I write these articles one month in advance and today comes the news that not only is the Senate re-evaluating a bill about stem cell research, but 13 out of 15 newly diagnosed type 1 diabetics in Brazil injected with their own stem cells remain insulin free up to three years after the initial treatment. All good news!
Let’s get started as there are many headlines to share with you. After that we’ll bring you abstracts on the relation of diabetes and mild cognitive impairment, and Periodontitis as a precursor to diabetes.
Diabetes organizations are backing H.R.3, the “Stem Cell Research Enhancement Act" which would expand federal funding for embryonic stem cell research. In the last session of Congress, both the House of Representatives and Senate passed the bill with bipartisan support, but were unable to override the President’s veto. Fortunately, the bill has been reintroduced and has already passes the U.S. House of Representatives. The Senate is expected to consider the bill soon and many organizations will continue to expand the federal commitment to stem cell research. On the subject, Dr. Elias A Zerhouni, the Chief of the National Institutes of Health, testified before the Senate health appropriations subcommittee. Funding research would better serve both science and the nation was his message. He was quoted as saying that allowing the ban to remain in place leaves his agency fighting “with one hand tied behind our back."
When we wrote Joslin Diabetes Gourmet Cookbook, I got a call from the editor about cinnamon controlling diabetes. The April Diabetes Care there was an article done by Dr. Kevin M. Curtis from Dartmouth-Hitchcock Medical Center and colleagues. They examined 72 adolescents with type 1 diabetes who took 1 gram of cinnamon per day while they continued with their existing medication, diet, and exercise. The researchers chose adolescents because this age-group is particularly at risk for uncontrolled blood sugar and had most to gain from the intervention. After 90 days, Curtis and colleagues failed to see any marked differences in blood sugar control, changes in blood sugar levels, total daily insulin requirement, or number of hypoglycemic events between the cinnamon takers and placebo takers. In fact, the trend favored the placebo group although not at a statistical level.
Only one in seven Americans exercises enough and eats enough fruits and vegetables, and men are worse than women, federal health officials have reported. The CDC tracked the percentage of Americans who eat at least five servings of fruits and vegetables daily and engage in moderately intense exercise at least 30 minutes five days per week or vigorous exercise for at least 20 minutes three days a week as recommended by the government. Overall, 14.6 % Americans met both dietary and exercise benchmarks, including 12.4% of men and 16.6% of women. It’s not that people don’t know that they need to eat more fruits and vegetables and to exercise, they just do not comply. This is disturbing at a time when obesity is a major problem in the U.S.
We all know that diabetes may precipitate certain long term complications such as cardiovascular, retinal, renal, and neurological diseases. It was therefore distressing to read in the April Diabetes Care journal and article written by Dr. Gang Hu and colleagues at the National Public Health Institute in Finland which found patients with type 2 diabetes are more likely to develop Parkinson’s disease. They found that type 2 diabetics were 83% more likely to be diagnosed with Parkinson’s later in life than people in the general population. The risk was the same for men and women and was independent of other risk factors. The researchers followed 51,552 Finnish men and women aged 25 to 74 for 18 years. None had Parkinson’s at the beginning of the study. About 600 developed Parkinson’s by the end of it, and those who did were nearly twice as likely to have diabetes as well, the researchers want to research the link further.
The BBC reported April 4, 2007 that researchers are looking at alternatives to the daily insulin injections diabetics each day. The team from the National Tsing Hua University has found a chemical in shrimp cells that can protect the drug from being destroyed by stomach acids. The current problem is that current doses needed to work in rat experiments far exceed those normally given in humans. Drugs that contain protein chemicals, including insulin, cannot survive exposure to stomach acid if swallowed. The Taiwanese researchers discovered a way to encase the drug in a shell which would resist stomach acid and other digestive fluids, and yet would be small enough to pass through the cells linings of the small intestine and release their cargo into the bloodstream. They put the insulin into tiny spheres made of chitosan, a natural carbohydrate derived from shrimp shells. This was designed to be attracted to the intestinal lining, making it more likely that the spheres would be absorbed and deliver their contents in the right place. When given the medication, rats with drug induced diabetes showed significant decreases in blood glucose levels, suggesting that insulin was getting into the bloodstream.
