Diabetes News
Week of June 18, 2000 |
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Many people with diabetes have the problem of
slow-healing wounds. A new study on the healing properties of
blood suggests that a certain blood component may dramatically
speed the healing process.
In a study performed by doctors at the University of Michigan
Medical School in Ann Arbor, wounds in mice with diabetes were
treated by the substance fibronectin, which is naturally present in blood.
As reported in the June issue of the Journal of Clinical
Investigation, wounds treated with a special preparation of fibronectin healed in just
eight days. This was compared to wounds treated with a saline
solution or a different kind of protein which took
between twenty and forty-two days to heal.
Fibronectin is produced in the liver, and is present in all
body fluids. It works at the site of a wound by breaking into pieces and
binding
to surrounding cells. This stimulates the cells to invade and
repair the wound.
People with diabetes often have problems with
circulation, which may prevent the fibronectin in their
bloodstreams from working as well. In the study,
researchers isolated one specific segment of the
fibronectin molecule, called PHSRN, which appeared to help the healing
process. They then used the PHSRN on the wounds to speed up
healing.
More studies are needed to determine the safety of applying
fibronectin to wounds in humans, and to make sure there are no
unwanted or toxic side effects.
Diabetes And Smoking Cessation
Although much research has been conducted on the health
hazards of smoking, it continues to be a major addiction in this
country. A new study shows that one factor that motivates people
to quit is the diagnosis of diabetes.
At the latest meeting of the American Diabetes Association, a
study (Diabetes, vol 49, supplement 1, abstract 348) was
presented that links the diagnosis of diabetes with people's
decision to quit smoking. Doctors at the University of Michigan
Ann Arbor studied 1,945 smokers between 1992 and 1996. They
found that 345 of the original smokers had quit smoking by 1996.
Of these people, 33 had been diagnosed with diabetes between
1992 and 1994. Researchers found that
those who were diagnosed with diabetes were 2.4 times more
likely to quit smoking than people who had not been diagnosed
with the disease.
The researchers believe that their study shows that sometimes
it takes something drastic before people will quit smoking. This
implies
that education techniques designed to help people quit must
be varied according to the target audience.
High Cholesterol Pervasive In Diabetes
With diabetes comes a variety of health complications, and
many people with the disease may not even know they are having a
particular health problem. A recent study shows that although
high cholesterol levels are common, many people may not even
know about it, and therefore aren't receiving adequate care.
At the meeting of the American Diabetes Association,
researchers from the Centers for Disease Control and Prevention
in Atlanta, Georgia, reported the results of a study that
included 1,269 adults with diabetes aged 18 or older who had
their lipids measured. Lipids are fats--such as
cholesterol--that are found in blood. This report (Diabetes, vol 49,
supplement 1, abstract 318) found that 97% of the adults studied had some sort of cholesterol problem. Seventy-six percent of
these were at high risk for cardiovascular disease based on
their cholesterol levels, and twenty-one percent had a
borderline risk.
Of the participants, only 36% had ever been told that they
had high cholesterol, and only 32% had ever undertaken any sort
of treatment for this, either through diet modification,
exercise, medication, or some other treatment. Clearly, people
with diabetes need to be educated about all health risks of the
disease, and especially that of high cholesterol. Most people
with diabetes die of cardiovascular problems, and many drugs and
techniques are available that can greatly reduce these risks.
Daily Exercise Healthy For Women
Health professionals have long promoted exercise as being the
key to good health. A recent study especially encourages women
to adopt some sort of daily exercise program.
The Nurses' Health Study was conducted by Brigham and Women's
Hospital in Boston, and Harvard, and is published in the Journal
of the American Medical Association. This large, long-term study included over
72,000 nurses, and was begun in 1976. Results showed that women
who did some sort of moderate or vigorous exercise for 30
minutes per day had a 20% decrease in risk of stroke than those
who did not exercise. Exercise also decreased the rates of heart
disease, Type 2 diabetes, osteoporosis, and some cancers.
Researchers encourage women to engage in a variety of exercises,
from swimming to walking.
