diabetes Tag
27 May Long Term Exposure to Air Pollutants Linked To Metabolic Alterations Especially in Diabetics
MedicalResearch.com Interview with: [caption id="attachment_24723" align="alignleft" width="150"]
Maayan Yitshak Sade[/caption]
Maayan Yitshak Sade MPH
Chief Scientific Officer
Clinical Research Center,
Soroka University Medical Center, Israel and
[caption id="attachment_24725" align="alignleft" width="125"]
Dr. Victor Novack[/caption]
Victor Novack, MD, PhD
Soroka University Medical Center and Ben-Gurion University in Beer Sheva, Israel
MedicalResearch.com: What is the background for this study?
Response: Numerous studies found association between exposure the air pollution and increased risk of cardiovascular and respiratory diseases. In recent years links were found between air pollution and diabetes as well. The scientific evidence supports a causal association between air pollution and oxidative stress, possibly involving impaired metabolism of glucose and lipids. In a recent study performed by our group, we observed a significantly increased risk for ischemic stroke among young adults, associated with air pollution exposure. Following these findings, and as a part of the possible theory linking the association air pollution exposure and cardiovascular diseases, we sought to investigate if this association might be mediated through the well-established cardiovascular risk factors such as abnormal lipid and glucose metabolism.
26 May Artificial Sugar Aspartamine Linked to Worse Glucose Metabolism
MedicalResearch.com Interview with: [caption id="attachment_24680" align="alignleft" width="150"]
Dr. Jennifer Kuk[/caption]
Jennifer L. Kuk, PhD
Associate Professor
York University
School of Kinesiology and Health Science
Toronto, Ontario
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Kuk: Artificial sweeteners are used to help individuals manage their weight, however, individuals who consume aspartame (a type of artificial sweeteners) have worse glucose metabolism than individuals with the same body weight but do not consume aspartame. This observation was only true for adults with obesity. Further, saccharin and natural sugars were not associated with differences in health after considering differences in obesity.
24 May Epigenetic Factors Linked to Glucose Tolerance and Fatty Liver Development
Posted at 21:42h
in Author Interviews, Diabetes, Genetic Research, Hepatitis - Liver Disease, Weight Research
MedicalResearch.com Interview with:
[caption id="attachment_24667" align="alignleft" width="131"]
Dr. Annette Schürmann[/caption]
Prof-Dr. Annette Schürmann
Department of Experimental Diabetology
German Institute of Human Nutrition Potsdam-Rehbruecke
Nuthetal, Germany
MedicalResearch.com: What is the background for this study?
Dr. Schürmann: The aim of our study was to clarify why genetically identical mice respond very different to a high fat diet. Some of the mice react with an elevated body weight, others not. We analyzed the expression pattern
of liver at two time points, at the age of 6 weeks, (the earliest time
point to distinguish between those that respond to the diet (responder
mice) and those that did not (non-responders)), and at the age of 20
weeks. One transcript that was significantly reduced in the liver of
responder mice at both time points was Igfbp2. The reason for the
reduced expression was an elevated DNA-methylation at a position that is
conserved in the mouse and human sequence. The elevated DNA-methylation
of this specific site in human was recently described to associate with
elevated fat storage (hepatosteatosis) and NASH. However, as 6 weeks old
mice did not show differences in liver fat content between responder and
non-responder mice we conclude that the alteration of Igfbp2 expression
and DNA methylation occurs before the development of fatty liver.
Our data furthermore showed that the epigenetic inhibition of Igfbp2
expression was associated with elevated blood glucose and insulin
resistance but not with fatty liver.
21 May Statin-Related Diabetes Has Same Impact as Non-Statin Diabetes on Heart Health in Women
Posted at 16:45h
in Author Interviews
MedicalResearch.com Interview with:
Yunsheng Ma, MD, PhD MPH
University of Massachusetts Medical School
Worcester
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Ma: The cardiovascular benefit of lowering LDL cholesterol with statins exceeds all known risk, even in individuals with < 5% risk of CVD over 5 year. Nevertheless, statins are associated with increased incidence of new-onset diabetes, women were disproportionately at higher risk for diabetes while on statins. However, there are no studies comparing CVD and CVD mortality outcomes for women who develop diabetes while not taking statins, to compare their CVD and CVD mortality outcomes against those who develop diabetes while taking statins.
