Once again, I am bringing you the latest updates on diabetes.

Erectile dysfunction linked to diabetes
There are many factors that can affect sexual function. Certain metabolic diseases, for example. Several research studies have shown that erectile dysfunction is quite common men with Type 2 diabetes mellitus. Men with diabetes have 3 times the risk for erectile dysfunction compared to those without diabetes, with estimates of prevalence ranging from 20 to 85%.  A study by researchers in Cairo University looked at 100 patients aged 35 and 50 who were diagnosed with type 2 diabetes. The study participants were asked to fill out the International Index of Erectile Function questionnaire. Based on the answers to the questionnaires, results showed that 53% of patients have good sexual potency, 20% had fair (20%), and 26% had poor potency. Potency was inversely related to glycemic control, as measured by hemoglobin A1c (HbA1c) values.

Lung cancer not linked to diabetes
In another study, American researchers looked at the relationship between diabetes and pulmonary diseases, including asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, pneumonia and lung cancer. Data were taken from a very large database of electronic health record of 1,811,228 members of a health plan in California. Of these, about 4% have been diagnosed with diabetes. Data analyses showed that diabetes is associated with an increased risk for asthma, COPD, pulmonary fibrosis, and pneumonia but not for lung cancer.

Gum disease linked to diabetes
A study by researchers of New York University indicates gum disease could be linked to diabetes. Base on national data collected by the CDC, gum disease is also linked to cardiovascular and metabolic disorders such as excess weight and hypertension.

“More than 90 percent of people with gum disease would have been recommended by the American Diabetes Association for diabetes testing because of their risk factors.”

In fact, based on the study results, gum disease could be used as a disease marker that can sound the alarm for further testing for diabetes.

Rise in diabetes limb amputations
Amputations due complications from diabetes are becoming more and more common, according to a BBC report. According to the report, major diabetes-linked amputations increased by 43% between 1996 and 2005 whereas lower extremity (below ankle) amputations doubled.

Vision Loss in Diabetics Becoming Less Common
On the bright side, vision loss brought about by type 1 diabetes less common. Comparing its current incidence to that in the 1970s, the decrease is significantly difference. Researchers believe this might be due “to better blood sugar control and improved treatment of diabetes-related eye disorders.”

So what did you drink for breakfast this morning? Coffee? Tea? How many cups? If you’ve had say, 3 or 4 cups of your favourite brew today, you may actually be protecting yourself from Type 2 diabetes. At least that’s what a team of researchers from University of Sydney in Australia is saying.

The researcher performed a so-called meta-analysis of data from 18 separate clinical studies that involved almost half a million participants. And the results of the analysis showed that people who drink lots of tea or coffee have lower risk for type 2 diabetes. A consumption of 3 to 4 cups of the drinks can reduce your risk by a fifth or even more. Each additional cup cuts the risk by 7%.

So what is in a cup of coffee or tea that gives us protection from diabetes? No, it is not the caffeine that provides the benefits because decaf coffee seems to work best. The researchers believe it might be other compounds that are responsible for the protection. Some of the possible compounds involved are the element magnesium and the antioxidants lignans or chlorogenic acids.

This isn’t the first time that decaf coffee gives positive health outcomes. A 2006 study of 28,000 women reported that consumption of 6 cups of decaf coffee a day translates into a 33% diabetes risk cut compared to no coffee consumption. In recent years, tea is also available in decaf form.

The authors concluded:

“The identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus. If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes mellitus, or who are at future risk of developing it, would be substantial.”

Now, before you put your kettle to boil, let us slow down a bit. Previous studies on tea and coffee have been linked these beverages to health benefits against cardiovascular disease and cancer, although there are also evidence of harmful effects. More studies are needed to confirm these findings.

