Vildagliptin provides similar glycated hemoglobin (HbA1c) reductions to metformin but with superior gastrointestinal tolerability in drug-naïve elderly patients with Type 2 diabetes, research shows.

Elderly people with diabetes are a challenging population to treat because of an increased risk for renal impairment, a high number of comorbidities and concomitant drug use, and a high prevalence of cardiovascular risk factors.

In the first study with vildagliptin to be conducted exclusively in Type 2 diabetes patients aged at least 65 years, Anja Schweizer (Novartis Pharma AG, Basel, Switzerland) and colleagues compared its efficacy and tolerability with that of metformin.

The 24-week study included 335 patients with an HbA1c of 7??”9% who had not received oral glucose-lowering agents for more than 3 consecutive months at any time in the past and no agents for at least 12 weeks prior to screening.

Patients were randomly assigned to receive vildagliptin 100 mg daily (given as a once-daily dose) or metformin titrated to a maximum of 1500 mg daily (given as 1000 mg in the morning and 500 mg in the evening).

The results, reported in the journal Diabetes, Obesity and Metabolism, show that patients receiving vildagliptin achieved similar HbA1c reductions to those taking metformin, at 0.64% and 0.75%, respectively, from baseline, and establish non-inferiority of vildagliptin to metformin.

As expected, the decrease in HbA1c with either agent was greater in patients with a baseline HbA1c greater than 8%, with mean HbA1c reductions from baseline of 0.93% with vildagliptin) and 1.02% with metformin.

Body weight decreased with both agents, although to a greater degree with metformin (0.45 kg versus 1.25 kg, respectively).

One or more adverse events were reported by 44.3% of patients receiving vildagliptin and 50.3% of patients receiving metformin. A low incidence of hypoglycemia was observed in both treatment groups.

In patients receiving vildagliptin, the most frequent adverse events were nasopharyngitis and dizziness, whereas gastrointestinal events were more frequently reported with metformin.

“We conclude that vildagliptin is effective and well tolerated in drug-naïve elderly patients with Type 2 diabetes in whom it could represent a valuable treatment option,” write the authors.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract

Treatment of patients with Type 2 diabetes without known large-vessel disease with fenofibrate significantly reduces their risk for amputation events, report researchers from the FIELD study.

However, the risk for major amputation among patients with atherosclerotic disease of the major peripheral arteries was not significantly influenced by fenofibrate treatment.

“Amputations in people with Type 2 diabetes mellitus substantially impair their quality of life and impose high costs on health-care systems,” say Kushwin Rajamani (University of Sydney, New South Wales, Australia) and co-investigators.

The researchers tested the effect of fenofibrate on amputation risk in participants of the FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study, which included 9795 patients with Type 2 diabetes aged 50??”75 years.

Of these, 4895 were randomly assigned to take fenofibrate 200 mg/day and 4900 to take placebo for a period of 5 years. During this time, 115 patients had one or more non-traumatic lower-limb amputations as a result of their diabetes.

Major amputations were defined as those above and minor those below the ankle. The researchers further classified individuals who underwent amputation as having minor amputation without previous large-vessel disease - thought to be due to microvascular disease, or minor or major amputations with documented large-vessel disease ??” thought to be due to atherosclerotic disease of the major peripheral arteries.

Writing in The Lancet, the authors report that fenofibrate treatment significantly reduced the risk for first on-study amputation (all types) and minor amputation without previous large-vessel disease by 36% and 47%, respectively, compared with placebo.

However, the reduction in risk for major amputation events with documented large-vessel disease was non-significantly different between the fenofibrate- and placebo-treated groups (7% reduction).

“These findings could lead to a change in standard treatment for the prevention of diabetes-related lower-limb amputations,” conclude Rajamani et al.

Of note, the reduction in amputation risk observed in this study was not associated with any lipid variables, suggesting “the effects of treatment with fenofibrate on the risk of amputation might go beyond the improvements in controlling the lipid profile,” says the team.

