Alanine-aminotransferase (ALT) is an independent predictor for impaired glucose tolerance (IGT), a precursor to Type 2 diabetes, show results from a German worksite population.

The BASF (Baden Aniline and Soda Factory) Occupational Medicine and Health Protection Department offered a diabetes screening program to its 33,000 employees in 2006, of whom 1594 had their diabetes risk tested.

Michael Morcos and fellow researchers from the University of Heidelberg found that of all the employees tested, 374 had the metabolic syndrome according to the International Diabetes Federation criteria.

They also found that 285 had a medium-to-high risk for IGT and Type 2 diabetes according to the Finrisk scoring system, of whom 157, aged 49 years on average, underwent the oral glucose tolerance test.

Of the 157 individuals tested, 18% had either IGT (n=22) or Type 2 diabetes (n=5).

Following adjustment for various confounding factors including age and gender, fasting glucose and ALT were the only independent predictors of IGT.

More specifically, mean fasting glucose was 97 mg/dl in individuals with normoglycemia and 103 mg/dl in those with IGT. In addition, ALT levels were 28 U/l in normoglycemic participants and 36 U/l in those with IGT.

Participants in the upper quartile for ALT and fasting glucose had a significant 4.8 and 5.5-fold increased risk for Type 2 diabetes compared with the lower quartile, respectively.

“These data point to an important role of the liver in insulin resistance and the development of IGT in the relatively young and small population studied,” conclude the authors in the journal Acta Diabetologia.

They add: “Our data support the intention to study ALT as a potential predictive marker of IGT and diabetes Type 2 in more detail in a larger population in a prospective, randomized study.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

Free abstract

Results from the Diabetes Prevention Program Outcomes Study reported in The Lancet show that the beneficial effects of lifestyle intervention or treatment with metformin for preventing or delaying the onset of Type 2 diabetes can persist for at least 10 years.

The initial Diabetes Prevention Program (DPP) study lasted for 2.8 years during which time intensive lifestyle intervention, involving help with weight loss and increasing physical activity, and treatment with metformin reduced the incidence of Type 2 diabetes in high-risk adults by 58% and 31%, respectively, compared with placebo.

In this study, the DPP Research Group based at George Washington University in Rockville, Maryland in the USA investigated how well these effects persisted over the following 7.5-year period between 2001 and 2008.

Of the original 3150 participants, 2766 (88%) participated in the DPP Outcomes Study; 910 from the intensive lifestyle intervention group, 924 from the metformin group, and 932 from the placebo group.

Participants in the metformin group continued to take metformin 850 mg twice daily and those in the lifestyle group were offered continued lifestyle support.

The incidence of Type 2 diabetes in the original study was 4.8, 7.8, and 11 cases per 100 person years in the intensive lifestyle intervention, metformin, and placebo groups, respectively.

In the outcomes study, the respective incidence rates were 5.9, 4.9, and 5.6 per 100 person years.

This translates to a 34% and 18% reduction in the incidence of Type 2 diabetes in the lifestyle intervention and metformin groups, respectively, compared with placebo over the total 10-year follow-up period.

“Prevention of diabetes is a long and winding road. There seems to be no shortcut, and a persistent and prolonged intensive lifestyle intervention seems to be the most effective mode to travel on it,” summarized Anoop Misra (Department of Diabetes and Metabolic Diseases, New Delhi, India) author of an accompanying comment also published The Lancet.

He added: “Because of the high prevalence and rapid increase in the metabolic syndrome and diabetes, there is a need to apply these findings to, and generate data from, other ethnic groups and developing countries.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

Free abstract

Diabetes whenever left untreated leads to a lot of complications. Few of the complications are cardiopathy, sightlessness, nephropathy, amputation and nerve damage. Is there any way to prevent these complications? Luckily the answer is yes, there is a way.

Diabetics have the ability to care and control their diabetes which could be controlled with proper knowledge and education of diabetes. A diabetic (type 1 or type 2) can modify his living style and start living a standard life by just following the below mentioned 12 simple and easy to follow steps:-

01) Bound the consumption of carbohydrates in every meal.

02) Avoid eating more than 45 grams of carbohydrates in every meal.

03) Consume around 25 grams of total carbohydrate in each snack and blend it with an unsaturated fat or a lean protein such as fruit with low fat cheese or yogurt with nuts.

04) Administer the consumption of carbohydrates equally throughout the day to avoid drops in blood sugar.

05) Consume foods that are slowly digested examples are oatmeal, brown rice whole grain bread etc.

06) Test the blood sugar levels prior to taking meals and at least 2 hours after meal to measure whether your body can deal the quantity of your carbohydrate consumption.

07) Target for the following results while testing the sugar levels twice i.e. before taking meal (Fasting) 90-127 mg/dl and 2 hours after meal below 180 mg/dl.

08) Eat after every three to four hours to keep your metabolic process functioning well.

09) The break between two meals should be a minimum of 2 hours.

10) Go regularly for the HbA1C test and aim for below 6%. This test states the average blood glucose level of the last 3 months.

11) Exercise minimum 5 days a week for at least 30 minutes a day as physical exercise helps insulin in its effective working.

12) Visiting your doctor regularly so that he may adjust your medication, exercising pattern, diet plan according to your body requirements.

There is no magic tablet or secret recipes to cure diabetes. You’ve the full control in your own hands the food, exercise, medication and strain level. You just have to learn to use these 12 easy steps and by complying to the above mentioned twelve steps you will be able to care and fine tune your diabetes and if decently abided you may even reverse your diabetes.

So just don’t allow diabetes to take control of your life when you are the in charge.