We hypothesized that new clinical diabetes related to statin use may be milder on CVD. However, our findings did not support this hypothesis, as we discovered that statin-related diabetes is no different from diabetes developed outside statin use in its significant impact on CVD and CVD mortality.
19 May Bright Light at Night Linked To Higher Blood Sugar Levels
MedicalResearch.com Interview with: [caption id="attachment_24501" align="alignleft" width="128"]
Dr. Kathryn Reid[/caption]
Kathryn Reid PhD
Research associate
Professor of Neurology
Northwestern University Feinberg School of Medicine.
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Reid: There is increasing evidence that light and dark exposure patterns over time impact health outcomes such as body weight and food intake.
This study found that bright light exposure increased insulin resistance compared to dim light exposure in both the morning and the evening.
In the evening, bright light also caused higher peak glucose (blood sugar) levels.
08 May Better Treatment Means More Patients With Type 1 Diabetes Pass on Disease Genes
MedicalResearch.com Interview with: [caption id="attachment_24154" align="alignleft" width="150"]
Wenpeng You[/caption]
Wenpeng You, PhD student
Biological Anthropology and Comparative Anatomy Research Unit
University of Adelaide | School of Medicine
Adelaide, Australia
[caption id="attachment_24262" align="alignleft" width="180"]
Dr. Maciej Henneberg[/caption]
Maciej Henneberg, PhD, DSc, FAIBiol
Wood Jones Professor of Anthropological and Comparative Anatomy
University of Adelaide School of Medicine;
Institute for Evolutionary Medicine, University of Zurich
Editor in Chief, Journal of Comparative Human Biology HOMO
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Type 1 diabetes disease has very strong genetic background. Prevalence of type 1 diabetes has been increasing globally. Previous studies focusing on regional genetics and environmental factors cannot fully explain this phenomenon. Due to insufficient medical knowledge up until early 20th century, people with type 1 diabetes disease would most commonly die during their teens or early 20s. Therefore, they did not have the opportunity to pass on their genes providing background for the development of type 1 diabetes to their next generations. Since discovery and introduction of insulin to modern medicine in early 1920s, more and more type 1 diabetes patients have been able to survive their reproduction cycle (up until and past 50 years of age). This has made more and more genes related to type 1 diabetes to accumulate in human populations.
We applied the Biological State Index which measures a probability to pass genes on to the next generation at population level. We found that the rapid increase in type 1 diabetes over the last few decades was correlated with increases of the Biological State Index and its proxy, human life expectancy, especially in more developed world in which natural selection has been relaxed most. This correlation was found after statistically excluding differences in countries income, levels of urbanization, sugar consumption and obesity prevalence.
21 Apr Glucagon-Blocking Drugs May Prevent or Reverse Diabetes If Some Beta Cells Remain
MedicalResearch.com Interview with: [caption id="attachment_23655" align="alignleft" width="148"]
Dr. Pedro Herrera[/caption]
Pedro L. Herrera, PhD
Professor
Dept. Genetic Medicine & Development, room #F09.2770
Faculty of Medicine, University of Geneva
Geneva, Switzerland
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Herrera: After meals, the digestion of food leads to an accumulation of sugar (glucose) in the blood (hyperglycemia). This triggers the release of the hormone insulin from the pancreas (beta-cells), which allows the tissues (liver, muscle and fat) to use and store it.
Another pancreatic hormone, glucagon, is released by alpha-cells during fasting or exercising, and opposes the action of insulin: it tells the liver to release glucose, which increases blood sugar levels. The balance between insulin and glucagon keeps blood sugar levels steady. Persistent hyperglycemia due to insulin deficiency is diabetes.
Glucagon production is exacerbated in diabetes, which aggravates hyperglycemia.
