In response to research confirming that even small elevations in blood sugar during pregnancy can lead to sick babies, an international panel of experts is recommending sweeping changes in how gestational diabetes is diagnosed.
If adopted, the changes would mean that in the future two or three times as many pregnant women would be diagnosed and treated for gestational diabetes.
About 5% of pregnant women in the United States receive a diagnosis of gestational diabetes.
But Northwestern University Feinberg School of Medicine Professor of Metabolism and Nutrition Boyd Metzger, MD, says closer to 15% of pregnant women and their babies would benefit from treatment.
“Current recommendations for the diagnosis of gestational diabetes are designed to identify women at risk for developing diabetes after pregnancy,” Metzger tells WebMD. “But we now know that many low-risk women with blood sugar levels considered normal in the past are at risk for having overweight babies.”
High-birth-weight babies have an increased risk for obesity and diabetes later in life, and women carrying large babies are at increased risk for premature delivery and C-section delivery.
Modest Blood Sugar Increases Risky
Findings from a seven-year, international study led by Metzger showed that even modest increases in blood sugar during pregnancy raise the risk for complications to mothers and their babies.
More than 23,000 women who took part in the trial were followed for nearly a decade. The study was published in May 2008.
Several months later, diabetes experts from across the globe met to consider the clinical implications of the findings and this meeting led to the new recommendations.
Under the proposed guidelines, a fasting blood sugar of 92 or higher, a one-hour glucose tolerance test reading of 180 or higher, or a two-hour glucose tolerance test of 153 or higher would meet the criteria for gestational diabetes.
“Any one of these would be enough to make the diagnosis,” Metzger says.
He says that at these levels, the risk of having an overweight baby or developing pregnancy-related high blood pressure doubles and the risk for early delivery increases by 40%.
The consensus panel recommendations appear in the March issue of the American Diabetes Association (ADA) journal Diabetes Care.
But it is not clear if the ADA or the American College of Obstetricians and Gynecologists (ACOG) will endorse the proposed guidelines.
An ACOG spokesperson tells WebMD the group does not comment on recommendations by other organizations.
Carol J. Homko, PhD, of the ADA, says the recommendations may overwhelm already struggling obstetrics practices.
Homko is an associate professor of medicine with a joint appointment in obstetrics and gynecology at Temple University in Philadelphia. She also served on the ADA’s Gestational Diabetes Mellitus workgroup.
“I worry that these practices may not have the resources to suddenly double or triple their gestational diabetes caseload,” she says.
Continue Reading...
Saturday, February 27, 2010
Saturday, February 6, 2010
Type 2 Diabetes Update
Scientists have completed a map of areas of the human genome that control which genes are switched on or off in type 2 diabetes, a finding that may advance understanding of the genetic basis of this and other common diseases.
"Most of the human genome is uncharted territory -- entire stretches of sequence with no clear function or purpose," study co-senior author Jason Lieb, an associate professor of biology at the University of North Carolina at Chapel Hill, said in a news release.
"In fact, the majority of the DNA sequences associated with disease found thus far reside in the middle of nowhere. Here we have developed a map that can guide scientists to regions of the genome that do appear to be functionally relevant, instead of a dead end."
Using a new method (called FAIRE-seq) developed in Lieb's laboratory, the researchers produced the first high-resolution atlas of these regulatory elements in pancreatic islet cells, the most studied cell type for the treatment and prevention of type 2 diabetes.
The study was published online recently in Nature Genetics.
This map is likely to help identify new genetic targets for understanding and treating type 2 diabetes, but the method used in this study isn't limited to diabetes or pancreatic islet cells. Lieb plans to use FAIRE-seq to investigate other cells, including immune cells.
Source : BusinessWeek
"Most of the human genome is uncharted territory -- entire stretches of sequence with no clear function or purpose," study co-senior author Jason Lieb, an associate professor of biology at the University of North Carolina at Chapel Hill, said in a news release.
"In fact, the majority of the DNA sequences associated with disease found thus far reside in the middle of nowhere. Here we have developed a map that can guide scientists to regions of the genome that do appear to be functionally relevant, instead of a dead end."
