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Diabetes Cure In Pig Cell
Transplant?
In recent years, there has been much discussion about the
possibility of transplanting animal cells into humans in order
to cure disease. A study begun nine months ago may bring that
possibility closer to reality.
The study is being conducted by doctors at Duke University
Medical Center in Durham, North Carolina, who presented their
findings at a meeting of the International
Pancreas and Islet Transplant Association in Austria (June 15,
2001). Nine months ago, a baboon with Type 1 diabetes was given
a transplant of 250,000 pancreas cells from three pigs. Since
then, the baboon has not needed insulin shots, and has
maintained normal blood glucose levels.
The transplant technique involved extracting islet cells from
the pigs, inserting them into a protective capsule, and
injecting them into the baboon. The cells then secrete insulin
through pores, which are large enough to allow the passage of
glucose and insulin, but too small to allow immune system cells
to enter, which would destroy the transplanted cells.
Researchers are hopeful that a similar technique will be used
in humans in order to eliminate diabetes.
Inconsistent Rates Of Amputation
One of the more extreme complications of diabetes is nerve
damage that is severe enough to warrant amputation. Although
diabetes complications account for over 50% of lower-limb
amputations in the US each year, the rates vary across the
country, suggesting that preventative measures can be taken.
Two studies published in a recent issue of the journal
Diabetes Care (volume 24; pages 855-859, 860-864; June 2001)
compare amputation rates in different geographical regions. One
study was conducted by researchers at the University of
Bielefeld in Germany, who studied records of amputations
performed between 1990 and 1991, and those performed between
1994 and 1998. They found that the rates of amputations due to
diabetes complications did not decline, although healthcare
facilities had this as a stated goal.
An additional study was conducted by doctors at Dartmouth
Medical School in Hanover, New Hampshire. They studied the
amputation rates between 1996 and 1997 in 300 hospitals across
the US, and found that people with diabetes were ten times more
likely to undergo amputation than those without diabetes.
However, the regions with the highest rates of amputation were
scattered across the country, with no real consistent pattern. Although
the researchers note that varying rates could be due to
different ideas about diagnosis and management of the disease,
they also believe that study results give hope in terms of
preventative measures to reduce amputation. They believe that
the regions with the lowest rate of amputation should be studied
in order to determine the best intervention methods.
Does Diabetes Impair Thinking?
Although the possible physical complications of diabetes are
well-known, and include heart disease, nerve damage, and vision
loss, the possible mental complications have not been as widely
studied or recognized. One recent study attempts to identify
such complications.
The June issue of Diabetes Care (volume 24, pages 1060-1065,
June 2001) includes a study conducted by doctors at Harvard
Medical School in Boston, Massachusetts. The study included
2,300 women between the ages of 70 and 78. They were given four
tests of their mental function between the years 1995 and 1999.
In addition, the researchers collected medical data every two
years, starting in 1976, in order to compare the test results of
women with and without diabetes.
Researchers found that women with Type 2 diabetes had lower
scores on all four of the tests, and were more than twice as
likely to do poorly on scores combining all four tests. In
addition, the women's scores decreased in proportion to the
length of time they had lived with diabetes. About 38% of the
women with diabetes were taking medication for their disease,
and they had test scores that were similar to those of the women
without diabetes.
The study authors believe more research on this topic is
needed, particularly because the rates of both diabetes and poor
mental function increase among the elderly as compared with
younger individuals.
Cesarean Births Less Risky In Diabetes
In five percent of all pregnancies, the mother develops
gestational diabetes. This is caused by hormonal changes during
pregnancy, and is accompanied by the risk of having a baby that
is larger than normal. A recent study compared the risks of
vaginal births with cesarean births for women with gestational
diabetes.
The study was conducted by doctors from Emory University in
Atlanta, Georgia, and involved the comparison of deliveries of
156 women with diabetes with the deliveries of 272 women without
diabetes. All of the participants were attempting to deliver
their babies through a vaginal birth after having undergone a
cesarean section in a previous pregnancy.