“Because development and care of skin ulcers are formidable predictors of future amputations, one has to wonder whether some of the effects of fenofibrate can be attributed to improvement in wound healing,” commented Sergio Fazio and MacRae Linton (Vanderbilt University Medical Center, Nashville, Tennessee, USA) in an accompanying commentary.

“This effect ??” more so than anti-inflammatory, antioxidant, or endothelium-mediated effects ??” would set fibrates apart from the many agents (statins, antihypertensives, aspirin, and vitamin E) that have so far been unable to reduce amputations in people with diabetes.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract

Is diabetes and yeast infection co-related Well, it is a well known fact that diabetes is a state that has many health problems attached with it. One of such possibilities is the occurrence of infections of yeast through diabetes, although many would not like to be very expressive about it. People believe that having it is an embarrassing situation and would not like to discuss about it.

In order to understand the link between the two, it is important to know how the skin infections occur. A lot of bacteria are present in the gastro-intestinal tract. Due to changes in lifestyle and diet, this balance is disturbed. One of such bacteria present is yeast.

How does this infection take place

One of the main causes of yeast overgrowth is chronic infections. This results on account of presence of too much sugar. Not only that it results in diabetes, but also causes Candida infections. If there are repetitive Candida outbreaks, then it would be well advisable to have the levels of glucose checked in your blood. Although diabetes is not the only reason for the incidence of a chronic infection, a high level of sugar consumption surely triggers this condition. Yeast is fed by sugars present in the body, in the same fashion as yeast type foods and carbohydrates.

Yeast infection and diabetes:

An important complication of diabetes is that the blood sugar levels if not kept under control could trigger such a skin infection. This happens because an increased level of glucose in the body does affect many other bodily mechanisms and has a tremendous influence on the body’s immune status.

If you happen to suffer from diabetes, chances are you will find yourself constantly battling with Candida outbreaks. In its advanced form, along with vaginal infections and thrush, you also experience chronic fatigue, pain in the joints and knees, loss of memory, intestinal problems like constipation and diarrhoea and dizziness. In general you experience bad health at all times.

Depending upon the gravity of the disease, the treatment of this infection coupled with diabetes can often be complex. However, a diet that is low in sugar is an absolute must. This will suppress the yeast fungus by letting it starve and ultimately destroys it. Another precaution to be taken is avoiding the consumption of mushrooms, honey and dried fruits that also help a lot in feeding the yeast. If you can remain on diet for a three to six months period, you can gradually re-introduce them into your diet thereafter depending on your situation.

Apart from the above suggestions, you can also try certain holistic treatments in order to get rid of diabetes and yeast infections. You can also consider following a simple Candida Diet that could help prevent any further recurring infections.

If you have adult onset diabetes, there are two types of foods that you may be ingesting on a regular basis that you should completely cut out of your diet altogether. These 2 are really bad choices and can greatly increase your risk of complications. You are the only one in control of what you eat and the only one that can really control what you put into your body. This makes you the only person who can increase your chances for better health and a good long life that is lived to its fullest.

The 2 Really Bad Foods Choices are:

1. Alcohol is really a non food item and its consumption should be limited or avoid it altogether. Talk to your doctor about how alcohol affects diabetes. Consuming too much can cause some serious complications, including coronary artery disease, high blood pressure and nerve damage.

A few common pointers are:

• Don’t drink on an empty stomach, instead drink alcohol with your meals
• Only drink moderate amounts. Men should only have as much as two alcoholic drinks a day and women should only have one

Avoid alcohol completely if your blood sugar is not under control

2. Unhealthy Snacks that are processed, high in fats and sugars, even when homemade, should be carefully limited and/or avoided.

