Scientists have long known that high blood sugar levels from diabetes damage blood vessels in the eye, but they didn't know why or how. Now a Michigan State University scientist has discovered the process that causes retinal cells to die, which could lead to new treatments that halt the damage. Diabetic retinopathy is a common side effect of diabetes and the leading cause of blindness in young adults in the United States. It's estimated that between 40 percent and 45 percent of people diagnosed with diabetes have some degree of diabetic retinopathy. Research by Susanne Mohr, MSU associate professor of physiology, found the siah-1 protein is produced by the body when blood sugar levels are high. She then discovered that the siah-1 protein serves as a type of chauffeur for another protein, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), shuttling the GAPDH into the nucleus of MГ ller cells, special cells that have contact with the blood vessels in the eye. When GAPDH accumulates in their nuclei, the MГ ller cells die, which leads to the vascular damage associated with diabetic retinopathy.
About one-third of doctors and their patients with diabetes do not see eye to eye on the most important health conditions to manage, according to a survey by the University of Michigan Medical School. While both groups frequently ranked diabetes and hypertension among their top concerns, 38 percent of doctors were more likely to rank hypertension as the most important, while only 18 percent of diabetics said it was the most important. Patients were also more likely to prioritize symptoms such as pain and depression. The findings appear in the current issue of the Journal of General Internal Medicine and may shed light on why some patients manage their diabetes so poorly. "If a patient and their doctor do not agree on which of these issues should be prioritized, it will be difficult for them to come up with an effective treatment plan together, " says lead author Donna M. Zulman, M.D., a Robert Wood Johnson Clinical Scholar at the University of Michigan Medical School and researcher at the Veterans Affairs Healthcare System in Ann Arbor.
The American Association of Clinical Endocrinologists (AACE) has approved the use of A1c as an additional diagnostic criterion for type 2 diabetes. An A1c of 6.5 or greater is now considered an alternate criterion for the diagnosis of type 2 diabetes. The decision was announced in a position statement entitled "The AACE/ACE Statement on the Use of A1c for the Diagnosis of Diabetes." The position statement also reviews the limitations of the test. For example, certain ethnic groups may have marginally elevated values which do not necessarily indicate diabetes. "Using A1c will provide doctors and patients a convenient additional tool to diagnose diabetes and thereby identify more patients with it, " said Dr. Jeffrey R Garber, president of AACE. A1c is a test that is used to determine the average level of blood glucose over a prior three month period. It is currently used to measure glucose control in patients already diagnosed with diabetes. The test requires a single blood draw, and the results can be available the same day.
METABOLIC DISEASE: Making macrophages protect against effects of obesity It is well known that diet-induced obesity increases dramatically a person's risk of developing type 2 diabetes. One reason underlying this susceptibility is that diet-induced obesity triggers the accumulation of inflammatory immune cells known as macrophages in fat tissue known as white adipose tissue (WAT). A team of researchers, led by Robert Farese Jr. and Suneil Koliwad, at the Gladstone Institute of Cardiovascular Disease, San Francisco, has now determined that engineering macrophages to store increased amounts of triacylglycerol (the main constituent of vegetable oil and animal fats) is sufficient to protect mice from diet-induced inflammatory macrophage activation, macrophage accumulation in WAT, and insulin resistance, a condition that preempts the onset of type 2 diabetes. The team made macrophages store increased amounts of triacylglycerol by using mice overexpressing the protein DGAT1, which is crucial for triaclyglycerol synthesis, in macrophages and fat cells.
Although transplantation of pancreatic islets is an attractive way to treat type 1 diabetes, early islet loss soon after transplantation has limited its clinical use. By studying islet transplantation in a mouse model of diabetes, a team of researchers, at the RIKEN Research Center for Allergy and Immunology, Japan, and Fukuoka University, Japan, has now identified a potential new set of targets to improve the efficiency of pancreatic islet transplantation. Previous studies have identified an immune mechanism essential for early loss of transplanted islets: immune cells expressing the proteins Gr-1 and CD11b produce the soluble molecule IFN-gamma in a process that is dependent on immune cells known as NKT cells. The team, led by Masaru Taniguchi and Yohichi Yasunami, found that the protein HMGB1 plays a crucial role in the initial events of early loss of transplanted islets in the mouse model of diabetes. Of potential clinical significance, treatment with an antibody targeting HMGB1 prevented early pancreatic islet loss and inhibited IFN-gamma production by NKT cells and Gr-1+CD11b+ cells.