20 Apr DiaRem Score Predicts Long-Term Diabetes Remission After Bariatric Surgery
MedicalResearch.com Interview with: [caption id="attachment_23623" align="alignleft" width="133"]
Dr. Annemarie Hirsch[/caption]
Annemarie G. Hirsch, PhD, MPH
Center for Health Research
Geisinger Health System
Danville, Pennsylvania
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Bariatric surgery is currently the most effective treatment in reversing insulin resistance in patients with type 2 diabetes. However, the likelihood of remission or cure after surgery varies tremendously based on certain patient characteristics. The DiaRem score provides patients with a personalized prediction of whether or not they can expect long-term remission of their disease if they choose to have surgery.
20 Apr Healthy Diet After Gestational Diabetes Lowers Long-Term Hypertension Risk
Posted at 12:10h
in AHA Journals, Author Interviews, Blood Pressure - Hypertension, Diabetes, NIH, Nutrition, OBGYNE
MedicalResearch.com Interview with:
[caption id="attachment_23530" align="alignleft" width="158"]
Dr. Cuilin Zhang[/caption]
Cuilin Zhang MD, PhD
Senior Investigator, Epidemiology Branch
Division of Intramural Population Health Research
NICHD/National Institutes of Health
Rockville, MD 20852
MedicalResearch.com: What is the background for this study?
Dr. Zhang: Hypertension is one of the most prevalent and preventable risk factors for cardiovascular and kidney diseases, and is one of the leading causes of death in the United States.
We have previously reported that the cumulative incidence of hypertension for women with a history of gestational diabetes mellitus (GDM) was 26% higher than those who did not have GDM even 16 years after the index pregnancy. Thus, women with a history of GDM represent a high-risk population for hypertension that could benefit from early prevention. While there is extensive literature on how lifestyle factors may influence blood pressure in the general population, no information is currently available on the role of diet and lifestyle in the development of hypertension specifically in this susceptible population. To address these gaps, we prospectively examined the associations between long-term adherence to three healthy diets with subsequent risk of hypertension among women with a history of gestational diabetes mellitus, specifically the DASH diet, the alternative Mediterranean diet (aMED), and the Alternative Healthy Eating Index (AHEI).
17 Apr Biomarker Endostatin Linked To Kidney Function Decline in Diabetes
MedicalResearch.com Interview with: Axel C. Carlsson, PhD Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University Uppsala Sweden MedicalResearch.com: What is the background for this study? Dr. Carlsson: Circulating endostatin levels has been shown to be associated with duration of hypertension and cardiovascular events. Moreover, endostatin levels were recently shown to parallel kidney function decline, and has been associated with increased mortality risk in different settings. However, less is known of circulating endostatin in patients with type 2 diabetes.12 Apr More Muscle in Lean Women Linked To Lower Diabetes Risk
MedicalResearch.com Interview with: [caption id="attachment_23387" align="alignleft" width="180"]
Dr. Britta Larsen[/caption]
Britta Larsen, Ph.D.
Assistant Professor
Family Medicine & Public Health
University of California, San Diego
Medical Teaching Facility
La Jolla, CA 92093-0628
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Larsen: We know that muscle is important for metabolic processes, but there has been very little research on the role muscle may play in the development of metabolic diseases like type 2 diabetes. While excess fat can increase the risk of metabolic disease, there are people who are normal weight who still develop diabetes, and it’s possible that this could be due to low muscle mass. Our main findings were that, in normal weight women, women with more abdominal, thigh, and overall muscle were less likely to develop diabetes over a 13-year period.
12 Apr Novel, Once Weekly GLP-RA For Diabetes Reduced HbA1c and Weight in 30 Week Trial
MedicalResearch.com Interview with: [caption id="attachment_23375" align="alignleft" width="117"]
Dr. Christopher Sorli[/caption]
Christopher Sorli, MD
SUSTAIN 1 investigator and
Chair of the Department of Diabetes, Endocrinology and Metabolism
Billings Clinic, Billings, Montana
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Sorli: GLP-1 receptor agonists (GLP-1 RAs) have been found to be useful in the treatment of Type 2 diabetes with potent effects on blood glucose lowering while minimizing the risk of hypoglycemia and weight gain often seen with other classes of hypoglycemic agents.