According to Dr Victoria King, of Diabetes UK, said:

“Without full information about what other factors may be influencing the type 2 diabetes risk of the studies’ participants – such as their physical activity levels and diet – as well as what the active ingredient in tea or coffee appears to be, we cannot be sure what, if anything, this observed effect is down to… What we can be sure of is that the development of type 2 diabetes is strongly linked to lifestyle, which means that many cases could be prevented by keeping active and eating a healthy balanced diet that is low in fat, salt and sugar with plenty of fruit and vegetables.”

Today, I am bring some diabetes updates on what increases or decreases our chances to develop diabetes.

Heading off diabetes
Researcher David Nathan of Massachusetts General Hospital Believes people can prevent getting diabetes even if they are at high risk. And he has 10 years’ worth of data to prove it at the Diabetes Prevention Program Outcomes Study. Here are Dr. Nathan’s trips to head off diabetes:

• A brisk 30-minute walk once a day or equivalent
• Proper eating,
• Kept off a crucial 5 pounds over those 10 years

The results: lower your risk by a third!

“We can actually push back, delay or prevent the development of diabetes in a substantial fraction of people over a long period of time. That means almost certainly that they will be healthier”, say Dr. Nathan.

Statin Drugs Might Slightly Boost Diabetes Risk
Statins do not lower diabetes risk. In fact, it can actually elevate the risks, albeit modestly. This is the result of a latest study by researchers at the Einstein College of Medicine, New York. Statins are cholesterol-lowering drugs that are commonly used in patients with cardiovascular conditions. However, its role in diabetes prevention has always been an issue of controversy. According to lead study investigator Dr. Swapnil

“Contrary to our expectation, we did not find any benefit of statins on diabetes risk. In fact, there is a suggestion that statins may be associated with increased risk — which needs to be explored further.”

Fish vs Shell fish in diabetes risk study
There is fish and there is fish. Some types can lower your risk for type 2 diabetes; some have the opposite effect. A British study reports that incorporating more white and oily fish in the diet lowers type 2 diabetes risk by 25%. However, one should take care about eating shellfish – e.g. mussels, oysters, crabs, and prawn. These seafoods actually elevate your diabetes risk by a whopping 36%! But is it really the shellfish? The researchers do not rule out that cooking and preparation methods can play a role in making these seafoods unhealthy. In the UK, for example, shellfish is usually fried in oil and served with sauces which are high in cholesterol. Fish that is good for the health should be eaten steamed, baked, of broiled with low fat sauces. Example of these fishes are:

• White fish: cod, haddock, sole, and halibut
• Oily fish: mackerel, kippers, tuna, and salmon,

What is World Diabetes Day

This Saturday, November 14 is World Diabetes Day. As the name suggests, it is a day dedicated to global awareness of diabetes. The annual observance of this special was started by the International Diabetes Federation (IDF) and the World Health Organization (WHO). November 14 was chosen to be the day because it is the birthday of Frederick Banting who, together with Charles Best, discovered insulin in 1922, a life-saving treatment for diabetes patients.

The theme of World Diabetes Day from 2009 to 2013 is Diabetes Education and Prevention. This year’s slogan is “understand diabetes and take control.”

The Blue Circle: The diabetes symbol

The World Diabetes Day logo is the blue circle, a symbol well-known globally to represent diabetes adopted since 2007. The logo was developed as part of the Unite for Diabetes awareness campaign. Here’s what the logo means:

“…the circle symbolizes life and health. The color blue reflects the sky that unites all nations. The blue circle signifies the unity of the global diabetes community in response to the diabetes pandemic.”