The Endocrine Society Recommends Against Changes In Blood Sugar Control Goals In Response To Study On A1C Levels And Mortality Published In Lancet
A study published this week in Lancet suggests that low A1C levels may be just as dangerous as high A1C levels in diabetes patients with respect to mortality and cardiovascular outcomes. Upon review of the study, The Endocrine Society released a statement recommending against any wholesale change in glycemic goals and strongly encourages patients to discuss these issues with their diabetes-care providers. Measurements of A1C show the percentage of hemoglobin (the main component of red blood cells) in the blood that is glycated, i.e., has glucose attached to it. The A1C blood test is currently one of the mainstays of diabetes management because it reflects the average blood sugar levels for the previous two to three months. The study by Currie et al. published online in the January 27, 2010 issue of Lancet is a retrospective database analysis using information on almost 50, 000 patients contained in the United Kingdom's General Practice Research Database. Researchers found that patients with both the lowest A1C levels (median 6.
In an age of soaring health care costs and staggering diabetes prevalence, the American Diabetes Association announced today its 2010 schedule for free community health events throughout the country -- the American Diabetes Association EXPO. By attending EXPO, people will be able to join the Association's new movement Stop Diabetes(SM) and learn how to live healthy, be active, and change the future of the disease. Communities can take advantage of free health screenings, cooking demonstrations, product exhibits and presentations on diabetes prevention and management. These events also include a Family Fun Zone with information and activities geared toward youth with diabetes and those who want to live a healthy lifestyle to prevent the disease. "Diabetes has a devastating effect on communities, " said Larry Hausner, CEO, American Diabetes Association. "EXPO is one way the American Diabetes Association helps combat this disease on a community level, by providing free access to diabetes information, educational presentations and screenings for things like blood pressure, blood glucose and cholesterol.
Leading health charity Diabetes UK is encouraging healthcare professionals to sign up for vouchers to give to children newly diagnosed with Type 1 diabetes, so they can claim a free DVD starter pack. The starter pack, Type 1 diabetes: journey of a lifetime, has been created primarily to help meet the needs of young people aged between 10 and 14 who have been newly diagnosed with Type 1 diabetes, and their families. However, the pack has also been designed to be useful to anyone recently diagnosed with Type 1 diabetes or as a refresher for those who have had the condition for a long time. The DVD includes an innovative animation of the body and explanation of what diabetes is as well as information on eating well, physical activity, advice from experts in the field and stories from children with Type 1 diabetes. The starter pack also comprises a specially-designed 36-page leaflet, information about the support Diabetes UK can offer, in particular their child support weekends, as well as a handy pocket guide designed to help both parents and children understand food labels.
Jim Cunningham, MP for Coventry South, and the Right Honourable Kevin Barron, MP for Rother Valley, were announced as winners of the Diabetes UK Parliamentary Champion Award at the House of Commons on Wednesday 27 January. The eight nominations for the award were announced throughout 2009 and the winners were chosen by Diabetes UK campaigners, staff and website visitors. The award aims to recognise politicians who have gone above and beyond the call of duty in raising awareness of diabetes in Parliament. Jim Cunningham Jim Cunningham became heavily involved in the charity's campaign to improve support given to children with diabetes in schools after meeting his constituent, Alick Doggett, at the Diabetes UK children's lobby in November 2008. As well as tabling many questions on this issue, Mr Cunningham agreed to use his Private Members' Bill to ensure that all children with long-term conditions, like diabetes, are properly supported in school. The Schools (Health Support) Bill was presented to the House on 21 January 2009 and Diabetes UK worked closely with Jim in the run up to its second reading on 8 May 2009.
Novo Nordisk receives US approval for Victoza® (liraglutide) for the treatment of type 2 diabetes Novo Nordisk announced today that the US Food and Drug Administration (FDA) has granted marketing authorisation for Victoza® for the treatment of type 2 diabetes in adults. Victoza® is the brand name approved in the US and Europe for liraglutide, the first once-daily human Glucagon-Like Peptide-1 (GLP-1) analogue developed for the treatment of type 2 diabetes. In the US, Victoza® is indicated as an adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes. This provides for Victoza® to be used in monotherapy, as second-line treatment and in combination with commonly prescribed oral medications for diabetes. "The US approval of Victoza® represents a major advancement in the treatment of type 2 diabetes and is an important milestone for Novo Nordisk that follows the recent approval in Japan and the ongoing successful launch in Europe.