Using a new method (called FAIRE-seq) developed in Lieb's laboratory, the researchers produced the first high-resolution atlas of these regulatory elements in pancreatic islet cells, the most studied cell type for the treatment and prevention of type 2 diabetes.
The study was published online recently in Nature Genetics.
This map is likely to help identify new genetic targets for understanding and treating type 2 diabetes, but the method used in this study isn't limited to diabetes or pancreatic islet cells. Lieb plans to use FAIRE-seq to investigate other cells, including immune cells.
Source : BusinessWeek
Monday, January 25, 2010
Diabetes Education
The Diabetes Education Program at Norwalk Hospital provides education to people with diabetes so that they can learn to better manage their diabetes, according to a news release.
By increasing their knowledge about the disease and promoting self-management, a person with diabetes will be able to better control blood sugar and prevent acute and chronic complications, according to Barbara Nadolny, coordinator of Diabetes Education.
Diabetes is growing at epidemic proportions. According to the American Diabetes Association, 23.6 million Americans have diabetes and each year 1.6 million people age 20 or older are diagnosed with diabetes.
Many first learn that they have it when they are treated for complications such as heart disease, stroke, kidney disease, blindness or nerve damage. Through education and self-management a person with diabetes can learn to control the disease, which will reduce the risk of getting diabetes related complications.
The American Diabetes Association has recognized Norwalk Hospital's Outpatient Diabetes Education Program as a quality diabetes self-management program. It is a comprehensive program with both individual and group sessions.
Sessions are provided by Certified Diabetes Educators that are Registered Nurses or Registered Dietitians.
The program begins with an individual one-hour initial assessment followed by group or individual classes.
Group classes are available in the day or evening hours.
According to Nadolny, "Diabetes is a controllable disease. People can learn to control their diabetes and we can help."
"Our goal is to provide quality education to people with diabetes and to promote self-management and participation in personal health," Nadolny said.
Norwalk Hospital Diabetes Self-Management Education is a certified provider for Medicare and many other insurance companies.
Source : Stamford Times
By increasing their knowledge about the disease and promoting self-management, a person with diabetes will be able to better control blood sugar and prevent acute and chronic complications, according to Barbara Nadolny, coordinator of Diabetes Education.
Diabetes is growing at epidemic proportions. According to the American Diabetes Association, 23.6 million Americans have diabetes and each year 1.6 million people age 20 or older are diagnosed with diabetes.
Many first learn that they have it when they are treated for complications such as heart disease, stroke, kidney disease, blindness or nerve damage. Through education and self-management a person with diabetes can learn to control the disease, which will reduce the risk of getting diabetes related complications.
The American Diabetes Association has recognized Norwalk Hospital's Outpatient Diabetes Education Program as a quality diabetes self-management program. It is a comprehensive program with both individual and group sessions.
Sessions are provided by Certified Diabetes Educators that are Registered Nurses or Registered Dietitians.
The program begins with an individual one-hour initial assessment followed by group or individual classes.
Group classes are available in the day or evening hours.
According to Nadolny, "Diabetes is a controllable disease. People can learn to control their diabetes and we can help."
"Our goal is to provide quality education to people with diabetes and to promote self-management and participation in personal health," Nadolny said.
Norwalk Hospital Diabetes Self-Management Education is a certified provider for Medicare and many other insurance companies.
Source : Stamford Times
Friday, January 15, 2010
Artificial Pancreas Being Developed for Juvenile Diabetes
HOUSTON - A major development in helping children with Juvenile, or Type 1, Diabetes. The Juvenile Diabetes Research Foundation announces an artificial pancreas is now being developed and is expected to change and save lives.
JDRF is partnering with Johnson & Johnson's Animas Corporation, to develop the first artificial pancreas.
We found a mother in Sugar Land, who has been volunteering and raising money for JDRF, to go specifically toward funding the new device. Lisa Brettman's 16-year old son, Trevor, has been dealing with Type 1 Diabetes most of his life.
"This is life changing for us... for those of us who live with Type 1 diabetes. We live in fear all the time," says Lisa.
