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Entries in Type 2 (10)

Tuesday
Apr172012

Weight-Loss Surgery Cuts Type 2 Diabetes 

iStockphoto/Thinkstock(ROME) -- Bariatric surgery may be the best treatment for obese people who suffer from Type 2 diabetes, according to a new study published in the Archives of Surgery that found that the procedure improved diabetes outcomes when compared to patients who received standard medication therapy for the disease.

Researchers from the University of Rome in Italy conducted a study that included 60 morbidly obese patients with Type 2 diabetes. Half the patients underwent sleeve gastrectomy, a surgical procedure in which the stomach is reduced to about 25 percent of its original size.  The other half of the study participants received conventional medical therapy for type 2 diabetes.

Eighty percent of patients who underwent the surgery were cured of diabetes 18 months after the surgery, and their BMI, which averaged 41.3 before the procedure among the participants, was reduced to 28.3 after the study period.  A BMI of 30 or above is considered obese. But patients who received medication for the disease did not show improvement, and remained diabetic during and after the study period.

Researchers also noted that patients who underwent surgery saw improvements in blood pressure, cholesterol levels and obstructive sleep apnea.

Medically treated patients required more medication for blood pressure and cholesterol control over time.

“Midterm and long-term results are needed to confirm the positive effect (remission and/or improvement) of [laparoscopic sleeve gastrectomy] on diabetes and, overall, on the chronic complications of the disease,” the authors wrote in the study. “Most importantly, the longer-term results will allow us to compare the costs and benefits of bariatric surgery vs conventional medical treatments.”

But the patients in the study who simply received medication for treatment were not newly diagnosed patients, and Dr. Vivian Fonseca, president of the division of Medicine and Science with the American Diabetes Association, said it would have been better to see how newly diagnosed patients responded to the medications versus the bariatric candidates.

“They selected people who were already obviously not doing well on medication therapy, so it’s unrealistic expectation that the medication therapy is going to be able to stop after a while,” Fonseca said. “It would have been better to see newly diagnosed patients who seemed to be doing well on medications.”

The Italian study comes on the heels of two studies published last month that found bariatric surgery lowers blood sugar levels almost immediately in patients with type 2 diabetes even before patients lost weight. One study found 42 percent of patients who underwent the gastric procedure showed no evidence of diabetes one year later, compared to 12 percent who received medication.

There are currently 25.8 million adults and children in the United States living with diabetes, according to the American Diabetes Association, and about 1.9 million new cases of diabetes were diagnosed in people 20 and older in 2010.

By 2020, the ADA estimates that the annual cost in caring for diabetic patients will near $192 billion. A typical bariatric surgery runs between $10,000 and $15,000 in the United States.

Only about 2 percent of these patients are currently treated with bariatric surgeries, but experts say the cost-effectiveness must be studied further to understand whether these surgeries are appropriate for the masses.

“There are a variety of treatments available in terms of altering the GI tract,” said Dr. Gerald Bernstein, director of the Diabetes Management Program at the Friedman Diabetes Institute at New York’s Beth Israel Medical Center.

Nevertheless, Bernstein said, given the tens of millions of people who have diabetes, it is economically impossible to offer the surgery to everyone. But it is important for primary care physicians, endocrinologists and surgeons to work together to decide which Type 2 diabetes patients would benefit most from these surgeries.

“Doctors need to be sure they find patients who will make this surgery worthwhile,” Bernstein said. “If you’re going to do something like this that significantly changes the body, you need to make sure they have the motivation to follow doctor’s recommendations.”

“Right now, this is another tool and option in the arsenal for diabetes treatment,” he said.

Copyright 2012 ABC News Radio

Monday
Mar262012

Bariatric Surgery Cuts Type 2 Diabetes, Studies Find

Jeffrey Hamilton/Lifesize/Thinkstock(NEW YORK) -- Type 2 diabetes, which affects nearly 26 million Americans, may have met its match.

The results of two separate trials published Monday in the New England Journal of Medicine showed for the first time that bariatric surgery can lower blood sugar levels immediately in patients with type 2 diabetes, even before the weight comes off.  The surgery limits the amount of food a person can eat, and the amount of calories they absorb.

"Bariatric surgery should not be considered just weight-loss surgery," said study author Dr. Francesco Rubino of Weill Medical College of Cornell University, "but a means to treat diabetes and metabolic disease."

