Diabetes News
October 3rd, 1999 |
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Get Your Flu Vaccination Now
New medications for treating flu symptoms have been reported
in the news recently. Unfortunately, many people may be lulled
into thinking that getting the flu is not so bad. But avoiding
this potentially deadly disease is still one of the smartest
preventive health steps a person can make. Your annual flu
vaccination is a clear winner in the fight to stay healthy.
The Centers for Disease Control and Prevention (CDC)
recommends annual flu shots for anyone who wants to reduce their
chances of contracting influenza, and especially for those with
diabetes. A flu vaccine is the best way to avoid absenteeism
from work, respiratory illness, and subsequent visits to your
doctor or an overnight clinic. It is also an excellent way to
avoid becoming one of the 110,000 people hospitalized, or one of
the 20,000 deaths, reported annually in the United States due to
flu.
Although healthy working adults between the ages of 18 to 64
are not the group most in need of vaccination, the annual cost
savings per person in this group who receives a vaccine is
estimated at $46.85. The yearly cost of influenza epidemics
exceeds $12 billion.
The CDC says the following people are at high risk for
contracting the flu and should absolutely have a flu shot:
- people 65 and over
- residents of nursing homes or chronic-care facilities
- adults and children who have chronic disorders of the
pulmonary or cardiovascular systems, including asthma
- adults and children who have required treatment during the
preceding year because of chronic metabolic diseases
(including diabetes), renal dysfunction, hemoglobinopathies,
or immunosuppression
- health care and day care workers
- women who will be in their second or third trimester of
pregnancy during the flu season
Medicare To Cover Insulin Pumps For Type 1 Diabetes
Medicare announced that it will start covering insulin
infusion pumps in the new millenium to allow people with
diabetes to more closely control blood sugar levels. The
coverage is for eligible people with Type 1 diabetes. Medicare
covers people over age 65, people with disabilities and people
with kidney failure.
Type 1 diabetes affects between five and 10 percent of the
estimated 16 million Americans with diabetes. The rest of the
group has Type 2 diabetes, but the Health Care Financing
Administration (HCFA) said the infusion pumps have not yet been
shown to be effective for Type 2 diabetes.
The new Medicare coverage begins in April and the
reimbursement rate will be determined by then. Studies have
shown that all types of diabetes are responsible for $92 billion
in medical costs and lost productivity each year. Medicare
serves as a windsock for HMOs and insurance companies. Insurers
who have not covered insulin pumps as therapy for diabetes in
the past, will now have difficulty defending this position.
Tumor-Starving Compound Offers New Treatment For Cancer And
Proliferative Retinopathy
A naturally-occurring compound that a company in now
producing in goat milk has been identified by researchers as the
newest approach to combat cancer tumors by cutting off their
blood supply.
Once tumors reach a certain size, they have to create a blood
supply to feed themselves in a process called angiogenesis. A
drug or compound that interferes with a tumor's blood supply is
known as an angiogenesis inhibitor. These drugs or compounds,
while not offering a cure by themselves, might be added to other
treatments against cancer to make them more effective and less
toxic to healthy cells. They may also provide an excellent tool
to stop the proliferation of new blood vessels that triggers
much of the blindness found in diabetes.
Writing in the journal Science, Dr. Judah Folkman of
Children's Hospital in Boston and his colleague Dr. Michael
O'Reilly said their new compound, anti-angiogenic antithrombin
III (aaAT or aaATIII), when tested in mice worked at least as
well as two highly-touted proteins (angiostatin and endostatin)
that their laboratory had already developed last year. When
injected into specially bred mice infected with cancer, aaAT
caused their tumors to wither and die.
Testing in humans is the next step. Researchers are working
with Genzyme Molecular Oncology in Framingham, Massachusetts,
which already produces a similar protein that is very similar,
called antithrombin. Folded within the antithrombin molecule is
the smaller protein aaAT that prevents tumor growth. Genzyme has
developed genetically engineered goats to make antithrombin in
very high levels in their milk, and expect to be able to create
the smaller protein in this way as well. They hope to file with
the U.S. Food and Drug Administration for human trials with aaAT
as early as next year.
New Type 2 Drug Restores First Phase Insulin Response
A report from the annual meeting of the European Association
for the Study of Diabetes (EASD) looked at a new investigational
drug, called nateglinide. Loss of insulin production from the
beta cells is an important cause of type 2 diabetes. Nateglinide
causes the beta cells to produce more insulin for meals, lowers
mealtime glucose spikes, and, because its action quickly ends,
reduces the risk of hypoglycemia and stress on the beta cell. It
also lowers longterm blood glucose levels so that overall
control is better, minimizing the risk of diabetes
complications.
