Diabetes News
Week of July 2, 2000 |
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With any disease, the risk of complications and greater
health problems is a given. When diabetes and high blood
pressure are combined, there is a greater likelihood that the
person will develop heart disease or even stroke.
In an attempt to prevent these unnecessary health problems, the National
Institutes of Health has recently issued a
statement advising physicians to closely monitor blood pressure
in people with diabetes. The statement recommends prescribing drugs for hypertension if a person's blood pressure
is not below the appropriate 130/85 level.
The authors of the statement, including doctors from the
State University of New York Health Science Center at Brooklyn
and the Morehouse School of Medicine in Atlanta, recommend the
use of exercise and moderation in using salt and alcohol. They also
recommend the use of drugs like ACE inhibitors, beta-blockers,
calcium antagonists, and diuretics when a person's blood
pressure will not come down with lifestyle changes.
Epidemiology surveys suggest that fewer than one out of
three people who have high blood pressure are even receiving
treatment for it, and only a fraction of those who are on some
treatment are receiving adequate treatment to reach recommended
blood pressure levels. High blood pressure is a risk factor for
heart attack, stroke, kidney failure, and possibly blindness. The authors emphasize the importance
of reducing the rates of hypertension in people with diabetes, since the risk
for further complications is so high.
Painless Heart Attacks Are Most
Dangerous
The most recognized symptom of a heart attack is a pain in
the chest, but a new study shows that this is by no means a
fool-proof method of diagnosis.
Recently, doctors at the University of Alabama at Birmingham
conducted a study of 434,877 heart attack victims. Their
results, published in the Journal of the American Medical
Association (JAMA.
2000; 283: 3223-3229), showed that one-third of these people had gone to
the hospital without ever having chest pains. Even more
disturbing is the fact that 23% of those who didn't have chest
pains died in the hospital, as compared to the 9% mortality rate
in those who did have chest pains.
Why the difference in survival rates? Researchers showed that those who did not have chest pains
delayed going to the hospital by two hours more than those who
did have chest pains. Also, those who did go to the hospital
with chest pains were twice as likely to be diagnosed
immediately and to receive appropriate drugs or angioplasty.
Measuring Glucose Levels Without Using
Blood
One of the most inconvenient aspects of having diabetes is
the necessity of continuously monitoring glucose levels. This
can also be a rather painful ordeal, if multiple finger-sticks
are required in order to obtain blood samples for testing. One
company is hoping to change the way glucose monitors work.
Integ Incorporated recently conducted clinical studies
using their glucose monitoring system, called the LifeGuide System. The
system works by measuring glucose levels in interstitial fluid, the fluid found between the cells in the body.
Interstitial fluid is readily accessible near the skin's
surface, so people who use the monitor will not need to draw blood
every time they want a glucose measurement.
In the studies, participants were divided into two groups.
The first group included 50-100 participants in seven different
trials. These people were not given any dietary restrictions
with blood samples drawn to measure blood glucose. Glucose levels
were also immediately measured in the participants' interstitial
fluid, and then
again 15 minutes later.
The studies showed that glucose
measurements in interstitial fluid are accurate a large
percentage of the time, with accuracy of the ISF measurement
improving when the measurement was delayed. This delay allows
glucose coming from the blood to disperse into the ISF.
A second series of trials was also conducted. This time, the participants'
food intake was purposely manipulated in order to make
their glucose levels dramatically increase and decrease. Their
glucose levels were measured frequently over several hours by
testing their blood and interstitial fluid. In most cases, the
test results of the two fluids were very similar, but in one
case, the results were very different. As a result, the company
has concluded that more research is needed to ensure that people don't
make poor treatment decisions based on inaccurate glucose
readings.
Integ is currently designing the LifeGuide as a small
attachment to the Amira meter.
Protein Therapy May Treat Diabetes
For many years, scientists have tried to find ways of curing diabetes. Hence the research into pancreatic
transplants, islet transplants, the artificial pancreas, etc.
The latest research involves proteins; specifically, blocking a
particular protein in order to enhance insulin production.
In a recent publication of the Proceedings of the National
Academy of Sciences, scientists reported their research into a
protein known as CD26. Studies conducted by Norvo Nordisk in
Bagsvaerd, Denmark showed that mice that did not have this
protein were able to produce enzymes that increase insulin
secretion. Scientists postulate that blocking this protein in
humans may be a way to treat Type 2 diabetes. Research has not
yet been conducted with human participants.
Life Is Beautiful For Those In Control
When people with Type 2 diabetes experience life with good
blood sugar control, they are often amazed by how much better
their life becomes. One recent study set out to show this to 700
people.
The study was conducted by doctors from Harvard Medical
School, and was presented at the recent American Diabetes
Association Convention (Diabetes vol 49, supplement 1, abstract 297). Participants were from nine different
countries, and all had Type 2 diabetes. They were given
either a placebo or 60 mg, 120 mg, or 180 mg of a new drug
called nateglinide. After 24 weeks, researchers measured the
participants' HbA1c levels. They found that the levels had
decreased for participants taking any dose of the nateglinide.
Researchers also questioned participants about the quality of
their lives. Those who had lower blood sugar levels claimed to
have less anxiety, depression, and stress in their lives, and
stated that they felt better about their lives over all.
The
results of this study speak volumes for the importance of blood
sugar control, and can serve as a motivation for people to
learn to take charge of their disease.
Milk, Kids And Diabetes
Another coal on the burning fire of milk as a cause of
diabetes has been thrown. The latest research into why children develop Type 1 diabetes
yields some startling statistics-- children who consume more
than three glasses of cow's milk a day may be more likely to
develop the disease than non-milk drinkers.
The study was conducted by doctors at the University of
Tampere in Finland, and results are published in a recent issue
of Diabetes. Researchers found that children who had a sibling
who already had diabetes were five times more likely to develop
diabetes themselves if they drank a lot of milk each day.
Scientists are not sure why this link may exist, but suggest
that some protein in the milk may cause the immune system to
attack cells that produce insulin. More research is needed to
determine whether or not this link really exists.
Another study in the British
Journal of Nutrition looked at low glycemic index foods
in an attempt to lessen insulin resistance. These researchers
looked at certain breakfasts to see if a mild rise in blood
glucose could be maintained until the next meal to significantly
reduce blood glucose and insulin levels after the meal. One
interesting finding in their study was that although milk had a
low glycemic index, it seemed to cause insulin levels to rise to
a level indistinguishable from a white bread reference meal. The
inconsistent behavior seen in milk products has not been
acknowledged until this study, and its metabolic consequences
remain unclear.
Glucose Monitor Deemed Lawful
The pharmaceutical company Home Diagnostics, Inc., which
manufactures a glucose monitor for people with diabetes, was
recently awarded a favorable ruling by the U.S. District Court
in Delaware. The company had been sued by Lifescan, Inc. for
infringing upon a patent for a glucose monitoring device.
Although a jury had decided that Home Diagnostics may have
indirectly infringed
on the patent, a judge overruled that decision. Home Diagnostics
plans to introduce their monitor, called The Prestige, to the
market via national drug store chains in the near future.
Diabetes Website Expands
One of the most helpful tools for people to obtain information
regarding just about anything is the Internet. This
certainly holds true for people with diabetes, as there are many
informative websites about this disease. A recent takeover of
one site by another hopes to expand the material
available.
Diabetes123.com
has taken over childrenwithdiabetes.com.
The combined site will provide comprehensive information on both
Type 1 and Type 2 diabetes. Jeff Hitchcock, webmaster of the
children with diabetes site will continue as webmaster and CEO
for both sites. Further funding is required before
the combined site will be fully developed.
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