Excessive Drinking Hurts Kidneys

In new research to find the perfect portions for magic elixirs, scientists say that more than a couple of alcoholic drinks a day may lead to kidney failure, but that total abstention is not good for the kidneys either.

It's been known for some time that high blood pressure, diabetes, and a variety of chemical poisonings raise the risk of kidney failure, but the exact reason why remains unclear. Previous research also pointed to drinking alcohol as a risk factor for kidney failure if the drinker had certain diseases. But the impact of drinking on the rest of the population was unknown. Does drinking hurt their kidneys?

To answer this question, Dr. Thomas V. Perneger, of the Johns Hopkins University in Baltimore, Maryland, and his colleagues compared 716 kidney failure patients with a 'control' group of 361 people without kidney disease. They discovered that kidney failure was four times more common in people who drank more than two alcoholic beverages each day. Their results are reported in the current issue of the American Journal of Epidemiology.

Why is too much drinking bad for the kidneys? Precise mechanisms are not known, but Perneger and his colleagues speculate that drinking may worsen other health problems, such as high blood pressure and diabetes, or alcohol or substances in alcohol may themselves be toxic to kidneys.

So, should people avoid alcohol altogether? Probably so, if they have certain diseases, but for otherwise healthy individuals, two or fewer drinks a day appear to protect them against kidney failure. This moderate drinking may have a positive effect on blood fats and blood clotting, and this could account for the benefits seen with moderation.

New Nasal Drug For Gastroparesis Studied

Emitasol, an intranasal treatment containing metoclopramide (Reglan), is under clinical development for the treatment of nausea and vomiting or delayed digestion caused by gastroparesis in diabetes.

Drug partners Questcor Pharmaceuticals, Inc. and Roberts Pharmaceutical Corporation are beginning enrollment of patients in year-long clinical studies to determine the safety and effectiveness of Emitasol.

Delivering this drug through the nose may improve compliance and effectiveness in patients with a compromised gastrointestinal system, or who may suffer from vomiting and nausea. In addition to diabetes, gastroparesis can be caused by chemotherapy or gynecologic surgery.

Questcor and Roberts have partnered to develop Emitasol in North America. Emitasol, under the brand name Pramidin, is already approved and marketed in Italy.

Gene For Type 2 Diabetes Found

One of the genes responsible for Type 2 diabetes and for two conditions associated with Type 2 diabetes, insulin resistance and hypertension, has been identified by Palo Alto's Incyte Pharmaceuticals Inc., in collaboration with researchers at Britain's Cambridge University.

The discovery, reported in the most recent issue of the journal Nature, could enable better treatment and drug therapy for Type 2 diabetes. Some 90 percent of diabetes cases reported worldwide are Type 2.

Incyte says it used single nucleotide polymorphisms technology, or SNP, which explores genetic variations between individuals, to discover this gene. SNP's can help determine individual disease susceptibility, and also identify who is likely to respond to a medication.

The research found mutations in the PPARy gene in two unrelated individuals, both with symptoms of severe insulin resistance, hypertension, and type 2 diabetes. This gene codes for a protein pursued by pharmaceutical companies as a drug target for the anti-diabetic agents, thiazolidinediones. In each case this mutation altered the amino acid sequence of this protein that compromised the normal action of the receptor protein. Tests of additional family members showed that the mutation is always present with the disease, and does not exist in unaffected relatives.

Incyte's report does not mention how widespread this gene is likely to be in the general diabetes population. Given the complexity of diabetes, most researchers look for multiple genetic and environmental causes, with lifestyle clearly identified as a major contributor.

New Oral Type 2 Drug Submitted To FDA

Novartis Pharmaceuticals Corporation has submitted a new drug application to the U.S. Food & Drug Administration for Starlix, also called nateglinide. Starlix mimics the body's natural insulin release by stimulating the beta cells to respond rapidly when food is eaten, which controls overall blood sugar.

The new drug application (NDA) includes using Starlix alone in either 60, 120 or 180 mg doses and in combination with metformin. Clinical trials with more than 3,700 participants with Type 2 diabetes showed that Starlix helped control spiking of glucose after meals and reduce fasting plasma glucose levels, with lower glycosylated hemoglobin or HbA1c.

Starlix appears to be well tolerated and safe, and its only side-effect being a low incidence of mild hypoglycemia.

Less Conflict Between Job And Health Care

Until President Clinton signed the disability bill this week, a person who received Medicare benefits for a disability could not work, even on a trial basis, part-time or at a low ability job, or they would lose their benefits. Now things are different.

The Work Incentives Improvement Act of 1999 enables people to retain federal health coverage until their private, employer-sponsored benefits kick in. The law provides $250 million to states for programs to provide Medicaid coverage to individuals with disabilities, such as diabetes and AIDS. The law is designed to ease the transition toward partial or full employment.

The Diabetes Mall @ http://www.diabetesnet.com 
Books, gram scales, and more: (800) 988-4772 or [011] 1-619-497-0900