Diabetes nowadays has grown to be a problem next to cancer or other respiratory diseases. It has become so common and yet so misunderstood. For a lot of people, diabetes is a hereditary disease. Hence, only genetic predisposition can cause diabetes. For some on the other hand, the diet of the people is the primary culprit for diabetes. How true or untrue are these? Are all people susceptible to this disease? Could you be a diabetic?

Before identifying the possible victims of this deadly illness, it would be best to understand what diabetes is. Diabetes is a metabolism problem where the pancreas either fails to produce enough sugar or to produce at all. It can also be the case that the cells of the body are not functioning well that’s why the insulin produced just passes out of the body leaving the body with little or no fuel to do everyday activities. Furthermore, there are many types of diabetes all of which have their own causes and proper management. This can be very dangerous and even deadly that is why this disease should be taken seriously.

With this, it can be easily said that people who have problematic pancreas or cells are automatically at high risk to suffer this disease. As mentioned earlier, those who have genetic predisposition are usually among those who cannot run away from this high risk. People over the age of 45 are also very susceptible to this illness. This can be associated to failure of the body to function properly. There is also such as thing as insulin resistance syndrome that predisposes people to diabetes. Studies also prove that race and ethnic backgrounds should be considered. Hispanics, Asians, Blacks and Native Americans are prone to developing type II diabetes. Being overweight (people who have greater than 25 body mass index) and hypertensive also increases the risk of developing certain types of diabetes. This is where the people’s diets get in. The common belief that consuming a lot of sweets or sugary food causes diabetes may be considered as a taboo. Sweet foods are like fatty foods, they contribute to the development of other health conditions such as those mentioned above which in turn triggers diabetes. High cholesterol levels are also not exempted from being a culprit in the development of this health condition. Having a very sedentary lifestyle also does not help. Development of diabetes during pregnancy also increases the risk. Similarly, history of vascular disease and polycystic syndrome renders people very much susceptible to diabetes.

With the foregoing, it clearly nullifies the common beliefs mentioned above. A lot of people and virtually any people are really susceptible to diabetes. It’s just a matter of adapting a very healthy lifestyle that can steer people away from this doom. We all love to eat and relax, but as the saying goes we become what we eat (and in this case maybe what we do also!). Diabetes like every other disease is common, deadly and can be very limiting once we develop it so prevention is always important!

Patients with diabetes who have poor glycemic control and high blood pressure (BP) are more likely to have diabetic retinopathy than their better controlled peers, show study findings.

Tien Yin Wong (Singapore National Eye Centre) and colleagues report results from the Singapore Malay Eye Study, which involved 3280 Malay individuals who were aged between 40 and 80 years.

This study focused on the 768 participants with diabetes, defined as a nonfasting glucose level of 200 mg/dl or more, use of antidiabetes medication, or a physician diagnosis of the condition.

The researchers found that only a low percentage of the diabetic cohort had optimal glycemic or BP control - defined as a glycated hemoglobin of 7% or less or a BP of 130/80 mmHg or less - at 26.9% and 13.4%, respectively.

Overall, 272 of the diabetic patients had retinopathy, diagnosed using gradable retinal photographs. Glycemic and BP control was significantly worse in these individuals with only 17.4% and 10.3% achieving optimum levels, respectively.

The researchers found that suboptimal glycemic control was significantly associated with younger age, being unaware of diabetes status, not taking appropriate medication, higher total cholesterol, and presence of diabetic retinopathy.

Patients with poor BP control were more likely to be older, have higher total cholesterol, higher body mass index, and diabetic retinopathy than those with optimal control.

“Our population-based study in this Malay population documented low proportions of persons with diabetes achieving targeted levels of diabetic control, with only one in four achieving optimal glycemic control and one in eight achieving optimal BP control,” summarize the authors. “Among individuals with diabetic retinopathy, this was even lower.”

“Our findings present a challenge to health care policy-makers and professionals regarding effective implementation of diabetes care in Asia,” they conclude.

The results of this study are published in the Archives of Opthalmology.

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; 2010

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A diet based on the traditional Mediterranean diet can improve glycemic control without causing weight gain in patients with well-controlled diabetes, an Australian study suggests.

“The intervention resulted in a statistically and clinically significant improvement in glycemic control, equivalent to mono drug therapy,” say Catherine Itsiopoulos, from the University of Canberra, and colleagues.

They also highlight that “in contrast to the commonly held view that a high-fat diet leads to weight gain, we demonstrated that a Mediterranean-style intervention diet, provided ad libitum with 40% energy from fat, did not cause weight gain. Indeed, a trend toward weight loss was observed.”

The team recruited 27 Australian-born patients with diabetes adequately controlled by diet (n=9), oral hypoglycemics (n=15), or insulin (n=3), and with no previous exposure to a Mediterranean diet.

