According to?several diabetes associations?there are approximately 24 million United States residence, or roughly 8% of the inhabitants, who have diabetes. The total dominance of diabetes increased 14% from 2005-2007.As much as 24% of people with diabetes have not been diagnosed. A total of Fifty Seven million people are pre-diabetics most who will become part of the adult onset group. Diabetes is a serious sugar metabolizing disease that leaves insulin in the system unable to be properly processed by the body. There is a serious correlation between diabetes, blood pressure control, cholesterol control and the leading to coronary heart disease, renal failure and stroke. Certainly not everyone can control whether they become a diabetic but many can avoid the adult onset version and can also take precautions to prevent further detrimental affects on their health once diagnosed

What types of diabetes are there?

Type 1 - Typically a result of the body being unable to produce enough insulin and usually is a disease that starts early in life and must be treated with insulin injections and lifetime management.

Type 2- Diabetes type two is unfortunate and usually develops later in life due to insulin insensitivity, meaning the body can no longer process the insulin sometimes the effects can be reversed through diet, proper weight management and consistent exercise others may be required to take oral medications to manage the diabetes.

How Do Insurance Companies View Diabetes?

While Type-1 diabetics may have difficulty find life insurance especially of they have already experienced other health issues that can affect their mortality there may be options available such as whole life or universal life plans that are not medically underwritten. Type-2 diabetics have more possibilities if they have taken care to properly manage the blood sugar, blood pressure and HDL’s and LDL’s the progression of the disease’ affects on the heart and mortality rate can be greatly diminished.

Can You Get Life Insurance coverage?

When an insurance carrier is trying to determine a health risk assessment they will ask more detailed questions about the specific health condition, such as when the disease onset occurred, and how you are managing the condition whether through insulin injections, oral medications or diet and exercise. Health issues such as these will definitely result in a rating below standard for a type 2 diabetic insured and below standard rating at best for insulin using diabetics. The underwriters will be looking for more detailed information to determine if you are already experiencing other issues that affect your overall health and longevity. Have you experienced any cardiovascular troubles, kidney function, numbness or tingling of extremities resulting from poor circulation? If so and your using insulin and have other medical issues you may opt for non medical whole life insurance. If you have type 2 and it is under good control with little other negative implications you may qualify for standard rates if your blood sugar is found within normal ranges. If you are unable to determine where you may stand speak with an insurance agent/broker who represents many insurance companies as they can usually identify which carrier may take you since they are familiar with underwriting guidelines additionally they can provide you a preliminary application which can be invaluable to determine your specific conditions and how you may obtain coverage and what the rates would be prior to application

Results from the LEAD-6 trial show that liraglutide provided greater reductions in glycated hemoglobin (HbA1c) and was generally better tolerated than exenatide in patients with Type 2 diabetes.

Both liraglutide and exenatide are glucagon-like peptide-1 (GLP-1) receptor agonists, which stimulate insulin secretion and reduce glucagon secretion in a glucose-dependent manner.

Previous study results reported by MedWire News have demonstrated a beneficial effect of liraglutide in combination with a sulfonylurea or metformin.

The LEAD-6 study compared liraglutide with more established GLP-1 receptor agonist exenatide. A total of 464 patients with inadequately controlled Type 2 diabetes who were taking maximum doses of metformin, sulfonylurea, or both were randomly assigned to receive additional liraglutide 1.8 mg once a day (n=233) or exenatide 10 µg twice a day (n=231) for a period of 26 weeks.

Presenting the results, which are also published in The Lancet, at the American Diabetes Association 69th Scientific Sessions held in New Orleans, Louisiana, John Buse (University of North Carolina School of Medicine, Chapel Hill, USA) and colleagues reported that liraglutide treatment reduced HbA1c and fasting glucose significantly more over the study period than exenatide, by 1.12% versus 0.79% and 1.61 mmol/l versus 0.60 mmol/l, respectively.

In addition, 54% of liraglutide patients compared with 43% of exenatide patients achieved an HbA1c value of less than 7% at the end of the study.

Weight loss was similar in both treatment groups with reductions of 3.24 and 2.87 kg for liraglutide and exenatide, respectively.

Nausea was the most common side effect for both drugs, but this was less persistent and subsided more quickly with liraglutide and at 26 weeks was only present in 3% of patients as opposed to 9% of exenatide treated patients.

Minor hypoglycemia was also less frequent in the liraglutide- than the exenatide-treated group at 25.5% versus 33.6%. Major hypoglycemia was only reported in two patients, both of whom were taking exenatide plus a sulfonylurea.

Buse and team comment that although some markers of ?-cell function improved in this study, they are currently unable to confirm “the ability of GLP-1 receptor agonists to reduce or reverse the progressive loss of ?-cell mass.”

Due to concerns about slightly higher rates of pancreatitis with exenatide and liraglutide in other studies, Christophe De Block and Luc Van Gaal (University of Antwerp, Belgium), the authors of an accompanying commentary also published in The Lancet, “recommend not to give GLP-1 analogues to patients at risk for pancreatitis (eg, with cholecystolithiasis, alcoholism, or hypertriglyceridemia).”

However, they conclude: “The LEAD-6 trial shows that liraglutide provides greater improvements in glycemic control and is better tolerated than exenatide; therefore, this novel GLP-1 analogue might be a good option for the treatment of Type 2 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

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LEAD 3 shows promising results for liraglutide plus glimepiride
Liraglutide reduces HbA1c, weight, blood pressure more than glimepiride
Liraglutide averts weight gain and hypoglycemia

The bone-related peptides osteopontin and osteoprotegerin may inhibit vascular calcification and thereby increase carotid artery intima-media thickness (IMT) in patients with Type 2 diabetes, show results from a Japanese study.

Vascular calcification is an early marker of atherosclerotic disease and is frequently accompanied by increased arterial IMT. Circulating levels of the bone-related peptides osteopontin and osteoprotegerin are known to be elevated in individuals with severe atherosclerosis.

Eiji Suzuki (Gifu University School of Medicine, Japan) and co-workers investigated the association of osteopontin and osteoprotegerin with coronary artery calcium score (CACS) and carotid IMT in patients with Type 2 diabetes, a population at increased risk for coronary artery disease.

They enrolled 168 consecutive patients with Type 2 diabetes and 40 non-diabetic people. Patients had no history of cerebrovascular disease, coronary artery disease, or peripheral artery occlusive disease. The researchers measured IMT of the common carotid arteries using B-mode ultrasonography and CACS by multidetector-row computed tomography. Plasma levels of bone peptide markers were also taken.

Writing in the journal Diabetes Research and Clinical Practice, the authors report that patients with diabetes had higher mean carotid IMT and CACS than non-diabetic individuals, while plasma levels of osteopontin and osteoprotegerin were similar in the two groups.

Patients in the highest CACS tertile had longer duration of diabetes, greater carotid IMT, and higher levels of osteopontin and osteoprotegerin than those in the lower two tertiles.

In patients with diabetes, both CACS and carotid IMT positively correlated with levels of osteopontin and osteoprotegerin.

Furthermore, both peptides were independently associated with IMT in multivariate analysis.

“These findings suggest that elevation of circulating osteopontin and osteoprotegerin concentrations reflects an active calcifying process, and that these molecules act as vascular calcification inhibitors and increase IMT,” write the authors.

While these data indicate that bone-related peptides may be involved in the pathogenesis of atherosclerosis in patients with Type 2 diabetes, the authors acknowledge that this was a cross-sectional study and that further prospective studies are required to determine their specific role.

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

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