Semaglutide is a novel GLP-1RA that is currently in clinical development. The molecule shares 94% amino acid homology with native GLP-1 and has a half-life of approximately one week allowing for once weekly dosing.
SUSTAIN 1 was designed to demonstrate superiority of semaglutide 0.5 mg and 1.0 mg once weekly over placebo in lowering HbA1c after 30 weeks of treatment. Additional secondary endpoints included weight loss versus placebo, percent of patients achieving HbA1c goals, percent of patients achieving 5% and 10% weight loss, and safety and tolerability.
06 Apr Life Expectancy Still Shortened For Patients With Type 1 Diabetes
MedicalResearch.com Interview with: [caption id="attachment_23245" align="alignleft" width="183"]
Dr. Dennis Petrie[/caption]
Dr. Dennis James Petrie
Melbourne School of Population and Global Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Petrie: Life expectancy estimates for those with type 1 diabetes allow gaps with the general population to be identified and improvements to be quantified. This research examined mortality for those with type 1 diabetes in Sweden from 2002 till 2011. The aim was to explore whether life expectancy of those with type 1 diabetes has improved in Sweden over the last decade and how any improvement compared with improvements seen in the general population. It found that for men with type 1 diabetes, the remaining life expectancy at age 20 increased significantly by about 2 years (from 47.7 in 2002–06 to 49.7 years in 2007–11) but for women with type 1 diabetes there was no significant change, with a life expectancy at age 20 of 51.7 years in 2002–06 and 51.9 years in 2007–11. There have been recent gains for both men and women from reductions in cardiovascular mortality however these gains were also seen in the general population which meant that the life expectancy gaps have stayed at about 11 years for men and 12 years for women over the last decade in Sweden.
06 Apr Switching from Sitagliptin to Liraglutide Can Control Hyperglyciemia in Some With Type 2 Diabetes
MedicalResearch.com Interview with: [caption id="attachment_23161" align="alignleft" width="125"] Dr. Maximo Maislos[/caption] Dr. Maximo Maislos MD Head of the Atherosclerosis and Metabolism Unit Department of Medicine of the Soroka University Medical Center Israel MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Maislos: When diet and exercise are insufficient, Type 2 Diabetes Mellitus patients...
04 Apr Type 1 Diabetes Still Associated With At Least A Decade of Reduced Life Expectancy
MedicalResearch.com Interview with: [caption id="attachment_23116" align="alignleft" width="133"]
Dr. Dianna Magliano[/caption]
Associate Professor Dianna Magliano BAppSci(Hon) MPH PhD
Head, Diabetes and Population Health
Baker IDI Heart and Diabetes Institute
Melbourne. VIC
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Magliano: This work shows that Australians with type 1 diabetes had an estimated life loss of 11.6 years for men and 12.5 years for women compared with the general population. We saw no evidence of improvement in this over recent years. For those who are older with type 1, cardiovascular disease contributed substantially to the years of life lost in type 1 diabetes. Death before 60 years and mortality from endocrine and metabolic disease were also important contributors to the years of life lost in type 1 diabetes.