Global statistics on diabetes

• 246 million: the number of people worldwide currently affected by diabetes
• 380 million: the number of people worldwide expected to have by diabetes and by 2025.
• 7 million: the number of new people developing diabetes each year.
• 3.8 million: number of deaths each year linked directly to diabetes-related causes including cardiovascular disease made worse by diabetes-related lipid disorders and hypertension.
• 26.8 million: number of Americans with diabetes
• 10: every 10 seconds. 2 people develop diabetes;  a person dies from diabetes-related causes.
• 12 to 20%: proportion of adult population affected by diabetes in many countries in Asia, the Middle East, Oceania and the Caribbean.
• 7 out of 10: proportion of countries in the developing world with the highest number of people living with diabetes
• 80%: proportion of all diabetes cases will be in low and middle-income countries.
• 40 to 59: age rangeof 50% of all people with diabetes
• 45 to 64: age range of diabetes patients in low and middle income countries
• 41 million: The number of people in India with diabetes, amounting to 6% of the adult population, the % highest in the world.
• 4.3%: proportion of the Chinese population with diabetes; this number is expected to exceed 50 million within the next 20 years.
• 3% per year: the rate of increase of Type 1 diabetes, which predominately affects the young.
• 70,000: the number of children aged 14 and below who develop Type 1 diabetes each year.
• 8 years: youngest age among children who develop Type 2 diabetes; reports reveal the existence of this type of diabetes in child populations previously thought not to be at risk.
• 13.9 per 100,000: prevalence of Type 2 diabetes amongst junior high school children in Japan from 1991 to 1995, up from 7.3 per 100,000 in 1976 to 80; Type 2 diabetes now outnumbers Type 1 diabetes in that country.
• 5%: proportion of all deaths globally each year caused by diabetes.
• 50%: increase in diabetes expected in the next 10 years is nothing is done now.

Events on World Diabetes Day

Monuments and landmarks to go “blue”

About 600 major landmarks and monuments the world over will be lighted blue to observe World Diabetes Day on November 14. Some of these landmarks are:

• London Eye (London, UK)
• Empire State Building (new York, USA)
• Burj al Arab (Dubai, UAE)
• Christ the Redeemer (Rio de Janeiro, Brazil)
• Table Mountain (Cape Town, South Africa)
• Tokyo Tower (Tokyo, Japan)
• Obelisque (Paris, France)

In the US, more than 40 American cities and landmarks will “go blue” this coming Saturday, including:

• the Alamo,
• the California State Capitol
• the Ferry Building in San Francisco
• the Morrison Bridge in Portland, OR
• the Philadelphia Free Library
• the Wright Brothers’ Flyer in Dayton, OH
• the Chase Tower in Austin, TX, and
• the Soldiers’ and Sailors’ Monument in Indianapolis, IN

For a complete list of participating monuments and landmarks, check out

http://www.worlddiabetesday.org/en/monuments/2009/United+Stat

World Diabetes Day videos launched on YouTube

Check out two short video clips launched by the International Diabetes Federation for World Diabetes Day.

The videos “feature people from all ethnic backgrounds and walks of life being quizzed about their knowledge of diabetes and its international symbol.”

The clips, titled “Understand Diabetes, Get Involved” and “Diabetes Blue Circle – Wear & Share”, can be viewed on the World Diabetes Day YouTube channel at:

• http://www.youtube.com/watch?v=60QEBpFh5Ho
• http://www.youtube.com/watch?v=B-yZLZfAWnU&feature=channel

November is the month focused on diabetes. It is only right that we take a look at what we know about this condition.

Diabetes mellitus is a group of chronic conditions characterized by high levels of glucose in the blood. This high glucose levels were due to disruption in insulin production, diminished action of insulin, or both. Diabetes is incurable but manageable.

There are several types of diabetes mellitus, namely:

• Type 1 diabetes is also known as insulin-dependent diabetes mellitus or juvenile diabetes and accounts for 5 to 10% of all diabetes cases.
• Type 2 diabetes is also known as noninsulin-dependent diabetes mellitus or adult diabetes and accounts for 90 to 95% of all diabetes cases.
• Pregnancy or gestational diabetes occurs in about 5% of all pregnant women.
• There are rare types of diabetes which account for 1 to 5% of all cases of diabetes.

The statistics

Some statistics from the American Diabetes Association (ADA):

• 24 million children and adults in the United States live with diabetes
• 57 million Americans are at risk for type 2 diabetes
• 1 out of every 3 children born today will face a future with diabetes if current trends continue.