The ADA and Reuters reported that cells from a pig transplanted into a diabetic man from New Zealand are still producing insulin nearly 10 years later, prompting a biotechnology company to plan to see if others could benefit. The article was published in the journal, Xenotransplantation. The man, now 41, has type 1 diabetes. The pig cells were injected into the man’s abdomen in 1996, which helped reduce his insulin requirements by 34% for a year. The man insisted he was still feeling better in 2006 and convinced the company to examine him. “A careful examination shows his diabetes control has been a lot better even 10 years after the transplant," Bob Elliot, medical director of Australia’s Living Cell Technology. Tests, which became available only recently, showed that insulin detected in the man’s blood were pig insulin, not human insulin. The company hopes to conduct small-scale clinical trials in Russia and New Zealand in coming months to inject more diabetic patients.
Diabetes complications costs the U.S health system $22.9 billion a year in direct medical costs to treat heart, eye, kidney, and other serious health problems associated with the disease according to a report released on April 10, 2007 by the American Association of Clinical Endocrinologists at their annual meeting in Seattle. Diabetic complications cost almost $10,000 per year per patient with $1,600 of that paid for by the patient. Treating type 2 diabetes alone costs about $37 billion a year. When people do fail to follow their diet, exercise, and drug treatment plans, the disease leads to complications that boost the total health bill to $57.1 billion.
Just when you thought that diabetes had been related to one too many long term complications, along pops up another. The Archives of Neurology, 2007;64 570-574 has an article titled Relation of Diabetes to Mild Cognitive Impairment by José A Luchsinger, MD et al from Columbia University. Type 2 diabetes is an important risk factor for Alzheimer disease and is more prevalent in elderly minority persons compared with non-Hispanic white persons. The objective of the study was to determine whether diabetes is related to a higher risk of mild cognitive impairment (MCI), a transitional stage between normal cognition and Alzheimer disease, in multiethnic cohort with a high prevalence of diabetes. They related diabetes defined by self-report to incident all-cause MCI, amnestic MCI, and nonamnesestic MCI. They conducted multivariate analyses with proportional hazards regression adjusting for age, sex, years of education, ethnic group, apolipoprotein E (APOE) E4 allele, hypertension, low-density lipoprotein level, current smoking, heart disease, and smoking. The results indicated that a total of 334 persons had incident MCI, 260 (47.9%) had amnestic MCI, and 174 (52.1%) had nonamnestic MCI. Diabetes was also related to higher risk of nonamnestic MCI, but this association was appreciably attenuated after adjusted for socioeconomic variables and vascular risk factors. The risk of MCI attributable to diabetes was 8.8% for the whole sample and was higher for African American persons (8.4%) and Hispanic persons (11.0%) compared with non-Hispanic white persons (4.6%), reflecting the higher prevalence of diabetes in minority populations in the United States. The researchers concluded that diabetes is related to a higher risk of amnestic MCI population with a prevalence of this disorder.
Periodontitis is Associated with Aggravation of Prediabetes in Zucker Fatty Rats, Journal of Periodontology, 2007, Vol.78. No. 3, Pages 559-565, by Carla C. Pontes Anderson et al from Denmark highlights the need for continuing dental care for all of us. Researchers from Denmark investigated if having periodontal disease can influence prediabetes and contribute to the progress of diabetes. The Zucker fatty rat (ZFR) is a known model of prediabetes, characterized by hyperinsulinemia, dyslipidemia, and mild hypertension. The aim of the study was to investigate whether Periodontitis affects the prediabetic state of ZFEs. Prediabetes is a condition in which blood glucose levels are higher than normal, bur not high enough to be diagnosed as diabetes. The ADA estimates 54 million people in the U.S. have prediabetes, and a significant proportion of these people will develop type 2 diabetes within 10 years. The researchers investigated if having periodontal diseases can influence prediabetes and contribute to the progression of the disease. They found that having periodontal disease can cause someone to develop prediabetic characteristics, and probably disturb the glucose regulation of a non-diabetic who has prediabetic characteristics, contributing to the progression of type 2 diabetes. The study, conducted with ZFR rat models is believed to be the first to evaluate the relationship between Periodontitis and prediabetes. “We have known that people with diabetes are more susceptible to periodontal diseases and have more severe disease," said Preston D. Miller, DDS and AAP president. “This breakthrough research shows having periodontal disease may aggravate prediabetes, which is a precursor of diabetes. These findings underscore the importance of taking good care of your teeth and gums: it may be a simple way to prevent diabetes, or to prevent the progression of diabetes."
BSP