Rubino and co-authors at the Catholic University in Rome enrolled obese patients to undergo either intense drug therapy for their diabetes or bariatric surgery.  Of patients who had Roux-En-Y surgery, the most common type of bariatric surgery in the United States, 75 percent showed no evidence of diabetes and were off their medications.  The improvement started 15 days after surgery.  No one in the drug treatment group was free of diabetes.

A similar study from the Cleveland Clinic found that 42 percent of patients who underwent gastric bypass surgery showed no evidence of diabetes one year later, compared with 12 percent of patients who received drug therapy.

"For about a century, we have been treating diabetes with pills and injections, and this is one of the first studies to show that surgical therapy may, at least in some patients, be much more effective than the polypharmacy approach to treating this disease," said study author Dr. Philip Schauer at the Cleveland Clinic Bariatric and Metabolic Institute.

The surgery also triggered a drop in triglyceride levels, and levels of good cholesterol went up.

"Currently less than 2 percent of patients are treated with bariatric or metabolic surgery," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at the University Hospital of the Albert Einstein College of Medicine, who was not involved in the studies.  "Many more people can benefit."

As to whether bariatric surgery is the answer, more research into its cost-effectiveness is needed.

"Given that there are millions of obese people with diabetes, it is physically and economically impractical to provide this technology for all," said Dr. Gerald Bernstein, director of the Diabetes Management Program at the Friedman Diabetes Institute at New York's Beth Israel Medical Center.

Copyright 2012 ABC News Radio

Friday
Mar162012

Think Twice About Rice? Study Suggests Risk of Diabetes

Photos.com/Thinkstock(CAMBRIDGE, Mass.) -- With every forkful of white rice you eat, your risk of type 2 diabetes could go up, according to an analysis published Friday in the British Medical Journal.

But don’t put the rice cooker away just yet.  Other experts caution there may be only a grain of truth to this latest health warning.

Researchers at the Harvard School of Public Health compiled data from seven studies that followed 352,384 subjects for up to 22 years and kept track of what they ate using food questionnaires.  The subjects came from all over the globe, with three of the studies done in Asia, three in the United States and one in Australia.

The results indicate that people in Asia who ate the most white rice were at the highest risk, showing a 55 percent increase in type 2 diabetes over other Asians who ate the least white rice.

But people everywhere were susceptible, as the risk of diabetes went up 11 percent for each additional serving of white rice eaten per day, according to the analysis.

In Asian countries where rice is a staple, this news could have widespread implications.  But diet experts argue it’s not just the rice causing trouble there -- rather, a societal shift away from physical activity and toward increased food consumption may be to blame.

“White rice has long been a part of Asian diets in which diabetes risk was very low,” says Dr. David Katz, associate professor of public health at Yale University.  “It is white rice plus aspects of modern living -- including less physical work -- that conspire to elevate the incidence of type 2 diabetes.”

The study authors acknowledge this, and note in their conclusion that, “this transition may render Asian populations more susceptible.”

Copyright 2012 ABC News Radio

Wednesday
Mar142012

Diabetes Linked to Ulcer-Causing Bacteria, Research Suggests

Jeffrey Hamilton/Lifesize/Thinkstock(NEW YORK) -- The same bacterium responsible for most stomach ulcers may play a role in the development of Type 2 diabetes among overweight and obese adults, New York University researchers report Wednesday.

And in the same way that antibiotics eradicate the bacterium and heal ulcers, antibiotics might eventually prove useful in diabetes prevention, they suggest in an article appearing in the Journal of Infectious Diseases.

Non-diabetic adults infected with Helicobacter pylori, whether or not they had ulcer symptoms, tended to have higher blood sugar than adults without H. pylori, according to the study co-authored by Yu Chen, an associate professor of environmental medicine at NYU, and Dr. Martin J. Blaser, chairman of NYU’s department of medicine.

Chen and Blaser assessed blood sugar levels using measurements of glycosylated hemoglobin (HbA1c or A1c), a marker of excess glucose in the bloodstream that in recent years has become a key tool for diagnosing and monitoring diabetes.

H. pylori is a complicated bacterium.  Persistent H. pylori infections beginning in childhood have been linked decades later to ulcers of the stomach and small intestine, and a heightened risk of stomach cancer.  Although H. pylori can inflame the stomach, many infected people have no symptoms.

Blaser called H. pylori a complicated and interesting organism that affects children and adults in entirely different ways.  In previous work, he and Chen found that H. pylori protects children against asthma and allergy.

