Too Little Sleep Suspected To Cause Diabetes 

You may know that losing sleep makes it hard for you to think clearly and respond accurately, but did you know it also possibly hastens the onset of age-related illnesses like diabetes, hypertension, obesity and memory loss? 

A research team from the University of Chicago reported in Lancet, a major medical journal from Britain, that routinely catching only a few hours of sleep hinders metabolism and hormone production so that age-related ailments occur earlier and are more severe. 

The researchers examined 11 healthy young male participants, ages 18 to 27, for 16 nights. The first three nights the participants slept eight hours, the next six nights they slept only four hours, and the final seven nights they spent 12 hours in bed, either asleep or resting. All followed the same diet, and the researchers monitored their blood sugar levels and several hormones involved in metabolism. 

After several nights of little sleep, the participants had elevated blood glucose levels and their first phase insulin response to eating carbohydrate decreased by 30 percent. The men's blood sugar levels took 40 percent longer to drop following a high-carbohydrate meal. These changes in metabolism are strikingly similar to those of insulin resistance, which causes most cases of Type 2 diabetes and essential high blood pressure, usually associated with older age.

The sleep-deprived men also had increased blood levels of cortisol, usually considered a stress hormone, and often seen elevated in older men who have memory loss. 

The subject's sleep debt, only six nights in the study, was corrected by spending longer than the normal eight hours in bed for seven nights, which returns the body's chemical balance to normal, or better.

The average night's sleep experienced by people today is 7.5 to 8 hours and shrinking, although many people often get considerably less due to work or leisure activities. This is down from nine hours early in the century. It is not known if an individual's metabolism and hormone levels can return to normal if the sleep deprivation goes on for long periods of time.

Avandia Fails To Get Approval In Europe

 A "negative opinion" was given on SmithKline Beecham's new Type 2 diabetes drug Avandia by the European Union's Committee for Proprietary Medicinal Products (CPMP). This opinion is considered a major setback for SmithKline in a fierce battle against rival drugs from Warner-Lambert Co (Rezulin) and Eli Lilly & Co (Actos) in the $6 billion world diabetes market. Rezulin, Actos and Avandia are all part of a new class known as glitazones. 

Shares in British drugs giant SmithKline Beecham fell after the opinion was issued. Apparently the EU is not worried about liver toxicity, which led to the withdrawal in Europe of Rezulin. Both Avandia and Actos have so far proven safer than Rezulin. 

Why the committee rejected the drug is unknown. Analysts are wondering if the EU panel felt the drug was simply not effective, although the United States Food and Drug Administration approved the drug earlier this year using the same data, plus data acquired during the first weeks following its U.S. launch. Avandia has been prescribed for 250,000 Americans since its U.S. launch in June of this year.

Teens With Type 2 Diabetes Have Unhealthy Families

The families of adolescents with Type 2 diabetes tend to eat unhealthy diets, to be sendentary and to be overweight. In addition to raising the risk for developing diabetes, living in this sort of family may make it harder for adolescents to keep their diabetes under control. 

These findings, from a study conducted by Dr. Philip Scott Zeitler of The Children's Hospital in Denver, are published in the Archives of Pediatric and Adolescent Medicine.

Type 2 diabetes is generally related to being both inactive and overweight. Until recently, Type 2 diabetes was considered a disease of adulthood, but the incidence of this condition in children and adolescents has skyrocketed. 

In order to understand this phenomenon, Zeitler and his colleagues studied 11 families who had an adolescent with Type 2 diabetes. The children, their parents and siblings had their body fat measured, their blood tested and they answered questions about their diet. The results showed that the adolescents and their families tended to be obese, to eat a high fat diet low in fiber, and to be inactive. None of the families had a regular exercise routine, and two families did not participate in any physical activity. Out of the 11 families, five of the mothers and seven of the fathers also had type 2 diabetes.

Like in early stages of Type 2 diabetes in adults, reversal of Type 2 diabetes in adolescents occurs when they exercise more, eat a healthy diet and lose weight. However, this is difficult if the rest of the family continues to live an unhealthy lifestyle.

Walking Cuts Diabetes Risk

You like to walk for exercise, but you're not sure you're getting any benefit. Stop worrying! One hour of brisk walking everyday cuts a woman's risk of developing Type 2 diabetes in half, according to the results of the Nurses Health Study in The Journal of the American Medical Association. 

A study of more than 70,000 women found that moderate to vigorous exercise, accumulated from a variety of activities through the day, such as walking to the bus stop, walking up several flights of stairs or doing housework, was associated with a 46 percent lower risk of adult-onset diabetes.

Walking, as with other types of exercise, apparently wards off older-age diabetes by keeping weight down and allowing the body to make better use of the insulin it produces, the report said. The study was designed to find the benefits of walking, the most common form of physical activity among middle-aged and older people.

The results of the study led by Dr. Frank B. Hu of the Harvard School of Public Health. are in line with previous research on both men and women. Both the Centers for Disease Control and Prevention, and the National Institutes of Health, recommend at least 30 minutes of moderate exercise a day. Another recent study shows a 30% reduction in breast cancer risk with walking, along with many earlier studies showing reduced heart disease and diabetes.

Take Your Insulin Orally

Protein Delivery Inc (PDI) has FDA acceptance for their Investigational New Drug Application (IND) for an oral insulin drug to treat diabetes. A Phase II clinical trial of oral insulin in patients with Type 1 diabetes is also underway at Georgetown Medical Center. 

Why oral insulin? Until now, insulin has been available to people with diabetes only by injection. But in theory, oral insulin has significant medical advantages over injected insulin. Oral insulin more closely mimics the activity of normal insulin in that higher levels reach the liver, while lower levels are seen in muscle and fat tissue. Oral insulin is also likely to improve compliance. If PDI has solved the problem of getting a protein like insulin past the acids and enzymes of the stomach, accuracy in dosing could pose a major problem, especially in Type 1 diabetes.

In two recent studies in Germany on humans, PDI's oral insulin was found to be safe and effective, with few side effects.

Endocrinologists Shorten Hospital Stays For People With DKA 

A study published in the November issue of Diabetes Care shows that endocrinologists save costs and improve care when providing primary care for patients hospitalized with diabetic ketoacidosis (DKA). 

The study, led by Claresa S. Levetan, MD, FACE, and her colleagues, found that endocrinologist-treated patients hospitalized with DKA stayed in the hospital 50% less time and accumulated $5,000 less in charges than patients treated by primary care physicians. These patients also had a three-fold lower readmission rate for DKA over the study period. 

This study provides support for using specialty care in acutely ill patients rather than primary care. The trend currently is to increase the delivery of medical care by primary physicians, which in circumstances such as these leads to worsening of outcomes. 

In a previous study, Dr. Levetan and colleagues reported a 56% reduction in time spent in the hospital among patients initially diagnosed with diabetes who were treated or had consultation by an endocrinologist-led team.

More than 100,000 people are hospitalized annually in the U.S. with DKA. More than $40 billion annually or 60% of the direct U.S. healthcare costs for people with diabetes, is spent on hospitalization.

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