Results of the study, which are published in the American
Journal of Obstetrics and Gynecology (volume 184, pages
1104-1107, 2001), indicated that the women with diabetes were
almost twice as likely to need another cesarean section, or the
assistance of forceps or a vacuum in their deliveries. In
addition, the mothers with gestational diabetes delivered babies
that were an average of 250 grams larger than the babies born to
mothers without the disease.
The researchers hope their study will make physicians aware
of the risks associated with gestational diabetes, and help them
make decisions about the best method of delivery for these
women.
Estrogen Therapy Reduces
Cataract Risk
Estrogen replacement therapy for women who have gone through
menopause has been used to prevent and treat osteoporosis.
However, a new study suggests that it may also be used to reduce
the risk of developing cataracts.
The study was led by researchers at the University of
Minnesota School of Medicine, and has been published in the
Archives of Internal Medicine (volume 161; pages 1448-1454; June
11, 2001). The researchers studied the effect of estrogen
replacement therapy on lens clarity in more than 500 women.
Almost 65% of the women reported that they were not using
estrogen, 23% said they had used estrogen in the past for at
least ten years, and 7% said that they currently took estrogen.
Results of the study showed that the use of estrogen was
inversely proportional to the risk of cloudiness in the lens.
Women who had used estrogen for one to two years were 20% less
likely to develop cataracts than those who did not use estrogen
at all. Those who had used estrogen for ten or more years were
60% less likely to develop cataracts. The link between estrogen
and a decreased risk of cataracts remained, even when risk
factors like diabetes, high blood pressure, body mass index, and
smoking were taken into account.
Other results of the study showed that women who had
undergone surgical menopause due to having their ovaries removed
were twice as likely to develop cataracts as those who had
undergone natural menopause. Study authors postulate that this
is due to an abrupt cessation of estrogen production after
surgical menopause, as compared to a gradual decline of estrogen
in natural menopause.
Diabetes Ups Risk Of West Nile Virus
Although insect- and animal-borne diseases have been the
subject of numerous horror films and novels, human outbreaks of
such diseases does remain possible, and precautions must be
taken to avoid them.
One such virus is the mosquito-borne West Nile Virus. In the
summer of 1999, at least 59 people were hospitalized with the
virus in New York City, seven of whom died. People with diabetes
or aged 75 or older were five times as likely to die from the
virus.
Symptoms of the virus are similar to those of the flu,
although healthy people may not exhibit symptoms at all.
Researchers estimate that only one in one hundred infections of
the West Nile Virus causes symptoms. This information was issued
by Dr. Denis Nash of the New York City Health Department and
researchers from other health agencies. It was published in
New
England Journal of Medicine (June 14, 2001).
According the the U.S. Centers
for Disease Control and Prevention, there were 21 cases
of West Nile virus in the northeast last year, two of which were
fatal. Hopefully, awareness about the virus will assist in
timely diagnosis and treatment of those who have been infected.
EU May Lift Ban On Drug Advertising
Since 1997, the United States has had a policy allowing for
direct-to-consumer advertising of available drugs for specific
health conditions. This is not allowed in Europe, but the
European Commission is now developing a proposal to lift this
ban.
The European Commission will propose that the European Union
(EU) allow pharmaceutical companies to have direct contact with
patients in regards to specific drugs available to treat AIDS,
asthma, and diabetes. The proposal is expected to be adopted by
the EU's executive leaders in July. From there, it must be
approved by the 15 member states of the EU and the European
Parliament.
The direct advertising would have to comply with a code of
conduct, and would be limited to drugs for the three specific
diseases. The Commission hopes to begin a five-year trial period
of the direct advertising. Already, people in Europe have access
to drug information via US websites. Some member states of the
EU object to the accessibility of the information, as
prescription drugs in Europe are partly or fully subsidized by
national health coverage. They believe that more information
about drugs could increase demands for them, at great cost to
healthcare budgets.
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