teens
The number of obese Americans, including teenagers, is clearly on the rise, and one solution to this problem may be gastric surgery.
Currently, there are few statistics available on the rates at which teenagers are having gastric surgery. At a recent presentation in San Francisco at the Digestive Diseases Week conference of gastroenterologists, researchers from Virginia Commonwealth University in Richmond spoke about their study involving 32 severely obese adolescents who underwent stomach surgery. All of the teens had health problems brought on by their obesity, including Type 2 diabetes, hypertension, sleep apnea, and degenerative joint disease.
The teens underwent a variety of gastric surgery, and were followed for twenty years. They lost an average of two-thirds of their original weight one year after the surgery, and were able to keep this weight off for up to ten years. However, the teens also experienced surgically-related complications, including wound infections, ulcers, bowel obstructions, and hernias. Two needed surgery to correct inadequate weight loss and malnutrition.
The researchers, who reported their findings at Digestive Diseases Week, an annual conference of gastroenterologists, are hopeful that gastric surgery may help teens who have tried unsuccessfully to lose weight in other ways. However, this may be difficult, as current National Institutes of Health regulations regarding this type of surgery only apply to adults, making it difficult to get approval for insurance coverage in teens.
Strength Training For Obese Children
The increase in obesity is not just occurring in the US; rather, it is becoming a worldwide problem. Recently, researchers from Hong Kong released study results about ways to decrease childhood obesity.
The researchers are from The Chinese University in Hong Kong, and have published their results in the Archives of Disease in Childhood (volume 86, May 2002). They involved 82 overweight children between the ages of 8 and 11 in their study, all of whom were either placed on a low-fat, high-carbohydrate diet or the diet combined with aerobic exercise and treadmill work. After six weeks, the researcher compared the health of the children in both groups.
The researchers found that the children in the diet and exercise group were more likely to have lost weight and gained height. They hope that parents will promote good eating and exercise habits in their children as a way of preventing obesity.
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