Living with Type-1 diabetes is definitely demanding.
"From playing the trumpet, to playing video games, and even sleeping - pretty much everything I do... it has changed every single thing," says Trevor.
The artificial pancreas will be software that stays on the outside of the body, along with an insulin pump and a continuous glucose monitor (which measures blood sugar levels).
"This new project will allow the two to talk to each other, so that the continuous glucose monitor can say to the pump - hey, the kiddo's blood sugar is too high so it's time to give him insulin now, and the pump will give him insulin. Or if it's too low, it can stop administering insulin," says Molly Naylor, who is the the Executive Director of the Houston Chapter of J.D.R.F.
She goes on to say, this is a huge development!
"It means kids won't end up in hospitals with comas or seizures, it means parents don't have to get up 5-6 times a night to check blood sugars, because they're afraid these kids won't wake up the next morning."
"It'll be really, really, really helpful, I can't even describe it. It will make the future that much brighter, and I could live every single day that much easier," says Trevor. "It will help get rid of the fear, some of the fear, we live with on a daily basis", says Trevor's mom.
Source : foxhouston.com
JDRF is partnering with Johnson & Johnson's Animas Corporation, to develop the first artificial pancreas.
We found a mother in Sugar Land, who has been volunteering and raising money for JDRF, to go specifically toward funding the new device. Lisa Brettman's 16-year old son, Trevor, has been dealing with Type 1 Diabetes most of his life.
"This is life changing for us... for those of us who live with Type 1 diabetes. We live in fear all the time," says Lisa.
Living with Type-1 diabetes is definitely demanding.
"From playing the trumpet, to playing video games, and even sleeping - pretty much everything I do... it has changed every single thing," says Trevor.
The artificial pancreas will be software that stays on the outside of the body, along with an insulin pump and a continuous glucose monitor (which measures blood sugar levels).
"This new project will allow the two to talk to each other, so that the continuous glucose monitor can say to the pump - hey, the kiddo's blood sugar is too high so it's time to give him insulin now, and the pump will give him insulin. Or if it's too low, it can stop administering insulin," says Molly Naylor, who is the the Executive Director of the Houston Chapter of J.D.R.F.
She goes on to say, this is a huge development!
"It means kids won't end up in hospitals with comas or seizures, it means parents don't have to get up 5-6 times a night to check blood sugars, because they're afraid these kids won't wake up the next morning."
"It'll be really, really, really helpful, I can't even describe it. It will make the future that much brighter, and I could live every single day that much easier," says Trevor. "It will help get rid of the fear, some of the fear, we live with on a daily basis", says Trevor's mom.
Source : foxhouston.com
Sunday, December 20, 2009
Coffee Reduces the Risks of Developing Type 2 Diabetes
A meta-analysis report, published this week in the Archives of Internal Medicine, suggests that consuming coffee reduces the risk of developing type 2 Diabetes. The data is based on 18 studies between 1966 and July of this year.
The findings indicate that for every additional cup of coffee consumed daily, there was an associated 5% to 10% decrease in excess risk of developing diabetes. There was a 25 % reduction in risk when consuming three to four cups of coffee per day over drinking less than three. Similar results were also suggested based on 6 studies on the consumption of decaffeinated coffee and 7 studies on the consumption of tea.
According to researcher, Dr. Rachel Huxley of the George Institute for International Health in Sydney, Australia, and her colleagues - "If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes, or who are at future risk of developing it, would be substantial,"
Dr Huxley went on to say - "For example, the identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus. It could also be envisaged that we will advise our patients most at risk for diabetes mellitus to increase their consumption of tea and coffee in addition to increasing their levels of physical activity and weight loss."
Conclusions of the report did however recognize that the individual studies researched were small, and as such, may contain "small study bias", which overestimate the “true magnitude of the association”.
SOURCE
The findings indicate that for every additional cup of coffee consumed daily, there was an associated 5% to 10% decrease in excess risk of developing diabetes. There was a 25 % reduction in risk when consuming three to four cups of coffee per day over drinking less than three. Similar results were also suggested based on 6 studies on the consumption of decaffeinated coffee and 7 studies on the consumption of tea.