The campaign

In the US, lots of events have been scheduled to observe the National Diabetes Month. Some are as follows:

• Launch of Stop Diabetes Movement by the ADA on November 1 in Denver, Colorado
• Release of education video series on diabetes
• Community events organized by the local ADA chapters.

The video series

The said series is a collection of online educational video clips to give practical tips and advice for living with the disease. The videos were developed in collaboration with Liberty Medical and can be viewed online at www.stopdiabetes.com under the “learn” section. Topics covered include

• symptoms
• risks
• weight management tips
• exercise tips
• an overview of
• insulin delivery methods
• tips on caring for a parent
• understanding the ABCs of diabetes – A1C, blood pressure, and cholesterol measurements

Community events

Some of the local events include

• Free blood glucose and A1C testing
• Free pharmacy consultation
• Walgreens Diabetes Wellness Events
• Free diabetes guides
• Fairs and expos
• Seminars and workshops

Other resources on diabetes:

• The Heart of Diabetes by the American Heart Association offers diabetes health assessments and cookbooks and recipes for diabetes patients.
• International Diabetes Federation (IDF)
• Diabetes UK
• Canadian Diabetes Association

Coming up: World Diabetes Day on November 14.

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Newly diagnosed with diabetes? Here is something you can do to postpone the need for anti-diabetes drugs: go for the Mediterranean diet.

Mediterranean diet has always been thought of as the ideal diet to maintain cardiovascular health without giving up nice-tasting food.

Italian researchers report that a low-carb Mediterranean diet works better than a low-fat diet in controlling this metabolic disease.

The researchers randomly placed 215 overweight patients newly diagnosed with type 2 diabetes into 2 different diet regimes as follows:

• A Mediterranean diet, which included lots of vegetables and whole grains, with little red meat but with poultry and fish instead, where <50% of calories were from complex carbohydrates and >30% of calories were from fat, largely olive oil.
• A low-fat diet based on American Heart Association guidelines, which included lots of whole grains and restricted sweets, fats, and high-fat snacks, where <30% of calories were from fat.

After a follow up period of 4 years, the researchers observed that 70% of patients placed on low-fat diet progressed to the drug therapy stage. Only 44% of those on a Mediterrranean diet progressed that far. In addition, Mediterranean diet patients also shoed better improvement in some cardiovascular risk factors, including high levels of „good“ HDL cholesterol, and lesser incidence of hypertension.

According to Dr Christine Laine, editor of the Annals of Internal Medicine where the study results were published

„The study confirms that lifestyle changes are a basic part of managing diabetes…[It also] suggests that people might be better off if the dietary advice they receive is in line with the Mediterranean diet.”

For this lifestyle strategy to work, however, the patients needed intensive support from nutritionists and dieticians and constant monitoring. The patients go this during the 4-year study. However, the this type of support may not be available in normal situations. It is recommended that primary care clinicians should not overlook the role of diet in the management of type 2 diabetes.

We have won the war against smoking. Anti-smoking bans, advertising regulations, and increased taxes are paying off.

Now it’s the war against sugary beverages and junk food. In the US, there is increasing demand from health advocates and consumers on increasing taxes on unhealthy food. This was brought about by the alarmingly high incidence of obesity, diabetes mellitus and heart disease among Americans. However, this problem is not only unique to the US. Many parts of the developed world are facing the same problems and have also joined the war against junk food. Legislations in terms of product labeling, marketing, and advertising are already in place in many countries. However, many experts believe that increasing levies on fattening foods is the next big step.

Proponents of increased taxes on junk food in the US put forward the following arguments:

• The taxes will raise money for health care reform.
• Increased taxes will lead to soaring prices of the affected products, thus discouraging their consumption. It is estimated that a 10% in soda prices could cut consumption by 8 to 10%.

However, there are also those who are against this so-called “sin tax” or “obesity tax” based on the following grounds:

• It would turn the US into “a nanny state, hurt business, threaten an already weak economy and place an unfair burden on low-income shoppers.”
• It gives cash hungry states and local governments a reason to boost taxes under the guise of promoting good health.
• “Taxes never made anyone healthy. Education, exercise and balanced diets do that.”, according to one ad.