04 Apr Sleeve-IT Surgery Achieves Glycemic Control in Mildly Obese Diabetic Patients
MedicalResearch.com Interview with: Ana Priscila Soggia Sirio Libanes Hospital, São Paulo, Brazil MedicalResearch.com: What is the background for this study? What are the main findings? Response: For many years, bariatric surgery is performed to treat class II and III obesity with diabetes remission in 80-90% of cases, related to weight loss and change in the secretion of intestinal factors that control blood glucose, like GLP-1 and GIP. In 2010, the International Diabetes Federation (IDF), proposed that diabetic patients with BMI between 30-35kg/m2 could be eligible, for bariatric surgery, in the case of no glycemic control with drug treatment. In this context, once glycemic control after bariatric surgery, was not related only to weight loss and also due to intestinal factors with physiological actions, the protocol was proposed. The objectives were to compare the clinical and surgical treatment in diabetics patients with class I obesity; and to compare the efficacy and security between two different surgical techniques. This study was developed and conducted by a research team from Sirio-Libanês Hospital in partnership with Ministry of Health through its philanthropic program PROADI. It is a clinical trial, with 42 class I obese diabetic type 2 patients with inadequate glycemic control that were randomized to tree arms: clinical treatment, gastric bypass surgery or sleeve with ileal transposition (sleeve-IT) surgery. The results showed that the sleeve-IT procedure is more effective for the treatment of diabetes in these patients compared with treatment with medication and with bypass surgery, currently considered the first choice of treatment. Among patients who underwent sleeve-IT, 100% achieved glycemic control after 1 year (HbA1c<6,5%) compared to 46% for bypass and 8% in the case of medication therapy. In addition, diabetes remission, that was defined as adequate glycemic control without any anti-diabetic medication, occured in 75% of sleeve-IT patients had versus 30% in bypass group.03 Apr Moderate Alcohol Consumption Reduces Risk of Diabetes by 28%
MedicalResearch.com Interview with: [caption id="attachment_23098" align="alignleft" width="200"]
Dr. Ken C. Chiu[/caption]
Ken C. Chiu, MD, FACE, FACP
Professor
Endocrinology Fellowship Training Program
Department of Clinical Diabetes, Endocrinology, and Metabolism
Diabetes and Metabolism Research Institute
City of Hope National Medical Center
Duarte, CA 91010-3000
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Chiu: The benefit of moderate alcohol consumption is well established in cardiovascular disease. However, the role of alcohol consumption in type 2 diabetes is less clear. We examined the role of alcohol consumption in type 2 diabetes using the data from the National Health and Nutrition Examination Survey 2005-1012, which is a representative US population. In the rare alcohol consumption group (< 12 drinks per year), 24.04% were diabetic while only 14.67% were diabetic in the moderate alcohol consumption (1-4 drinks per day) group (P><0.000001). In contrast, 21.05% were diabetic in the heavy alcohol consumption (≥ 5 drinks/day) group (P=0.003) when compared to the rare alcohol consumption group. Thus, in compared to the rare alcohol consumption, moderate alcohol consumption was associated with a lower risk of diabetes (OR: 0.72; 95%CI: 0.65-0.79) after adjustment for co-variates, while there was no benefit from heavy alcohol consumption (OR: 0.97; 95%CI: 0.90-1.05). Our study demonstrates that moderate alcohol consumption reduces the risk of diabetes by 28%.
28 Mar Study Finds No Increased Risk of Heart Failure From Incretin-Based Diabetes Drugs
MedicalResearch.com Interview with: [caption id="attachment_22924" align="alignleft" width="133"] Dr. Kristian Filion[/caption] Kristian B. Filion, Ph.D., FAHA Assistant Professor of Medicine, Division of Clinical Epidemiology, McGill University Principal Investigator, Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital Associate Member, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University MedicalResearch.com: What is the background for this study? What...
18 Mar Maternal Weight, Blood Glucose and Blood Pressure Affect Baby’s Birth Weight
Posted at 00:47h
in Author Interviews, Blood Pressure - Hypertension, Diabetes, JAMA, Weight Research
MedicalResearch.com Interview with:
Debbie Lawlor PhD
School of Social and Community Medicine
University of Bristol, Oakfield House, Oakfield Grove
Medical Research Council Integrative Epidemiology Unit
University of Bristol, UK and
Rachel Freathy PhD,
University of Exeter, Institute of Biomedical and Clinical Science,
Royal Devon and Exeter Hospital, Exeter UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A healthy birth weight is important for babies’ health and wellbeing in the first year of their life. It reflects how well the baby has grown and developed in the womb. The experience of fetuses in the womb and how well they grow and develop might also determine their future health, even into adulthood. Both being too light or too heavy at birth is not good for the baby. Lots of studies have shown that mothers who are fatter at the start of their pregnancy have babies who are more likely to be heavier. But is it not clear whether the mother being fatter causes their baby to be bigger at birth. If mothers’ fatness does cause their baby to be heavier at birth, why this happens is not clear.