According to researcher, Dr. Rachel Huxley of the George Institute for International Health in Sydney, Australia, and her colleagues - "If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes, or who are at future risk of developing it, would be substantial,"
Dr Huxley went on to say - "For example, the identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus. It could also be envisaged that we will advise our patients most at risk for diabetes mellitus to increase their consumption of tea and coffee in addition to increasing their levels of physical activity and weight loss."
Conclusions of the report did however recognize that the individual studies researched were small, and as such, may contain "small study bias", which overestimate the “true magnitude of the association”.
SOURCE
Saturday, December 12, 2009
Gene Action May Lead to Diabetes Prevention
A gene commonly studied by cancer researchers has been linked to the metabolic inflammation that leads to diabetes.
Understanding how the gene works means scientists may be closer to finding ways to prevent or cure diabetes, according to a study by Texas AgriLife Research appearing in the Journal of Biological Chemistry.
"Because we understand the mechanism, or how the gene works, we believe a focus on nutrition will find the way to both prevent and reverse diabetes," said Dr. Chaodong Wu, AgriLife Research nutrition and food scientist who authored the paper with the University of Minnesota's Dr. Yuqing Hou.
Wu said the research team will collaborate with nutritionists to identify what changes or supplements in a diet will activate the gene to prevent or stop the progression of diabetes.
Diabetes is a disease in which blood sugar (glucose) levels are higher than normal and the body has a hard time converting food to glucose which is then turned into energy, according to the National Institutes of Health. When the body cannot metabolize food, the amount of glucose builds in the blood while the cells lack energy. Complications can include heart disease, stroke, kidney disease, blindness, nerve problems and gum infections. Some of the complications can lead to amputation.
The gene with the possible answers to ways of fighting the disease is known in the science world as PFKFB3. Wu and the team of researchers identified it as a regulator for metabolism, which plays a vital role in the development of diabetes.
Wu noted that while it is a major health concern in the U.S., obesity does not necessarily cause diabetes to develop; i.e., just because a person is overweight does not mean they have diabetes. Rather, "metabolic inflammation" causes or exacerbates the disease. That's where the team began looking at PFKFB3 -- because it regulates metabolism -- to find the mechanism or how the inflammation begins. Metabolic inflammation is different from classic inflammation because there is no infection, virus or bacteria present, though the symptoms appear similar.
He believes nutritionists working with the biological chemists can help develop food consumption plans that either prevent people from developing metabolic inflammation or cause existing conditions to retreat.
"First we will need to identify what effective compounds will trigger the gene to regulate metabolism," Wu said. "Then we need to determine what combinations within foods are more effective."
In the meantime, Wu suggested, people need to consume healthier foods.
"Basically, fish and seafood," Wu said. "That's always good in a diet."
SOURCE
Understanding how the gene works means scientists may be closer to finding ways to prevent or cure diabetes, according to a study by Texas AgriLife Research appearing in the Journal of Biological Chemistry.
"Because we understand the mechanism, or how the gene works, we believe a focus on nutrition will find the way to both prevent and reverse diabetes," said Dr. Chaodong Wu, AgriLife Research nutrition and food scientist who authored the paper with the University of Minnesota's Dr. Yuqing Hou.
Wu said the research team will collaborate with nutritionists to identify what changes or supplements in a diet will activate the gene to prevent or stop the progression of diabetes.
Diabetes is a disease in which blood sugar (glucose) levels are higher than normal and the body has a hard time converting food to glucose which is then turned into energy, according to the National Institutes of Health. When the body cannot metabolize food, the amount of glucose builds in the blood while the cells lack energy. Complications can include heart disease, stroke, kidney disease, blindness, nerve problems and gum infections. Some of the complications can lead to amputation.
The gene with the possible answers to ways of fighting the disease is known in the science world as PFKFB3. Wu and the team of researchers identified it as a regulator for metabolism, which plays a vital role in the development of diabetes.