Of the 7.5 million men in the U.S. who have diabetes, it is
estimated that half of them also have problems with erectile
dysfunction (ED). Studies presented at the annual meeting of the
American Diabetes Association suggest that Viagra may be the
answer to their problems.
In one report (Diabetes, vol 49, supplement 1, abstract 143), researchers at the University of Manchester studied 220 men
with Type 2 diabetes who also had ED. Participants were divided
into two groups, and received either Viagra or a placebo for
twelve weeks. Those taking the Viagra had an increase in
successful intercourse, with the success rate going from 14.4%
before the study to 58.8% while on Viagra. Those taking the
placebo had no change in success rates. Adverse side-effects
were rare and moderate.
A similar study (abstract 354) was conducted at the Ochsner Medical Institution
in New Orleans, and included 152 men with Type 1 diabetes, 822
men with Type 2 diabetes, and 1,693 men without diabetes. All
had ED. Participants were given either Viagra or a placebo for
six months. Results showed the best improvement with Viagra for
those who did not have diabetes, with successful intercourse
rates increasing from 26% to 83%. Those with Type 1 diabetes
experienced similar improvements to those with Type 2. Type 1
participants went from an 18% success rate on the placebo to a
59% success rate on Viagra. Those with Type 2 on the placebo had
a 17% success rate, while those who took Viagra had a 63%
success rate.
A follow-up study of the same group of men reported in
abstract
354 compared the rate of side-effects experienced by men taking Viagra or the placebo. Results showed
that the rate of adverse effects was similar among participants
with or without diabetes, and that there is no difference
between the rate of side-effects in those with Type 1 and those
with Type 2. The most common side-effects among all participants
were headache, flushing, dyspepsia, and dizziness. There were no
reports of fainting or postural hypotension in any of the
participants with diabetes.
All three of the studies suggest that Viagra is an effective
way to treat erectile dysfunction, a problematic complication
for many men with diabetes. Appropriate guidelines for prescribing Viagra come with the
drug and restrict its use by some people.
Update: Avandia Still Safe For The
Liver
A danger of many medications designed to treat a
specific problem is that they can sometimes have side-effects
that are even more problematic than the disease. This happened
with the diabetes drug Rezulin, which created deadly liver
problems in some of the people taking it. According to a recent
study, the new diabetes drug Avandia is showing no signs of
causing similar liver problems.
The report (Diabetes, vol 49, supplement 1, abstract 159)
includes data from trials involving 5,000 participants with Type
2 diabetes.
Researchers assessed the participants' levels of alanine
aminotransferase, which is a liver enzyme present when there is
disease or drug-related damage. After one year, participants who
were receiving Avandia had alanine aminotransferase levels far
below the levels of those who were receiving a placebo. Their
levels had also decreased over the course of the year on Avandia.
The study offers hope to those relying on medication to slow or
stop the progression of Type 2 diabetes.
More Testing Enables More Control
It seems like common sense that the more you test your
glucose levels, the more awareness you will have of your blood
sugars, and the better you will be able to control them. A new study promotes
this idea of frequent testing, and also says that you should
test periodically your fructosamine and hemoglobin as well as glucose levels.
Researchers, led by Steve Edelman, M.D. at the Univ. of California, San Diego
recently released their study (Diabetes, vol
49, supplement 1, abstract 421) of twenty-five people who had poor control of
their diabetes. The participants were divided into two groups.
The first group was asked to test only their glucose levels four
times per day. The second group was asked to test their glucose
four times per day, and their fructosamine once per week.
If fructosamine levels were above 350 micromole, they were to
call their doctor, and were given treatment advice over the
phone.
At the conclusion of the three-month study, doctors found
that those who had tested both glucose and fructosamine levels
had a 13% improvement in their HbA1c test results, as compared
to the 3% improvement in those who only tested their glucose
levels.
The LXN Corporation has developed a weekly fructosamine test,
known as the GlucoProtein test. People can test both
glucose and fructosamine levels on the same machine, called the In
Charge Diabetes Control System.
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