Examples of bad snacks are:

• Pastries
• Candy
• Ice cream
• Donuts
• Chips
• Cookies

Choose Really Good Food Choices Instead

Get used to reading labels and look for foods that are low in sugar, fat, salt, and replace unhealthy choices with these foods such as:

• Fresh fruits
• Fresh vegetables
• Lean meats
• Low fat cheese
• Whole grain flour
• Brown rice
• High fiber foods as in grains and legumes

Although changing your diet over to a healthier way of eating because you have diabetes may be difficult and frustrating at first. After time, you will begin to notice you are feeling better, have more energy and your blood sugar is under control. The choice is really simple, choose life giving foods and avoid the disease causing ones and you will increase not only the quality of your life but the length of it as well.

Quite a few women are affected by gestational diabetes, and many women are not sure what this is until they encounter it. Basically this condition is a type of diabetes that affects women who are pregnant. If you have never had diabetes in the past and suddenly have blood sugar levels that are too high while pregnant, this is considered to be gestational diabetes.

What Causes it?

No one is really sure what actually causes this condition to occur, but there are some ideas about what happens. As the baby grows, the placenta is the support for the baby. The hormones put out by the placenta aid in the development of the baby. Unfortunately these hormones can block some of the insulin action in the mother’s body, which is known as insulin resistance. This makes it harder for the body to use the insulin and some women need more insulin than their body provides.

This condition of gestational diabetes usually occurs at the point where your body can’t use or make the insulin that it needs while you are pregnant. The lack of insulin keeps the glucose in the blood instead of making it into energy. As it builds up, it cause the blood glucose levels to go up.

How it Affects Your Baby

Although gestational diabetes usually doesn’t cause birth defects to occur, your baby can be hurt if you have this condition and don’t have it treated or you don’t control it well. Glucose can cross through the placenta, and the extra glucose that you have in your body can go to your child. This causes the blood glucose levels of your baby to be too high. The baby has to make more insulin, and since they have more energy than needed, they will store more fat.

This fat can turn into macrosomia, and this can bring with it some health problems to the baby. Their shoulders could be damaged during the birthing process. Also, since the baby is making more insulin, when they are born they may have blood glucose levels that are dangerously low. Babies can also end up having more risk for breathing problems too. If your baby has too much insulin, they can be at risk for developing type 2 diabetes in adulthood and are at risk for becoming obese children. So, gestational diabetes can definitely affect your baby in a negative way.

Treatment for the Problem

Diabetes nutrition is one of the best treatment options for women who are dealing with gestational diabetes. It is important that you start treating this problem quickly so that you don’t cause harm to your baby. This can include eating very carefully, having regular exercise, and in some cases you may even need insulin injections to control your blood sugar. Many moms are able to use diabetes nutrition and exercise alone, but in extreme cases the insulin injections can help moms keep better control of the condition.

Many people are very much afraid of their diabetic condition, not knowing of how to beat diabetes. It is true that some people are counting the days with over imagination of diabetes as life threatening. This is because of their poor knowledge about diabetes. If they know exactly what causes diabetes, they can easily manage the ailment without suffering much. There is no basis in their fear because there are many other diseases which are really dreadful of keeping a person on bed for long years in life. Can you say it is so with diabetes too The answer for this question is ‘No’. Even at an extreme level of increased high blood sugar, there is no high risk if proper treatment is given to control blood sugar. Since there are home remedies to cure diabetes, and special clinics to give specialized treatments, you need not lose your hopes to live long.

Why should a diabetic lose hopes and peace of mind Diabetes can be easily managed by controlling blood glucose within limits. It will not claim the life of a patient all of a sudden. Nowadays, awareness has been created among the people to prevent diabetes. The mostly needed things are to recognize the early symptoms of diabetes and consult the doctor to start preliminary treatment. The doctor carefully diagnoses the disease and decides the prescription of medicines to go well with the body type of the diabetic.

Here is the emphasis for a change of lifestyle you have been following so far. It can be the only solution for beating your diabetes with no risk and no expense of money. A person chooses to change his lifestyle means he keeps off unhealthy foods and other associated habits. The easy tips that you can follow are delivered here.