Wu noted that while it is a major health concern in the U.S., obesity does not necessarily cause diabetes to develop; i.e., just because a person is overweight does not mean they have diabetes. Rather, "metabolic inflammation" causes or exacerbates the disease. That's where the team began looking at PFKFB3 -- because it regulates metabolism -- to find the mechanism or how the inflammation begins. Metabolic inflammation is different from classic inflammation because there is no infection, virus or bacteria present, though the symptoms appear similar.
He believes nutritionists working with the biological chemists can help develop food consumption plans that either prevent people from developing metabolic inflammation or cause existing conditions to retreat.
"First we will need to identify what effective compounds will trigger the gene to regulate metabolism," Wu said. "Then we need to determine what combinations within foods are more effective."
In the meantime, Wu suggested, people need to consume healthier foods.
"Basically, fish and seafood," Wu said. "That's always good in a diet."
SOURCE
Sunday, December 6, 2009
Popular Diabetes Drug Could be Fatal
Sulphonylureas, a type of drug widely used to treat type 2 diabetes, has a greater risk of causing heart failure and death as compared to metformin, another popular antidiabetes drug, according to a study.
The findings suggest that clinically important differences in the cardiovascular safety profiles of different antidiabetes drugs, and support recommendations that favour metformin as first-line therapy for type 2 diabetes.
Type 2 diabetes affects more than 180 million people worldwide and is associated with at least a two-fold increased risk of death, mainly from cardiovascular disease.
Oral antidiabetes drugs are widely used to help control blood sugar levels, but there are concerns that some may increase cardiovascular risk.
Thus, researchers led by Professor Paul Elliott from Imperial College London set out to investigate the risk of heart attack (myocardial infarction), congestive heart failure and death from any cause associated with prescription of different types of oral antidiabetes drugs.
They used data from 91,521 men and women (average age 65 years) with diabetes included in the UK General Practice Research Database between 1990 and 2005 and took into account factors that could potentially affect the results.
Metformin was the most commonly prescribed drug, followed by second generation sulphonylureas. Compared with metformin, both first and second generation sulphonylureas were linked with significant excess risk of all cause mortality, and second generation sulphonylureas with up to 30 percent excess risk of congestive heart failure.
Another class of antidiabetes drugs called thiazolidinediones were not associated with risk of heart attack, and there was significantly lower risk of all cause mortality associated with pioglitazone use compared with metformin.
"The sulphonylureas, along with metformin, have long been considered the mainstay of drug treatment for type 2 diabetes. Our findings suggest a relatively unfavourable risk profile of sulphonylureas compared with metformin," the British Medical Journal quoted the authors as saying.
SOURCE
The findings suggest that clinically important differences in the cardiovascular safety profiles of different antidiabetes drugs, and support recommendations that favour metformin as first-line therapy for type 2 diabetes.
Type 2 diabetes affects more than 180 million people worldwide and is associated with at least a two-fold increased risk of death, mainly from cardiovascular disease.
Oral antidiabetes drugs are widely used to help control blood sugar levels, but there are concerns that some may increase cardiovascular risk.
Thus, researchers led by Professor Paul Elliott from Imperial College London set out to investigate the risk of heart attack (myocardial infarction), congestive heart failure and death from any cause associated with prescription of different types of oral antidiabetes drugs.
They used data from 91,521 men and women (average age 65 years) with diabetes included in the UK General Practice Research Database between 1990 and 2005 and took into account factors that could potentially affect the results.
Metformin was the most commonly prescribed drug, followed by second generation sulphonylureas. Compared with metformin, both first and second generation sulphonylureas were linked with significant excess risk of all cause mortality, and second generation sulphonylureas with up to 30 percent excess risk of congestive heart failure.
Another class of antidiabetes drugs called thiazolidinediones were not associated with risk of heart attack, and there was significantly lower risk of all cause mortality associated with pioglitazone use compared with metformin.
"The sulphonylureas, along with metformin, have long been considered the mainstay of drug treatment for type 2 diabetes. Our findings suggest a relatively unfavourable risk profile of sulphonylureas compared with metformin," the British Medical Journal quoted the authors as saying.
SOURCE
Subscribe to:
Posts (Atom)