We used genes to find out whether being fatter in pregnancy causes babies to be born heavier. We also tested whether risk factors in the mother that are affected by her fatness, such as her blood pressure, and the level of glucose (sugar) and lipids (fats) in her blood stream affect how heavy her baby is.
Our results showed that being fatter during pregnancy did cause a mothers’ baby to be born heavier. We also showed that having higher blood levels of glucose in pregnancy also caused a mothers’ baby to be heavier. But we did not find any effect of mothers’ blood levels of lipids in pregnancy on their baby’s weight. Whilst mothers who are heavier in pregnancy will tend to have higher blood pressure in pregnancy we found that higher blood pressure caused the women’s babies to be lighter.
15 Mar CPAP Benefits Sleep and Blood Pressure in Diabetics, But Not Glucose Control
MedicalResearch.com Interview with: [caption id="attachment_22702" align="alignleft" width="142"]
Dr. Jonathan Shaw[/caption]
Jonathan Shaw MD, FRACP, FRCP (UK), FAAHMS
Associate Professor
Domain Head, Population Health Research
Baker IDI Heart and Diabetes Institute
Melbourne VIC 3004
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Shaw: Over the last decade or so, there has been a lot of research connecting obstructive sleep apnoea with type 2 diabetes. They co-exist very frequently in the same individual, they are both much more common in overweight and obese people than in people of healthy weights, both improve with weight loss, and both are associated with other conditions such as hypertension and heart disease. In addition, there has been evidence that some of the key abnormalities occurring in sleep apnoea (in particular, fragmented sleep and intermittent low oxygen levels) may have a direct effect on glucose metabolism, and increase blood sugar levels. This led many people to suspect that untreated sleep apnoea might be one reason that type 2 diabetes is hard to control, and that treating sleep apnoea in people with type 2 diabetes would improve their blood sugar control.
We, therefore, undertook a large trial among people with type 2 diabetes, and previously unrecognised sleep apnoea, in which participants were randomised to either a group receiving specific treatment for sleep apnoea (continuous positive airways pressure, or CPAP, therapy at night) or to a control group.
Over the six months of the trial, we saw no benefit of CPAP therapy in regard to blood sugar control (as measured by HbA1c). Even when we looked at sub-groups with worse blood sugar control at the start or worse sleep apnoea or who did the best in terms of using CPAP every night, there was still no sign of benefit on blood sugar control. We did, however, see some other benefits of CPAP therapy, with less daytime sleepiness, improvements in quality of life and lower diastolic blood pressure.
10 Mar Critical To Treat Comorbidities That Worsen Course of Multiple Sclerosis
MedicalResearch.com Interview with: Jorge Correale MD Department of Neurology, Institute for Neurological Research Dr Raúl Carrea Buenos Aires, Argentina MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Correale: First it is now well known that in parallel to the specific treatment of Multiple Sclerosis, those comorbidities that worsen the course of the disease should be treated. For example, cardiovascular diseases. Moreover there are in vitro and in animal models evidence of an anti-inflammatory role of compounds investigated in this publication evidence.09 Mar Treating Diabetes Can Reduce Breast Density on Mammograms
MedicalResearch.com Interview with: Dr. Zorana Andersen Department of Public Health Center for Epidemiology and Screening University of Copenhagen MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Andersen: Diabetes is associated with increased risk of breast cancer, but exact mechanisms are unknown. The role of insulin has been debated. High mammographic density (MD) is one of the strongest predictors and a biomarker of breast cancer risk. Few studies have linked diabetes to mammographic density, finding none or weak inverse associations, but none had data on diabetes treatment. We examined whether diabetes and diabetes treatment are associated with mammographic density in a prospective cohort study of Danish women above age of 50 years. MedicalResearch.com: What should clinicians and patients take away from your report? Dr. Andersen: Women with diabetes, as well as clinicians working with diabetes and breast cancer and breast cancer screening, would have interest to know how different diabetes treatment can affect breast density, and hereby possibly breast cancer risk. For example, diabetic women taking insulin may possibly benefit from informing radiologists at breast cancer screening about their insulin use, due to increased breast density and increased risk of masking bias.01 Mar Combination Degludec/Liraglutide Reduced HgA1C and Insulin Side Effects in Type 2 Diabetes