The patients, who were were aged between 44 and 77 years, were randomly assigned to receive the intervention Mediterranean diet, consisting of plant foods, whole grains, and olive oil, or their usual diet for 12 weeks, followed by a crossover to the alternative diet for a further 12 weeks.

Body composition, markers of glycemic control, lipid levels, and biomarkers of dietary adherence, such as plasma carotenoid and fatty acid (FA) levels, were assessed at the end of both dietary periods.

The Mediterranean diet appeared to improve glycemic control, with glycated hemoglobin levels falling from 7.1% when patients consumed their usual diet to 6.8% when they consumed the Mediterranean diet (p=0.012).

Diet quality also improved, as illustrated by an increase in the patients’ plant to animal food ratio, from an average 1.3 on the usual diet to 5.4 after 12 weeks on the Mediterranean diet (p<0.001).

The patients’ mean body mass index (BMI) and homeostasis model assessment of insulin sensitivity (HOMA) score also improved, from 30.3 kg/m² and 6.1, respectively, when they consumed their usual diet to 30.0 kg/m² and 5.2, respectively, after 12 weeks on the Mediterranean diet.

Of note, the patients’ lipid profiles also improved while on the Mediterranean diet, with a 15% increase in monounsaturated FAs (p=<0.001) and a 17% decrease in trans and saturated FAs (p=0.001) compared with during their normal diet.

Writing in the journal Nutrition, Metabolism & Cardiovascular Diseases, Itsiopoulos et al conclude: “Despite major differences from their usual diet, subjects reported very positively both on their enjoyment of the Mediterranean-type diet and on how well they felt while consuming this diet.”

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; 2010

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The National Institute for Health and Clinical Excellence (NICE) in the UK has recommended treatment with the glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide for some patients with Type 2 diabetes in a preliminary draft guidance document.

“The incidence of Type 2 diabetes is on the increase in England and Wales ??” and sadly so too are the complications of the disease,” said NICE spokesperson Carole Longson.

“We are pleased, therefore, to recommend liraglutide 1.2 mg daily as a clinically and cost effective treatment option as part of both dual and triple therapy regimens for some patients with Type 2 diabetes mellitus under restrictions.”

This follows the recent approval of liraglutide by the US Food and Drug Administration with some stipulations, as reported by MedWire News.

NICE recommends that liraglutide 1.2 mg/day should be given to Type 2 diabetic patients requiring dual therapy to replace either metformin or a sulphonylurea due to being unable to tolerate either of these drugs.

As part of a triple therapy regimen, it suggests liraglutide 1.2 mg/day can be given in combination with metformin and a sulphonylurea or with metformin and a thiazolidinedione to patients whose glycated hemoglobin (HbA1c) is inadequately controlled, at levels of 7.5% or above. The guidance also recommends that these patients should have a body mass index (BMI) of 35 kg/m² or above and specific psychological or medical problems linked to high body weight.

Other patients in whom liraglutide 1.2 mg/day is indicated include those with a BMI of 35 kg/m² or below who would have severe occupational problems with taking insulin, or in whom weight loss would benefit any significant obesity-related comorbidities.

Notably, the NICE team does not recommend use of liraglutide at a dose of 1.8 mg/day as they say that the available evidence does not suggest a significant additional benefit with this higher dose.

NICE says that final guidance documents are likely to be published in October 2010.

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; 2010

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Results from a genome-wide association study show that a variant of the gene HHEX-IDE previously associated with Type 2 diabetes is also linked to elevated childhood body mass index (BMI).

“Previously we thought that this gene affects insulin production during adulthood, but we now see that it may play an early role in influencing insulin resistance through its impact on body size during childhood,” said Struan Grant (University of Pennsylvania School of Medicine, Philadelphia, USA).

“One implication is that if we can develop medicines to target specific biological pathways in childhood, we may be able to prevent diabetes from developing later in life.”

The team investigated the association of pediatric BMI with 20 single nucleotide polymorphisms (SNPs) at 18 previously discovered genetic loci associated with Type 2 diabetes. The study cohort comprised 7184 children of European ancestry who were randomly divided into a “discovery” cohort (n=3592) and a “replication” cohort (n=3592) for the purposes of this study.

Grant and co-investigators found that presence of the Type 2 diabetes risk-conferring G allele of the rs7923837 SNP of HHEX-IDE was associated with significantly increased pediatric BMI in both the discovery and the replication cohorts between the ages of 3 and 16 years.

The HHEX-IDE association with childhood BMI was the only one of statistical significance, with the exception of the previously established association between BMI and the rs3751812 SNP of the FTO gene.

“This finding suggests that there may be genetic activity during childhood that lays the foundation for the later development of Type 2 diabetes,” concluded Grant.