“This study provides further evidence of late-in-life cost to having H. pylori,” Blaser said in an interview.  The findings also give new support to “the concept of eradicating H. pylori in older people.”

Theoretically, antibiotics that wipe out H. pylori might protect older, overweight men and women from developing diabetes, Blaser and Chen said.  However, scientists still need to determine how eliminating H. pylori might affect Type 2 diabetes, and how H. pylori affects sugar breakdown among people of different weights.

Copyright 2012 ABC News Radio

Wednesday
Dec282011

Shift Work Might Lead to Type 2 Diabetes, Obesity

iStockphoto/Thinkstock(NEW YORK) -- While shift workers are needed to help our 24-7 world go 'round, an editorial written by Dr. Virginia Barbour, chief editor of the journal PLoS Medicine, warned that such work schedules can put a person at increased risk of obesity and type 2 diabetes.

She even argued that unhealthy eating habits on the job should be considered an occupational health hazard.

"We have a long-standing interest in publishing on the diseases and risk factors that cause the highest burden of disease," Barbour told ABC News. "We would suggest that employers need to take unhealthy eating very seriously, to the extent that they consider that unhealthy foods are essentially environmental hazards and that they should consider what the implications are of exposing their employees to high levels of such hazards in the form of vending machines and fast-food restaurants."

In the editorial, Barbour cited a study that was published in the journal earlier this month that examined rotating night-shift work and the risk of type 2 diabetes, a chronic disease in which blood-sugar levels are abnormally high in the body.  Most people are overweight or obese at the time of diagnosis.

The study found that more than 11 percent of a participating nurse cohort reported doing shift work for more than 10 years, and the research results suggested that an extended period of rotating night-shift work was associated with a modestly increased risk of type 2 diabetes in women.

The study noted that late-night workers might be more likely to grab a fast, less-nutritious meal than those who work normal business hours. They might also get less sleep and exercise less because of the disturbed sleep schedules.

"A substantial proportion of the work force will be working in shifts and advice from governments needs to reflect that," Barbour said. "And shift workers, in turn, need to ensure they understand that shift work is not just inconvenient and anti-social, but also a substantial risk factor for poor health outcomes. Hence, they need to consider their shift work as their 'normal' hours and make a positive effort to ensure they incorporate a balanced diet, and exercise into their lifestyle, despite the hours."

Shift workers make up about 15 to 20 percent of the European and U.S. working population.  It is "notoriously associated" with poor eating habits and, ironically, shift work is especially associated with the health care industry.

Copyright 2011 ABC News Radio

Thursday
Aug112011

Can Red Meat Consumption Lead to Diabetes?

Polka Dot Images/Thinkstock(BOSTON) -- Harvard researchers have found a strong link between eating red meat of any kind and risk of developing Type 2 diabetes.

The large long-term study by the Harvard School of Public Health found a 19 percent higher risk for people who eat unprocessed red meat daily -- like steak or hamburger.  Furthermore, they found there was a 51 percent higher risk for those who eat processed red meat -- like a hot dog or sausage -- every day.

The researchers also found that risk of developing Type 2 diabetes is significantly lower if individuals replace red meat with healthier proteins such as low-fat dairy, nuts or whole grains.

The study's findings are published in the American Journal of Clinical Nutrition.

Copyright 2011 ABC News Radio

Wednesday
Mar232011

Actos May Prevent Type II Diabetes

Jeffrey Hamilton/Thinkstock(AUSTIN, Texas) -- Much attention has come to the use of glitazones, a class of drugs for the treatment of diabetes, especially in light of the Avandia (rosiglitazone) black box warnings.  Avandia is associated with an increased risk of heart attacks and has been taken off the market in Europe. However, Actos (piolitazone), has fewer side effects and is still used as a therapy for type 2 diabetes. 

In this study, conducted by University of Texas Health Science Center and published in the New England Journal of Medicine, over 600 participants who have elevated blood sugar, a risk factor for developing type 2 diabetes, were given either Actos or a placebo and then followed for 2.4 years.  Results of the study show participants in the Actos group were 72 percent less likely to develop diabetes than those taking placebo. 

This is a modest improvement over lifestyle change alone, which can lead to a 58-percent decrease in progression to diabetes.  Patients in the Actos group also had slightly lower blood pressure, less plaque buildup in arteries, and an improvement in cholesterol.  However, patients taking Actos had more weight gain and leg swelling than those on placebo. 

It is not clear weather this medication will benefit patients in the long term or actually decrease complications from diabetes down the line. 