A total of 1400 patients with Type 2 diabetes participated in
two 6-month studies at several sites. These included studies
using nateglinide alone, at various doses, or in combination
with metformin, a biguanide drug that lowers glucose production
in the liver and enhances the uptake of glucose in skeletal
muscle. The combination controlled overall glucose levels and
looks promising for patients with more advanced diabetes.
Another eight-week study had 150 patients receive either
nateglinide, placebo, or glyburide/glibenclamide, a sulfonylurea-type
of diabetes drug that promotes increased insulin secretion
throughout the day. Nateglinide is an investigational agent
under development by Novartis Pharma AG of Basel, Switzerland.
Extendin-4 Enhances Insulin Production In Type 2 Diabetes
Extendin-4, a 39 amino acid peptide, helps people with type 2
diabetes respond appropriately to high glucose levels in the
body by producing a potent, enhanced insulin response.
Furthermore no increase in blood glucose was seen following a
meal given three and one-half hours after the extendin-4. People
with type 2 diabetes often have trouble regulating their own
insulin response so that their blood glucose stays controlled.
Researchers at the National Institute on Aging, Baltimore,
MD, and Massachusetts General Hospital, Boston, reported the
results of their study at the 35th Annual Meeting of the
European Association for the Study of Diabetes in Brussels,
Belgium.
These independent researchers infused extendin-4
intravenously into people with type 2 diabetes and also into
others without diabetes but with induced high blood glucose
levles. The drug resulted created an enhanced insulin response
during the high blood glucose period in both groups. A sustained
action was also noted in that no increase in blood glucose was
observed when a meal was eaten three and one-half hours after
the extendin-4 infusion had been stopped.
Amylin Pharmaceuticals in San Diego is now conducting Phase 2
clinical studies of AC2993 (synthetic extendin-4) as a drug
candidate for use in type 2 diabetes.
Cerivastatin Plus Fibrate Treats Diabetic Hyperlipidemia
Heart disease is the most life-threatening complication in
Type 2 diabetes. A significant part of the problem, found
especially in type 2 diabetes, is a combined hyperlipidemia with
high triglycerides, low protective HDL, and high bad LDL. A new study in the
European journal Diabetologia suggests that aggressive treatment
with new combination therapies and new statin drugs may help
prevent coronary heart disease in these patients.
Evidence from three new studies all demonstrate that
cerivastatin (Bayer's Lipobay or Baycol), one of the statin
drugs for lowering cholesterol, given either as single
therapy or in combination with a fibrate drug, may be a treatment
option for diabetic dyslipidemia.
Combination studies of Professor Michel Farnier and Professor
Ricardo Esper used 0.3mg. of cerivastatin in combination with
fenofibrate (Tricor) and bezafibrate. With 200 mg. of
fenofibrate, cerivastatin reduced LDL cholesterol over 40 per
cent, TGs over 37 per cent, and raised good HDL by more than 12
per cent. When combined with 400mg of bezafibrate. LDL was
reduced by over 42 per cent, TGs by 44 per cent and HDL
increased by more than 32 per cent.
Previous lipid lowering trials in people with Type 2 diabetes
have investigated patients who have already had a cardiovascular
event. But a new landmark Lipids in Diabetes Study will evaluate
the effect of lipid lowering therapy with cerivastatin and a
fibrate (fenofibrate) on cardiovascular morbidity and mortality
in 5,000 patients with type 2 diabetes prior to any event.
Cerivastatin is a third generation micro-statin, which works
well, produces few side effects, and interacts well with other
medications. Statin drugs will rarely trigger a severe muscle
disorder called rhabdomyolysis with possible renal failure. The
risk of rhabdomyolysis appears to be higher when statins are
used with fibrate medications.
Vaccines Do Not Cause Childhood Diabetes or Asthma
New research shows that childhood vaccines that protect
against ear infections, meningitis and chest infection, as well
as hepatitis B, do not cause Type 1 diabetes. This should lay to
rest rumors circulated by anti-vaccine groups that vaccines can
cause the immune system to create autoimmune diseases such as
Type 1 diabetes.
Anti-vaccine groups had fought against infant hepatitis B
virus immunizations, arguing in Congressional hearings earlier
this year that these vaccines can confuse the immune system. The
concern has been great enough that a team at the Centers for
Disease Control and Prevention (CDC) in Atlanta looked at the
rate of Type 1 diabetes and asthma for three large health
maintenance organizations. Of all children born since 1988, they
found 140 children with Type 1 diabetes. This was not a
significant number of the 94 percent of all children, those with
diabetes and those without, who had been vaccinated for
Haemophilus influenzae type B (Hib) and the 40 percent who had
been vaccinated against the hepatitis B virus.
The same team also looked at 116,000 children, 11,000 of whom
had asthma, and found no relationship between the common DTP
(diphtheria, tetanus and pertussis) vaccine or measles, mumps
and rubella vaccines and asthma. Researchers concluded that the
vaccines have significant health benefits and do not appear
linked to either type 1 diabetes or asthma.
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