The results of this study are published in the journal Diabetes.

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

Many people are suffering from the problem of diabetes worldwide. The health concern of diabetes can strike anybody and is not dependent on factors like gender or age. There are particular things that will raise your chance of going through diabetes manifolds. Read on to know about these factors and in which way they may end up in the occurrence of diabetes.

As is generally known, obesity is a strong risk factor, especially for type 2 diabetes. Any obese person has many more likelihood of becoming diabetic than an individual with normal Body Mass Index. Needless fat negatively impacts the insulin levels in human body. As your body weight goes up, the capacity of your insulin tends to decline. This leads to increase in sugar level of your body. You must maintain proper body mass to be certain that you look healthy enough. At the same time it is critical to maintain balance and never turn overweight. For this, make sure you get a lot of exercise, at least 30 minutes a day would do the trick.

Sedentary lifestyle is another risk factor for diabetes. Your blood sugar levels are certain to be low if you are physically active. Also, muscle cells have more insulin receptors in comparison to fat cells. So, when you exercise, the insulin resistance of your body decreases. This stabilises your blood sugar levels. Besides, inadequate activity or a leisurely way of life lifestyle is one of the prime causes of obesity, which in turn increases the danger of diabetes.

Unhealthy eating habit is another prime cause of diabetes. People who are into wrong diet habits easily fall prey to the problem of diabetes compared to ones who take healthy diet. Consumption of sugar is the main culprit for the difficulty of diabetes. Besides sugar another thing that can contribute to hike in sugar levels of the blood is carbohydrates. They are extraordinarily straightforward easy to digest and thus contribute majorly to body’s sugar levels. This is the proven fact that you want to cease from eating carbs and sugar rich preprocessed food. It is a clever decision that you incorporate more fiber in your diet.

Family history and genetics also play an important role in causing diabetes. If either of the parents or someone in the family is diabetic then the possibilities are robust that you too could be a victim of the issue. Afro-Americans, Hispanic-Americans and indigenous Americans all have a higher than standard rate of type two diabetes due to heriditary factors.

Additionally to the above debated reasons; other factors that increase the possibility of diabetes are high blood pressure, age, high cholesterol levels and many others. You can’t do much about preventing yourself from factors like family history. However, you still have control over other that kind of weight and diet. It’s preferable to pinch the issue in the bud. Keep an eye out for these risk factors and take acceptable cares so you can prevent the problem from arising at all.

Have you been diagnosed with diabetes? Or do you have fear that you may develop it? In both cases you may be in the search of the factors that cause diabetes. There was a time when nobody was aware about the basic reason that causes diabetes. However the years of researches have revealed the exact answer of “what cause diabetes” and the ways to prevent diabetes.

Genetic Disposition: In the previous days the leading cause of diabetes was thought to be the genetic disposition. The recent studies have revealed that no doubt the genetic disposition is the cause of diabetes but it is not the leading cause.

Before jumping on to the leading cause of diabetes; I would like to explain what genetic disposition is. It means that if a person in his blood line has diabetes; specifically in the first blood line then he is at higher risk of developing diabetes.

Obesity: Now the reader must be wondering what the leading cause is. The leading cause of diabetes is obesity. When a person becomes overweight his body becomes resistant to insulin. This holds particularly true if the Body Mass Index (BMI) is more than 30 %. If for some reason you are unable to calculate your BMI; then an easier way is to measure the waist. The waist of the males should not be bigger than 40 inches and in case of female it must not be bigger than 35 inches. If your waist is bigger than the given inches then you are at an increased risk of developing diabetes.

Unhealthy Eating Habits: No matter a person is overweight or underweight; poor eating habits lead to diabetes. The healthy diet means that it should be full of dietary fiber and proteins or otherwise you are at an increased risk of diabetes.

Sedentary Lifestyle: Inactive physical lifestyle also leads to diabetes. A person must exercise at least three times in one week for around 30 minutes. Any type of exercise can be chosen from brisk walk to aerobic dances or even weight training.

Infections: Research studies have revealed that certain infections also lead to diabetes. Age is also one of the causes; as a person gets older the chances of developing diabetes increases. Further hypertension also leads to diabetes.

Medicines: There are certain medicines that “help” the body in developing diabetes. Examples are Olanzapine, Clozapine, Ziprasidone, Quetiapine and Risperidone.

So it is important to get tested for diabetes if any of the above mentioned condition applies to you.

Build-up of fat in the pancreas increases with increasing body mass index (BMI) and is associated with elevated risk for Type 2 diabetes, show results from a magnetic resonance spectroscopy (MRS) study.

