Renal failure is associated with an increase in left ventricular hypertrophy (LVH) in Afro??”Caribbean hypertensive patients with Type 2 diabetes, a cross-sectional study reveals.

The research also shows that the major risk factors obesity and pulse pressure differ by level of renal function.

Afro??”Caribbean patients are at increased risk for both diabetes and hypertension, the leading causes of renal failure, compared with White populations. Furthermore, dialysis and hypertension increase LVH, a strong predictor of cardiovascular events.

To investigate the association between LVH and renal function, Anne Blanchet Deverly (University of Antilles and Guyane, Pointe-à-Pitre, Guadeloupe) and co-workers evaluated left ventricular structure and function in a population of Afro-Caribbean patients with both hypertension and Type 2 diabetes and varying levels of renal failure.

They divided the patients into three groups: normal renal function (150 patients); impaired renal function (183 patients); and those undergoing hemodialysis (75 patients).

Left ventricular mass was calculated and adjusted for height to give the left ventricular mass/height value. Left ventricular structure and function were assessed by echocardiography.

Reporting their results in the journal Diabetes and Metabolism, the authors say that left ventricular mass/height increased progressively with worsening renal function. Values were 49.0 g/m^2.7 in patients with normal renal function, 57.1 g/m^2.7 in patients with impaired renal function, and 59.8 g/m^2.7 in dialysis patients.

The prevalence of LVH was 48.3%, 64.8%, and 70.3%, respectively, in the three groups, and was more concentric than eccentric in those with impaired renal function.

The authors note that while use of antihypertensive treatments varied across the patient groups with calcium-channel blockers more often prescribed in patients with end-stage renal disease, this could not explain the observed differences in LVH.

In this study, factors associated with LVH differed according to renal function profile. Obesity was a risk factor for LVH in patients with normal and impaired renal function, but not in dialysis patients, whereas an increase in pulse pressure of 10 mmHg was a risk factor in patients with impaired renal function and in dialysis patients.

“Our results show that to reduce LVH in hypertensive diabetic patients, obesity and pulse pressure are the parameters that need to be particularly followed, as these are the risk factors for LVH in such a population,” conclude 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

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If you just found out that you have diabetes you are probably struggling with your diet. It is so frustrating and hard to have to change the way you have been eating your entire life up until now. Not to mention just dealing with all your emotional aspects of being told you have this awful condition is hard to adjust to also. Now, changing your lifelong habits not only going to be difficult and challenging, but it will be lifesaving. Type 2 Diabetes is a disease that can be controlled to a greater extent by what foods you eat and which ones you avoid.

There are certain foods that you really must cut way back on or avoid altogether if you have diabetes. These foods can further damage your pancreas and affect the output of your insulin levels. Maintaining a strict diet can help regulate this disease so that it puts you back into control of your own life.

List of 3 types of foods to limit if you have diabetes

1. Fats are number one on the list because even though they may not cause your blood sugar to spike, they will affect your ability to lose weight. Since a person who is diabetic has a higher risk of heart disease, it is important to control the blood fats and prevent weight gain. However, there are good fats and bad fats. The bad fats to limit or avoid are:

• Fatty meats
• Fatty dairy products like cheese and ice cream
• Butter
• Fried foods
• Solid vegetable fats like hydrogenated shortening that are in cookies and other such snacks
• Egg yolk (only 3 per week)

Avoid so-called diabetic foods, they have way to much fat to make up for the lack of sugar

2. Sugar should only be limited, not eliminated. Everyone needs a certain amount of sugar to maintain proper body and brain functioning. The problem is, Americans eat way too much sugar in their daily diet and that really is contributing to the rise in diabetes in this country.

Limit sugar intake between meals

Avoid eating high sugar foods like candy, even high sugar fruit drinks

Only eat sugar that is a part of your meal, as in fruit salads, pies or puddings, etc

Eliminate all soft drinks, even diet soft drinks if you are able to

Avoid processed foods high in sugar

3. Salt should be watched. People who have diabetes usually have high blood pressure. As a consequence, you should limit your salt intake. Research has proven that too much salt in the diet is not good for people who have high blood pressure.

• Remove the salt shaker from the your table, replace with a product like Mrs. Dash all natural seasonings
• Slowly cut down on the salt you use when cooking food
• Avoid high sodium chips, cracker, canned foods and processed meats

For more information on what to limit or avoid in your battle with diabetes, visit: http://www.monsterdiet.net/diabetes

The first dose-ranging study of linagliptin in male patients with Type 2 diabetes demonstrates significant improvement in glucose parameters and good tolerability, report researchers.

Linagliptin is one of the latest agents in the dipeptidyl peptidase (DPP)-4 inhibitor class to enter phase III trials for the treatment of Type 2 diabetes. Klaus Dugi (Boehringer Ingelheim GmbH, Ingelheim, Germany) and colleagues report the first results with this agent in patients with Type 2 diabetes in a placebo-controlled, dose-ranging study.

To explore the safety, tolerability, pharmacokinetics, and pharmacodynamics of linagliptin, 47 men with Type 2 diabetes were randomly assigned to receive linagliptin 1.0, 2.5, 5.0, or 10.0 mg, or placebo, once daily for 12 days.

The patients, most of whom were on metformin, entered a washout period prior to participating in the study for a period of 3??”12 days.

Presenting the results in the journal Diabetes, Obesity and Metabolism, the authors write: “Linagliptin had a long-lasting effect on DPP-4 inhibition with almost complete DPP-4 inhibition at the 5.0- and 10.0-mg dose levels (92.3 and 93.7% inhibition at steady state, respectively, and more than 80% inhibition over a 24-hour interval after drug intake).”

Linagliptin resulted in a significant reduction in blood glucose levels following an oral glucose tolerance test, 24 hours after the last dose, at doses of 2.5 mg or higher, when compared with placebo.

The agent was rapidly absorbed in all patients with a median t_max of approximately 1.5 hours after drug intake. Linagliptin exposure (AUC and C_max) increased dose dependently, but less than dose proportionally.

Accumulation half-life was short and decreased with dose from about 24 hours for the 1.0-mg dose to about 9 hours for the 10.0-mg dose. As a result there was rapid attainment of steady state (2??”5 days) and little accumulation (range 1.18??”2.03).

The long terminal half-life (113??”131 hours) led to the sustained inhibition of DPP-4 activity.

Renal excretion was only a minor route of linagliptin elimination (less than 7%), in contrast to other DPP-4 inhibitors.

The frequency of adverse events was 54% for linagliptin and 75% for placebo. No serious adverse events were reported and there were no episodes of hypoglycemia.

The authors note that these properties compare favorably with those reported for other DPP-4 inhibitors, but indicate that linagliptin may have an even longer-lasting effect making it particularly suitable for once-daily dosing.

“Further investigations are needed to confirm that these unique pharmacological properties of linagliptin, together with the predominantly non-renal elimination route, lead to clinical improvements beyond those already observed with other compounds of the DPP-4 inhibitor class,” they conclude.

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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