You should know that the basic reason for the onset of diabetes is the non-secretion of insulin in the pancreas. Sometimes, it may be an insufficiency in the secretion of this hormone. The third possibility is with the insulin not potent enough to convert the glucose in the blood into energy. If you find a solution to set right this defect, then you can be sure of beating diabetes. You can take control by eating only that much you need. The best solution is the changing of your lifestyle as follows:

1. Consult a dietitian to choose the right diabetic diet foods.

2. Have a busy life in general with some exercise routine.

3. Avoid stressful situations in your daily activities.

4. Avoid over loading of your stomach with starchy foods.

5. Have divided servings of meal instead of a loaded portion.

6. Eat fresh vegetables and fruits low in sweet content.

7. Choose high fiber and low carb diet foods avoiding fatty items.

Diabetes is a disease that affects many Americans today, and it is important that it is diagnosed as early as possible. The earlier the disease is diagnosed and treated, the easier it is to treat. For this reason, it is important that you know the diabetes symptoms that occur. This way if you are dealing with any of these symptoms, you can quickly get the help that you need to combat this deadly disease.

Extreme Thirst

One of the main symptoms of diabetes that you may experience is extreme thirst. This is a common symptom, whether you have Type 1 or Type 2 diabetes. When this occurs, you may feel like you are not able to drink enough, even though you are drinking more water than you usually do. The body takes more water from the blood when you have diabetes and it means you can quickly become dehydrated, leading to the feeling that you have to drink a lot more.

Frequent Urination

Along with the extreme thirst, you will find frequent urination is another of the diabetes symptoms that you may experience. When you have too much glucose within the blood stream, then you can end up going to the bathroom more than usual. All the glucose often can’t be dealt with by the kidneys, so they take out more water to dilute it. This keeps you going to the bathroom on a regular basis.

Fatigue or Weakness

Fatigue or weakness, or both, can end up being a symptom of diabetes as well. Since the glucose isn’t being used by your body’s cells, you don’t get the energy that your body needs. The glucose just stays within the blood. This makes your cells think they are starved for energy and you begin to feel very tired.

Numbness and Tingling in Extremities

Usually this is a symptom that happens in people that have been dealing with diabetes for some time. Over time all the glucose in the blood stream can cause damage to the nervous system. This especially affects the extremities, such as the feet, legs, and the hands. You may experience tingling in these areas or numbness. When you better control your blood sugar, such as with a good diabetes diet, you may see these symptoms improve.

These are just a few of the diabetes symptoms that can occur. There are several other symptoms that can occur as well, such as bruising, taking a long time to heal, a lot of infections, or itchy and dry skin. Blurry vision can even be a symptom as well. Going on a good diabetes diet, exercising, and taking any medications provided by your physician can help to alleviate many of these symptoms.

Here I want to explain a basic doubt which will arise in the minds of diabetic or non diabetic people that eating more sugar causes diabetes or not?

Answer:

First of all what is diabetes and how it is caused? Diabetes can be genetically or acquired (in the sense non-genetic), in the body when we take food body simplifies it into glucose which is a main energy generator and this glucose is produced rapidly when we eat any food stuff for this body converts this glucose into glycogen storage component and when needed again glycogen will be converted to glucose. The function of converting glucose into glycogen will be monitored and done by an enzyme called insulin and when this insulin which is produced from the pancreas is deficient in its production then more glucose will remain in the blood stream, glucose content in the blood will increase and this is not good for the body. This glucose which is in the blood will come out through urine.

This is the all the basic knowledge on diabetes but coming to our question eating more sugar causing diabetes, I will give an equation that is eating more and more sugar (not normally ok) then more glucose will remain in the body and more the insulin should be secreted from the body then the work load on pancreas increases, going on like this the efficiency of pancreas decreases and the production of insulin will be decreased or stopped finally leading to diabetes!

This is an assumption and it is possible so what we should do is to regulate our body glucose by doing exercise so that the blood glucose will be utilized when we do exercise and even obesity can also be controlled as more and more glucose in the body causes fat deposition finally leading to obesity.