MedicalResearch.com Interview with: [caption id="attachment_22181" align="alignleft" width="200"]
Dr. John Buse[/caption]
Dr. John Buse MD Ph.D
Professor, Medicine
Director, Diabetes Care Center
Chief, Division of Endocrinology
Executive Associate Dean, Clinical Research
University of North Carolina School of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Buse: Degludec is an longer acting basal insulin analog recently approved in the US. Liraglutide is a once-daily GLP-1 receptor agonist. Both are among the most powerful glucose lowering drugs available in the setting of type 2 diabetes. They have very different properties. Degludec is best at lowering fasting glucose. Liraglutide has effects on postprandial glucose as well. The major side effects of degludec are hypoglycemia and weight gain. Liraglutide on the other hand has not an inherent effect to cause hypoglycemia and does promote weight loss. Liraglutide does cause nausea and in fewer patients vomiting in a dose dependent manner. In developing the fixed dose combination the idea was to amplify glucose lowering efficacy and minimize the adverse effects of both components. Prior studies have basically shown that this has been accomplished. In this study we looked at the very common clinical scenario of the patient with type 2 diabetes inadequately controlled on basal insulin glargine and asked the question of whether switching from glargine to IDegLira (the combination product) would do better than continued titration of glargine.
01 Mar Women with Type 1 Diabetes Have Elevated Risk of Some Cancers
MedicalResearch.com Interview with: [caption id="attachment_22195" align="alignleft" width="160"]
Bendix Carstensen[/caption]
Bendix Carstensen
Department of Clinical Epidemiology Steno Diabetes Center
Gentofte
Medical Research: What is the background for this study? What are the main findings?
Response: It has long been known that all diabetes patients have elevated risk of cancer (10-15%). Patients on insulin slightly more (20-25%). Type 1 patients is only a small fraction (10%) of all diabetes patients, but they ALL take insulin. If insulin has a role in cancer occurrence it would be expected to be particularly pronounced in type 1 patients, and increasing by duration.
But it is not, the risk of cancer is 15% elevated (if we disregard prostate, breast and other cancers only occurring in one of the sexes), and there is no increase in the excess risk by duration of insulin use. Breast cancer risk is 10% lower and prostate cancer risk some 40% lower. Overall there is very little increased cancer risk - 1% for men 7% for women.
26 Feb Diabetics Need To Find ‘Sweet Spot’ For Blood Pressure Control
MedicalResearch.com Interview with: [caption id="attachment_22121" align="alignleft" width="200"]
Dr-Mattias-Brunström[/caption]
Mattias Brunström, MD PhD student
Department of Public Health and Clinical Medicine
Umeå University Hospital
Umeå, SE Sweden
Medical Research: What is the background for this study? What are the main findings?
Dr. Brunström: Current guidelines differ in their recommendations on blood pressure treatment targets for people with diabetes. We did a systematic review and meta-analysis of 49 studies, including almost 74 000 patients, to investigate the effect of treatment at different blood pressure levels. We found that treatment reduced the risk of death, stroke, myocardial infarction and heart failure if systolic blood pressure before treatment was above 140 mm Hg. However, if systolic blood pressure was below 140 mm Hg, treatment increased the risk of cardiovascular death.
22 Feb Gestational Diabetes Raises Risk of Low Milk Supply in Breastfeeding Moms
MedicalResearch.com Interview with: [caption id="attachment_21895" align="alignleft" width="200"]
Dr. Laurie Nommsen-Rivers[/caption]
Laurie A. Nommsen-Rivers, PhD, RD, IBCLC
Assistant Professor, UC Department of Pediatrics
Cincinnati Children's Hospital Medical Center
Medical Research: What is the background for this study?