“These are very early results, but if they hold true, pancreatic MRS would be a fast and noninvasive test to screen people at risk for diabetes either because they’re obese or they have a family history of Type 2 diabetes, or the metabolic syndrome,” said lead author Ildiko Lingvay (University of Texas Southwestern Medical Center, Dallas, Texas).

“It could potentially tell physicians which patients are most likely to develop diabetes in the near future and thus are in need of more aggressive interventions,” she added.

The researchers first validated the MRS method by measuring the pancreatic triglyceride content of 12 lean and 12 fatty rats. They then used MRS to measure the pancreatic fat or triglyceride content of 79 human volunteers. Of these, 33 had duplicate measurements taken 1??”2 weeks apart.

Writing in the Journal of Clinical Endocrinology and Metabolism, the team reports that participants who were of normal weight and normoglycemic had a median pancreatic triglyceride content of 0.46 f/w%. In those who were overweight or obese (BMI above 25 kg/m²) but normoglycemic this increased to a median of 3.16 f/w%.

Overweight or obese individuals who also had impaired fasting glucose or glucose tolerance had an even higher pancreatic triglyceride content of 5.64 f/w%, which was very similar to the value for participants with untreated Type 2 diabetes (5.54 f/w%).

“The method offers a unique strategy for early detection of ectopic fat accumulation in high-risk individuals,” conclude Lingvay and team.

“Our results set the stage for future studies to determine if pancreatic steatosis leads to B-cell dysfunction and if interventions that reduce plasma triglycerides levels favorably impact B-cell function,” they add.

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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Overall control of cardiovascular (CV) risk factors has deteriorated over the last 35 years to a greater extent in diabetic individuals than in their nondiabetic counterparts, an analysis of Framingham Heart Study data suggests.

The finding is worrying given the higher cardiovascular morbidity and mortality faced by diabetics, and suggests that further, more aggressive efforts are needed to improve risk-factor control in this group.

For the study, Caroline Fox (National Heart, Lung, and Blood Institute, Framingham, Massachusetts, USA) and team examined trends in CV risk factors among Framingham participants between 1970 and 2005. The researchers compared risk-factor control in 4195 patients aged 50 years and 3495 patients aged 60 years with and without Type 2 diabetes mellitus.

Reporting their findings in Circulation, Fox et al say that those with diabetes experienced a greater increase in body mass index than those without diabetes at 2.52 vs 0.39 kg/m² per decade.

Encouragingly, diabetic participants also exhibited a greater decrease in low-density-lipoprotein (LDL) cholesterol than nondiabetics of 15.5 versus 7.43 mg/dl (0.40 vs 0.19 mmol/l). Reductions in systolic blood pressure and smoking prevalence were of a comparable magnitude in diabetics and nondiabetics.

Nevertheless, the overall control of both hypertension and LDL cholesterol remained suboptimal in both sets of patients. “Overall, individuals with diabetes have not experienced the necessary declines in CV risk factors to overcome their increased risk for CV disease,” remark Fox et al.

Noting that diabetic patients continue to have a 2??”3-fold increased risk for CV disease relative to those without diabetes, the researchers conclude: “To further reduce the differences in CV disease rates between those with and without diabetes, efforts must be intensified to achieve guideline targets for systolic blood pressure and cholesterol levels among those 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

LEAD-4 results show liraglutide provides significant improvements in glycemic control as part of triple combination therapy with metformin and rosiglitazone, report researchers in the journal Diabetes Care.

The 26-week LEAD-4 study is part of the Liraglutide Effect and Action in Diabetes (LEAD) program and investigated the effect of different doses of the once-daily glucagon-like peptide 1 (GLP)-1 analog liraglutide in combination with metformin and rosiglitazone.

“These three glucose-lowering agents are of particular interest as they have complementary modes of action and are not generally associated with increased risk of hypoglycemia,” write Bernard Zinman (Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Canada) and colleagues on behalf of the LEAD-4 study investigators.

LEAD-4 randomly assigned 533 patients with Type 2 diabetes to receive add-on treatment with once-daily liraglutide (1.2 or 1.8 mg) or placebo in a 1:1:1 ratio after a run-in period of metformin (1 g twice daily) and rosiglitazone (4 mg twice daily). Prior treatment with oral agents other than metformin and rosiglitazone was discontinued.

Patients with a glycated hemoglobin (HbA1c) between 7 and 11% (prestudy oral agent monotherapy) or between 7 and 10% (prestudy combination oral agent therapy) and a body mass index of no more than 45 kg/m² were included.

Compared with baseline, HbA1c was reduced by 1.5% in the two liraglutide groups versus 0.5% with placebo. This was achieved by significant reductions in both fasting and postprandial glucose with 1.2 and 1.8 mg liraglutide compared with placebo.

At the end of the study, dose-dependent weight loss with 1.2 and 1.8 mg liraglutide (1.0 and 2.0 kg, respectively) was obse