It is well known that diabetes is a dreadful disease which is caused due to the excess sugar deposited in the blood. Usually, blood glucose levels depend on the volume and nature of the foods taken. There are some diet foods including fruits which increase the blood sugar levels. The fruits identified as bad fruits for diabetics should be totally avoided. Diabetes can deteriorate the patient’s condition if the patient happens to consume foods that are not recommended by the dietician. There are some diet foods, in general, which are to be totally avoided. There are some other foods which can be eaten in small quantities just for taste. The third category of diet foods are those which should necessarily be consumed for controlling blood sugar.

By foods, one should not mistake rice or wheat or bread pieces alone. These foods are normally eaten by all people with vegetables as side dish. Many people do not eat fruits but they simply taste them. Eating is different from tasting. It is emphasized that the diabetics should EAT fruits also. It is not sufficient that they simply taste fruits. Some fruits should be eaten in one plateful as a regular meal. In similar sense, there are some other fruits which should be totally avoided when they are loaded with high sugar.

In fruits also, there are some varieties rich in fiber content and others rich in fat content. Since the fiber content foods are good for diabetics, you can eat such fruits and avoid other fruits which contain high sugar. Good nutrition is the basic requirement to get rid of diabetes. Vitamins and minerals are also needed at balanced level.?

Bad fruits for diabetics:

There are some diabetes fruits to avoid since they are partially harmful for your health. Fruits like mango, banana, ripened papaya, pineapple and sweet grapes are not helping to beat diabetes. Since these fruits do not contain pectin needed for stimulating good digestion, they are not helping to clean your digestive track by removing the waste products. So, all such fruits are very bad for diabetics.

Synthetic juice in the name of fruit juice is highly harmful. The juice is highly sweetened with refined sugar. Fruit salads can be good but fruit drinks and sugar cane juice are not recommended for diabetics. There are lots of ready packed fruit drinks which are sold in the market. They contain synthetic sugar which can be extremely harmful for the diabetics. They should be completely avoided even though the label of the packed food may contain the words of promising that it is sugar free.

Women who experience hypertensive pregnancy disorders have significantly increased risk for future hypertension and Type 2 diabetes, report researchers.

Hypertensive pregnancy disorders occur in 5??”7% of all pregnancies, with a higher incidence in women with no previous children, explain Jacob Lykke (Yale University School of Medicine, Connecticut, USA) and colleagues.

As data on the relationship between these disorders and subsequent cardiovascular events is minimal, Lykke and team investigated associations of gestational hypertension and pre-eclampsia with subsequent cardiometabolic complications using data from 782,287 Danish women who gave birth to their first baby (singleton) between 1978 to 2007. A second cohort of 536,419 women who gave birth to two consecutive babies (singletons) in the same time period was also included.

The two cohorts excluded women with previous cardiovascular disease or diabetes. The first cohort were followed up for an average period of 14.6 years and the second cohort for a period of 12.9 years after delivery.

Overall, 43,109 women in the first cohort and 40,450 in the second cohort experienced either hypertension or pre-eclampsia during their pregnancies.

Pooling the data from the two cohorts, the researchers found that gestational hypertension and severe pre-eclampsia increased the risk for subsequent Type 2 diabetes by 3.12- and 3.68-fold, respectively.

In addition, women who experienced these disorders had a much higher risk for subsequent hypertension than women who did not. More specifically, women who had gestational hypertension, mild pre-eclampsia, and severe pre-eclampsia had a 5.31-, 3.61-, and 6.07-fold increase in risk, respectively.

“Physicians and other health care professionals should be encouraged to include the history of a woman’s pregnancy outcomes when estimating the risk of cardiovascular disease,” conclude Lykke et al in the journal Hypertension.

“Identifying these women early will allow for prompt intervention, either primarily as modification of other classical cardiovascular risk factors or secondarily as medical prophylaxis.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract