Erectile dysfunction (ED) affects three-quarters of Chinese men with Type 2 diabetes, say researchers who add that the majority of such men can be successfully treated with sildenafil citrate.

Significant risk factors for ED in these men included older age, longer duration of diabetes, and a glycated hemoglobin (HbA1c) level higher than 6.5%. Changyu Pan (Chinese PLA General Hospital, Beijing) and colleagues recruited 5477 men with Type 2 diabetes, aged 54.2 years on average. Of the cohort, 75.2% had ED, as defined by a score of 21 or less on the International Index of Erectile Function (IIEF)-5.

Compared with diabetic men without ED, patients with ED were significantly older, and had higher blood pressure and blood glucose. They were also more likely to have hypertension and heart disease, and they had a significantly longer duration of diabetes and lower body mass indices.

These findings are in agreement with previous studies linking ED with Type 2 diabetes and increased risk for heart disease, as reported by MedWire News.

Men who were diagnosed with ED and who consented to treatment (n=389) were given three tablets of sildenafil citrate 100 mg/day for use over 3 months. Efficacy was assessed using the IIEF-5 and the Global Efficacy Questionnaire (GEQ).

Overall, 84% of patients reported improved erectile function following treatment, with improvements maintained even after discontinuation of treatment in the majority of cases.

Adverse events were generally minor, and 37 were reported by 25 patients. These included flushing (17 events), headache (seven events), mild palpitations (two events), and dry mouth (two events).

“This report represents the largest epidemiological study to assess the prevalence of ED in Chinese men with Type 2 diabetes mellitus to date,” write the authors in the International Journal of Impotence Research.

“Because of the high prevalence of ED, clinicians should provide early screening and treatment for ED to patients with diabetes mellitus,” they add.

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 both the original and offspring Framingham Heart Study cohorts suggest that high levels of serum uric acid independently predict increased risk for Type 2 diabetes.

These results agree with those from both the Rancho Bernardo Study and a Japanese meta-analysis, as previously reported by MedWire News.

Hyon Choi (Boston University of School of Medicine, Massachusetts, USA) and colleagues analyzed prospective data on 4883 and 4292 individuals from the Framingham original and offspring cohorts, respectively.

The original Framingham cohort was recruited in 1948, when participants were aged 29-62 years, and the offspring cohort in 1971, when the participants were aged 5-70 years.

For the purposes of this study, the team stratified the participants into quintiles of baseline serum uric acid levels, namely, less than 5.0, 5.0-5.9, 6.0-6.9, 7.0-7.9, and 8.0 mg/dl or more.

The participants were followed up for incident Type 2 diabetes from baseline until last attended examination or study completion, which was 2000-2002 for the original cohort and 1998-2002 for the offspring cohort. During this time, 641 and 497 incident cases of Type 2 diabetes were recorded in the original and offspring cohorts, respectively.

The incidence rates of diabetes per 1000 person years from the lowest to the highest quintile of serum uric acid were 3.3, 6.1, 8.7, 11.5, and 15.9, respectively, in the original cohort. The corresponding values for the offspring cohort were 2.9, 5.0, 6.6, 8.7, and 10.9 per 1000 person years.

The team calculated that the multivariable relative risk increase associated with 1 mg/dl increase in baseline serum uric acid was a significant 20% and 15% for the original and offspring cohorts, respectively.

“These prospective data from two generations of the Framingham Heart Study provide evidence that individuals with higher serum uric acid, including younger adults, are at a higher future risk of Type 2 diabetes independent of other known risk factors,” write the authors in The American Journal of Medicine.

“These data expand on well-established, cross-sectional associations between hyperuricemia and the metabolic syndrome, and extend the link to the future risk of Type 2 diabetes,” they conclude.

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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High serum uric acid may be predictor for Type 2 diabetes
High uric acid levels predict Type 2 diabetes

Science does not have an answer as to why the pancreas stops making insulin, or why when it is produced the body is resistant to it. We do know that a mutant gene handed down from long ago ancestors may be responsible. Other possible causes include:

Genetics

Obesity/potbelly

Stress

Physical inactivity

Pancreatic infections

Elevated Serum cholesterol and triglyceride levels

You will find that most risk factors responsible for diabetes, also are factors that exist for heart disease.

Diabetes is due to insulin that is either insufficient or ineffective leading to increased blood glucose levels. This leads to symptoms of polyuria (frequent urination), polydipsia (excessive thirst). Insulin is a hormone secreted by the pancreas. When glucose levels are elevated, insulin changes glucose into energy that the body can use for fuel.

Inefficient insulin and it’s affect on the body:

When insulin is produced but the body fails to use it appropriately, it is said the body is resistant to insulin. A second reaction is when the body does not produce enough insulin to change glucose into energy. In both cases the insulin is inefficient and causes blood glucose levels to rise in the blood.

Is it curable?

Presently no, but there are several exciting and experimental procedures being performed that are showing high success rates. these procedure include;

Pancreatic Transplant: For those with uncontrolled Type 1 DM, but have a functioning kidney. Thankfully, these patients no longer need insulin injections to keep them alive. Additionally, their risks for developing complications associated with diabetes is greatly decreased.

Kidney/Pancreas Transplant: Reserved for patients who have substantial kidney failure, as well as uncontrolled Type 1 diabetes. This surgical procedure allows the patient to be free of dialysis treatments and insulin injections. Patients who avoid rejecting their organs in the first year after surgery, have a greater likelihood of non-rejection for 10 years and more.

Islet Transplants: This procedure is currently in clinical trials and involves replacing the bad Islets Of Langerhans with good islets from a deceased donor. Islets of Langerhans are the insulin producing beta cells of the pancreas. The islets are extracted from the donor pancreas and injected into the liver of the receiver. The cells start manufacturing insulin which works to regulate blood sugar levels.

All of these procedures are currently experimental and are not yet approved by the FDA. In a study of 36 patient who received islet transplant, only five remain free of the need for insulin 2 years after their transplant.

The search for better treatments and a cure for diabetes is on-going, and it is hoped that a cure will present itself in the very near future. But until then, lifestyle changes will help those who are living with diabetes to live a long and productive life in spite of having the disease.

If you’ve been told that you or someone you love has been diagnosed with pre-diabetes then the first question you’re probably asking is “What is pre-diabetes?” The second would likely be whether it will necessarily lead to type 2 diabetes. Don’t worry about asking questions about this kind of thing since they’re quite logical and natural considering the impact that diabetes can have on long-term health and lifestyle.

To begin, pre-diabetes is a condition that occurs when your blood sugar levels are higher than normal. This typically means that they are within the range of 100 to 125 mg/dl (5.5 to 7 mmol/l). Though these levels are not quite to diabetic proportions, they are still quite high.

That being said, if you already have high risk factors or if you don’t make any positive changes to your lifestyle, then you can make the condition worse and it may lead to type 2 diabetes. The risk factors include:

• A family history of type 2 diabetes
• Your age (your risk increases with your age)
• Your ethnicity (there is a higher risk in non-Caucasians)
• A history of gestational diabetes
• Having polycystic ovary syndrome (PCOS)
• Having insulin resistance
• Severe obesity
• Having cardiovascular disease

Any of these risk factors can mean that you have an increased chance of developing type 2 diabetes. For example, if you are a non-Caucasian person in his fifties with a family history of the disease, then you have a much greater risk than someone else who does not have these factors. You will need to make the right lifestyle changes to do your best to prevent it.

The trouble with pre-diabetes is that it is often present without causing any symptoms. One factor that seems to be strongly related to pre-diabetes is obesity, however this is not always the case. Anyone who is quite overweight or obese should have their blood sugar levels checked once a year during their annual physical. Noticeable symptoms of type 2 diabetes can include increased thirst, frequent urination, fatigue, blurred vision, frequent infections, excessive hunger and unexplained weight loss.

If you have pre-diabetes and do not make the necessary lifestyle changes needed, you may simply be topping off that final risk factor that will make all the difference in triggering the development of type 2 diabetes. Most obese people with pre-diabetes will develop type 2 diabetes within 10 years if they do not lose at least 5-7% of their body weight. A pre-diabetes lifestyle should include efforts to help your body to control its own blood glucose levels. This will mean that you’ll need to ensure that you begin to lose excess weight and that you eat a healthy diet and exercise moderately every single day. If you don’t do these things, then it will be as though you’ve made your own choice to continue your condition.

Remember that every little thing that you do can make all the difference for working to keep pre-diabetes under control and avoid its development into a situation where you will be diagnosed with type 2 diabetes. Even replacing your unhealthy snack in the evening with a healthy one and going for a good brisk walk every day (enough to make you sweat a bit and increase your breathing rate) can be an excellent start.

Study results show that patients with Type 2 diabetes who are treated with insulin or a thiazolidinedione (TZ) have fewer highly stenotic coronary artery lesions than those not treated with these drugs regardless of duration of diabetes, glycemic control, or other risk factors.

“Patients with diabetes continue to die of coronary artery disease (CAD) at rates two to four times higher than patients without diabetes, despite advances in treatment of cardiovascular disease,” say Teresa Jones (National Institutes of Health, Bethesda, Maryland, USA) and co-investigators.

They explain that “the role of glycemic control therapies, independent of their glucose-lowering effects, on cardiovascular disease is a recurring question.”

To investigate this further, the team assessed the association of different glycemic control therapies (insulin and TZs) with the extent of CAD found on angiography in 1803 participants of the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial.

All participants had Type 2 diabetes, documented CAD, no previous revascularizations, and were aged 62.1 years on average.

As reported in the American Journal of Cardiology, the researchers found that individuals who were using insulin at baseline had 23% less highly stenotic lesions and a significantly lower myocardial jeopardy index than those not using insulin. This was despite having a worse overall cardiac risk factor profile, increased inflammatory markers, and a higher prevalence of unstable angina than non-users.

Type 2 diabetics who had been taking a TZ for 6 months or more at baseline had 17% fewer highly stenotic lesions and significantly lower levels of the inflammatory markers C-reactive protein, fibrinogen, and plasminogen activator inhibitor-1 than those not taking TZs.

Of note, participants who were taking insulin and a TZ had 43% fewer highly stenotic lesions than patients taking neither treatment.

As this is significantly less than for individuals taking either treatment alone the researchers suggest that “different mechanisms or factors relating to CAD… might be affected by these two therapeutic classes.”

The authors caution that their results need to be confirmed by further research.

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 have been paying attention to the news at all, you know that diabetes is quickly becoming one of the most common ailments in the United States and many parts of Europe. Some have even said that the prevalence is reaching epidemic proportions. Why? What causes diabetes?

First of all, it is important to realize that there are two types of diabetes: Type 1 is congenital and cannot be prevented. Type 2 is not congenital, although there may be a tendency for it to run in families, and it can be prevented. Neither type of diabetes can be cured, but they can both be managed well in most people through medication and lifestyle.

With so many people now being diagnosed with diabetes, you may be wondering if you are at risk. In order to know that, it is important to know what causes diabetes. The two most significant reasons for developing type 2 are inactivity and obesity, but there are other risk factors as well, which include:

A family history of the disease. If a parent or brother or sister has type 2, you have that as a risk factor Hypertension. If you or a close family member such as a parent or sibling has high blood pressure, you are at greater risk for developing diabetes.

Being over age 45. The older you get, the more chance you have of getting diabetes.

Irregular cholesterol levels. Having too much “bad” cholesterol or too little “good” cholesterol increases your risk of diabetes.

Insulin resistance. If your doctor has determined that you are insulin-resistant, that is often seen as a precursor to diabetes. Some doctors even call this “pre-diabetes.”

Developing gestational diabetes. It is by definition temporary; that is, it occurs only during pregnancy and goes away after delivery of the baby. But, having gestational diabetes increases the risk of getting type 2 diabetes later on.

Type 2 diabetes sufferers, who have recently been diagnosed, seek a cure as one of their first responses to hearing their diagnosis. This is the 21st Century, so there must be a cure! Their reality is that, as yet, medical science has not found a cure for what is often the result of many years of having a poor diet and a sedentary life style.

Type 2 diabetes is characterized by insulin resistance. With this condition, your pancreas (the organ in your body that produces insulin) may be fully functional but your body’s cells are resistant to the influence of insulin. Consequently, your body converts less glucose into energy. This causes high blood sugar levels.

Risk Factors

Type 2 diabetes is believed to be caused by genetic and life style factors. For those sufferers who don’t have a genetic pre-disposition to the condition, life style factors are the main cause of their type 2 diabetes. In particular, a poor diet, sedentary life style and being over weight increase the risk of developing the condition.

No cure, just prevention or management

At present there is no cure for type 2 diabetes. Prevention is the closest you can get to a cure.

The best way to reduce the risk of developing the condition is to tackle the environmental factors that can trigger it.??Being more active, following a healthy diet and losing weight will significantly improve the management of your condition and may even reverse its affects.

Most people who are diagnosed as having diabetes have type 2. The condition can be managed, especially when detected early, because it does not involve a defective pancreas. In addition to any treatment prescribed by your physician, management of your condition also includes following a healthy diet, taking regular periods of moderate exercise and losing weight.

If you follow a healthy life style, lose weight and manage your condition sensibly you can lead a life that is close to normal, even without a cure for type 2 diabetes.?