Copyright 2011 ABC News Radio

Wednesday
Mar022011

Study Finds Gene Mutation Associated with Type 2 Diabetes

Photo Courtesy - Getty Images(SAN FRANCISCO) -- Type 2 diabetes affects more than 200 million people worldwide. The disease involves an inability of bloodsugar to enter the cells to supply energy. A new study finds that about 10 percent of these patients in the United States and Europe have a gene mutation associated with the disease. 

Dr. Ira Goldfine from the University of California, San Francisco, the co-author of the study, analyzed DNA from patients with and without Type 2 diabetes over a period of several years. Researchers found the HMGA-1 mutation -- a gene that makes a protein and when present tells the cells to make insulin receptors -- in a group of Italian diabetics and then replicated that finding in U.S. and French patients. "About 10 percent of Type 2 diabetics in the United States and Europe have defects in this gene," Dr. Goldfine says. 

The study appears in this week's Journal of the American Medical Association and researchers say they identified four abnormalities in the gene sequence.  "There's a sort of scrambling of the sequence which shows that there is a defect at this point in the gene," according to Dr. Goldfine.

Researchers also took cells from these patients and in a test tube managed to correct the defect and normalize the cells. "We have a screening test now to identify these people and people who are related to them so we can start treatment and intervention early," says Goldfine. 

Researchers also say understanding the genetic component may help diabetic patients receive more targeted treatments.

Copyright 2011 ABC News Radio

Friday
Jan212011

Woman With Diabetes Gains Weight to be Eligible for Gastric Bypass

Photo Courtesy - Getty Images(LOS ANGELES) -- Rebecca Blair, a veterinarian from Rancho Cucamonga, Calif., got a dreaded diagnosis back in 2007: type 2 diabetes.

"I was on four different oral medications and injections, but my diabetes was very bad and nowhere near controlled," said Blair.

She ate healthy foods and did everything she could to lose weight, but wasn't successful at either dropping the pounds or bringing her blood sugar under control.

Blair said she watched a lot of health-related television programs and learned about overweight people who had a gastric bypass surgery that actually helped their diabetes in addition to helping them lose weight.

"That sparked my interest, and I did some more research," said Blair. After that, she was convinced she wanted to have a gastric bypass.

But the bariatric surgeon she saw, Dr. Theodore Khalili of Cedars-Sinai Medical Center in Los Angeles, dashed Blair's hopes.

"Her BMI [body mass index] was too low to do a gastric bypass, because we follow the guidelines set by the CDC [Centers for Disease Control and Prevention]," said Khalili. Those guidelines, he said, recommend against doing bariatric surgery on diabetics with a BMI less than 35. Blair's was only around 24.

Blair was undeterred.

"I did more research, then I tried to find a clinical trial, and then I decided to gain weight," she said.

Blair hoped to gain enough weight to qualify for a bypass -- and eventually she did. She gained about 85 pounds over a two-year period by eating a lot of fat.

"When she came back, she qualified for surgery," said Khalili, who by then had founded the Khalili Center for Bariatric Care in Beverly Hills. "She underwent the surgery, and is now down to one diabetes medication that she can probably discontinue soon."

But Khalili and other surgeons say that while gastric bypass seems to work wonders for diabetics by resolving their condition and helping them lose weight, they would never recommend that any patient deliberately gain weight in order to meet criteria for weight loss surgery.

Copyright 2011 ABC News Radio

Friday
Jan142011

Can Coffee Consumption Reduce Risk of Type 2 Diabetes?

Photo Courtesy - Getty Images(LOS ANGELES) -- A new study suggests there may be a link between coffee consumption and diabetes.  Researchers have found that coffee raises the amount of sex hormone-binding globulin (SHBG) in the blood, which leads to a lower risk of developing Type 2 diabetes. 

James D. Lane, an associate research professor at Duke University Medical Center who was not involved in the study, told MyHealthNewsDaily that these new findings are "impressive," but more research would be necessary to confirm the link. 

In the recent UCLA study, researchers observed the possibility that a molecular mechanism might be the reason for coffee's "protective effect," reports Medical News Today.  The UCLA trial found that women who drank four cups of caffeinated coffee each day showed higher levels of SHBG and were 56 percent less likely to develop Type 2.

According to The American Diabetes Association, Type 2 Diabetes is the most common form of the disease accounting for more than 90 percent of diabetes cases.

Copyright 2011 ABC News Radio







ABC News Radio