The group Americans Against Food Taxes is especially vocal against the taxation and supposedly has big backers in the food industry that have the most to lose including Pepsi Co, McDonalds, American Beverage Association and Burger King.

Will the taxation strategy work?

Experts believe that what happened to the tobacco industry is the best proof that levies do work. According to Mary Story, a dietitian and public health professor at the University of Minnesota:

“The research around tobacco has shown that large increases on taxes on cigarettes has been the single most effective policy to reduce tobacco use.”

Other ways of discouraging junk food consumption are already going on.

New York City has been one of the most active in the war against junk food. It has forced restaurants to eliminate the use of trans fats. The NYC health department is launching an anti-sugary beverage ad campaign that says

“Are you pouring on the pounds? Don’t drink yourself fat!”

The battle is far from over. The fight will be bitter. But in the end, we hope that consumers’ health will win.

Starting this month, I would like to keep you updated on the latest developments in the management and prevention of diabetes. Diabetes updates will appear in this blog once or twice a month.

Early warning on diabetes

It is there before you know, sneaking up from behind. First it is just that the prediabetes stage when the blood sugar level is slightly up but not that high. Like many chronic conditions however, early detection is very important in diabetes. That is why a blood test is recommended to catch the big D early.
Even at the pre-diabetes stage, there is so much you can do to prevent the disease from progressing: diet, physical exercise and weight loss.
At the National Institute of Diabetes and Digestive and Kidney Diseases, Dr. Judith Fradkin says you don’t have to drop to your ideal body weight to dramatically reduce your risk of moving from pre-diabetes to diabetes.
“Even losing an average of 15 pounds makes a huge difference in developing type 2 diabetes.”

Consumer Guide Compares Type 2 Diabetes Treatments

Researchers at the for Healthcare Research and Quality (AHRQ), part of the U.S. Department of Health and Human Services (HHS) released a consumer guide to diabetes treatments earlier this year. The guide compares the effectiveness of pre-mixed insulin and other treatments for adults with type 2 diabetes and present the  results of the comparison in plain language that non-medical people can understand.
AHRQ researcher Dr. Barbara Bartman explains:
“The guide helps consumers better understand the difference between insulin that lasts all through the day, insulin for meal time, and the newer pre-mixed insulin analogues that work throughout the day and also at meal time when blood sugar levels can rise suddenly. The guide not only describes how effective these medicines are, but also explains their potential side-effects. We want consumers to have access and understand this information, so they can work with their clinician to decide which treatment option is best for them.”
You can listen to the audiocast about the guide as well as download it from the AHRQ site.

Potential preventative therapy for Type 1 diabetes

A potential preventative therapy for Type 1 diabetes? Scientists at Garvan Institute of Medical Research in Sydney, Australia believe this may be it.  Type 1 diabetes is a form of autoimmune disease wherein the body attacks its own insulin producing cells. The new therapy, using a molecule that blocks immune B cells “makes the body’s killer immune cells tolerate the insulin-producing cells they would normally attack and destroy, prior to disease onset. “

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We all know that dogs have exceptional sense of smell. But do their olfactory powers extend to sniffing out health problems? Well, it seems that dogs can detect the smell of a hypoglycemia attack coming, probably in the form of chemicals given off by body during the attack. Several of these amazing stories are featured in this video in the National Geographic.

According to the British Paul Jackson, who is suffering from type 2 diabetes, his collie Tinker would get agitated when he was about to have a hypoglycaemic attack.

“It was his behavior around me when I was having a hypoglycemic attack. The way he would lick my face, or cry gently while I was sitting down, or bark even. And then we noticed that this behaviour was happening while I was having a hypoglycemic attack so we just put two and two together.”

This is one of the stories that prompted the UK organization Cancer and Bio-Detection Dogs to investigate and then make use of this astounding discovery.