Dr. Nommsen-Rivers: Breastfeeding provides important benefits for mother and infant. Exclusive breastfeeding—that is, without any other food or fluids provided to the infant—is recommended for the first six months of life by multiple public health organizations. Some mothers, despite their best efforts, have difficulty establishing and sustaining sufficient milk production to support exclusive breastfeeding. Our previous research suggested that mothers with less optimal glucose tolerance are at risk for prolonged delays in time between birth and the establishment of copious milk production. We wanted to extend this finding by probing if mothers who had diabetes in pregnancy, as a sign of less optimal glucose tolerance, are at greater risk of sustained low milk production. “Glucose tolerance” refers to the body’s ability to metabolize glucose and maintain a healthy blood sugar level, which is orchestrated by the hormone insulin. For a long time, we did not consider insulin to play a role in milk production, but we are now learning that insulin plays an essential role in milk production.
16 Feb Maternal Obesity and Gestational Diabetes May Raise Risk of Autism
MedicalResearch.com Interview with: [caption id="attachment_21640" align="alignleft" width="200"]
Dr. Katherine Bowers[/caption]
Katherine Bowers, PhD, MPH
Division of Biostatistics and Epidemiology
Cincinnati Children's Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Bowers: Autism spectrum disorder (ASD) affects approximately 1 in 68 children and the prevalence continues to rise. Past studies have suggested that conditions experienced by women during pregnancy (for example, obesity and gestational diabetes mellitus (GDM)) may be associated with having a child with ASD. We collected medical record data from patients who resided in the Cincinnati Children’s Hospital Medical Center’s primary catchment area and linked those data to data from birth certificates to identify metabolic risk factors. Two comparison groups were analyzed; one with developmental disabilities; and the other, controls without a reported ASD or other developmental disability. Descriptive statistics and regression analyses evaluated differences.
We found that maternal obesity and gestational diabetes mellitus were associated with an increased risk of Autism spectrum disorder in the offspring; however, no difference in risk of Autism spectrum disorder according to BMI and GDM was seen when comparing to the group with other developmental disabilities. The strongest observed association was the joint effect of obesity and GDM (compared to neither obesity nor GDM) :OR=2.53 (95% CI: 1.72, 3.73).
08 Feb Too Much Screen time Raises Risk of Pre-Diabetes in Children
Posted at 20:59h
in Author Interviews, Diabetes, Exercise - Fitness, JAMA, Lifestyle & Health, Pediatrics
MedicalResearch.com Interview with:
[caption id="attachment_21397" align="alignleft" width="160"]
Mélanie Henderson[/caption]
Mélanie Henderson, MD, FRCPC, PhD
Pediatric Endocrinologist and Assistant Clinical Professor
Division of Endocrinology and Diabetes
University of Montreal/Centre Hospitalier Universitaire Ste-Justine
Montréal, Québec
Medical Research: What is the background for this study? What are the main findings?
Dr. Henderson: Dysregulation in insulin sensitivity and insulin secretion are the basic elements in the pathophysiology of type 2 diabetes. There is extensive data suggesting that better lifestyle habits are associated with the prevention or the delay in onset of type 2 diabetes in adults, with improved lifestyle habits having been more effective than pharmacologic agents at diabetes prevention in one study. Little work however has been done to determine whether this holds true in children. Cross-sectional studies in youth have found conflicting results and no study has considered the combined effect of physical activity, fitness and sedentary behavior on insulin dynamics in children.
Understanding the impact of lifestyle habits on insulin dynamics in childhood has become paramount, given that less than 7% of Canadian children are currently meeting physical activity guidelines and that 1/3 of school-aged Canadian children and 2/3 of Canadian teenagers are exceeding the current guidelines in terms of screen time, which advocate for a maximum of 2 hours daily.
Our study shows that adiposity is the central predictor of insulin dynamics in children, and that physical activity and screen time play an important role, in part through their effect on adiposity. Thus, establishing and maintaining a highly physically active lifestyle early on in life, while minimizing sedentary behaviour (specifically screen time) appear to be important strategies to consider to prevent type 2 diabetes in youth.