One of the trainers at the cancer center, Kimberley Cox, also has diabetes. She trained a golden retriever named Rory by capturing her body odor during a hyploglycemic attack in a cotton wool and stored it in an air tight bottle. She then simulated the attack by opening the bottle in the presence of Rory. On this olfactory cue, Rory is trained to fetch an insulin kit which includes a blood sugar tester and insulin injections. For achieving his task, Rory gets a food treat as a reward.

Says Kimberley

“I’ve taught him to recognize the odor, and the odor signals to him a big reward, so he knows to come up to me and recognize that odor.”

These are not isolated incidents. Researchers from the Queen’s University in Belfast investigated 212 dog owners with type 1 diabetes. 138 of these canine lovers (65.1%) reported that their dogs showed some behavioral changes during hypoglycemic episodes. These behaviours are aimed to attract the attention of their owners and take the form of:

• vocalizing (61.5%)
• licking (49.2%)
• nuzzling (40.6%)
• jumping on top of them (30.4%)
• staring intently at their faces (41.3%)
• trembling (7.2%)
• running away (5.1%)
• hyperventilating (2.2%)

The study concludes

… behavioral reactions to hypoglycemic episodes in pet owners with type 1 diabetes commonly occur in untrained dogs. Further research is now needed to elucidate the mechanism(s) that dogs use to perform this feat.

But this is not the only health problem that dogs can sniff out. Check out our Battling Cancer site for a feature on cancer-sniffing dogs.

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Remember the controversy about the diabetic drug rosiglitazone (market name Avandia)? Remember the issues surrounding the APPROACH Trial – Assessment on the Prevention of Progression by Rosiglitazone on Atherosclerosis in Type 2 Diabetes Patients with Cardiovascular History? The drug was thought to increase cardiovascular risk, which brings to mind the problems faced by Vioxx.

Well, it seems that new trials indicate that it is not all bad news about rosiglitazone. In a late-breaking clinical trial using IVUS technology, rosiglitazone was compared with another diabetic drug glipizide. The trial’s primary endpoint, which is “a significant difference in percent atheroma, or plaque, buildup in coronary arteries“, was not met, but it did bring up some good points about rosiglitazone, especially with the secondary end points. The recent results show that:

• Rosiglitazone did increase levels of “good” cholesterol, improved blood pressure and reduced hs-CRP, a marker of inflammation.
• There was a significant difference in a secondary endpoint, the absolute atheroma volume, and fewer patients had hypoglycemia (low blood sugar) with rosiglitazone.

IVUS stands for intravascular ultrasound and is the world’s largest study of diabetic patients with established coronary artery disease (CAD). The study involved 672 patients from 92 hospitals in 19 countries worldwide. The effect of diabetic drugs on the progression of CAD was assessed using the intravascular ultrasound technique. This was done by measuring the plaque burden using IVUS in a 40 mm segment of an atherosclerotic artery which hasn’t undergone any intervention because level of plaque build up was considered to be too low to require treatment.

People suffering from diabetes have increased risks for atherosclerosis, heart attack, stroke, and other cardiovascular disorders. Diabetes a metabolic disorder which interferes with blood sugar metabolism due to problems with insulin, the hormone produced by pancreas needed to metabolize glucose in the blood.

About the two drugs:

Rosiglitazone is a member of the thiazolidinedione class of diabetes drugs. It works by making the cells of the body more sensitive to insulin. In addition, the drug also has a positive impact on blood pressure, high density lipoprotein (HDL “good”) cholesterol and has anti-inflammatory properties. However, in 2007, the US FDA issued warnings about rosiglitazone increasing risk of cardiac events.

In a more recent report, the RECORD (Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of Glycemia in Diabetes) trial reports that rosiglitazone “does not increase overall cardiovascular risk.”

Glipizide belongs to the sulfonylurea class of insulin secretagogues. It works by inducing the pancreas to secrete more insulin. It has been on the market for more than 40 years.

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