TUESDAY, Oct. 14, 2014 (HealthDay News) -- In the future, could people with type 2 diabetes manage their medications with a pulse of light? A preliminary new study suggests it may be possible.
In the study, scientists showed that the prototype drug -- for now just called JB253 -- stimulated insulin release from pancreatic cells in the lab when they were exposed to blue light.
"In principle, this type of
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(HealthDay News) -- Diabetic moms, after talking with their doctors, should still try to breast-feed their babies, some experts say.
The Eunice Kennedy Shriver National Institute of Child Health and Human Development says potential benefits of breast-feeding, despite maternal diabetes, may include:
For baby, improved defense against illness and infection.For baby, the right balance of nutrients.For mom, burning extra calories and losing some extra pounds acquired during pregnancy.For many moms who developed gestational diabetes (diabetes that emerged during pregnancy), better fasting blood glucose, and lower blood sugar levels overall.-- Diana Kohnle
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THURSDAY, Oct. 23, 2014 (HealthDay News) -- Daughters of women who developed gestational diabetes while pregnant may be at increased risk for being obese later in childhood, a new study suggests.
The research included more than 400 girls in California who were followed from 2005 to 2011, with annual visits to check their height, weight, body fat and abdominal obesity. The girls were between 6 and 8 years old at the start of the study. The researchers also examined the medical records of the girls' mothers.
Twenty-seven mothers developed gestational diabetes, according to the researchers. Girls whose mothers had gestational diabetes were 3.5 times more likely to be overweight later in childhood than those whose mothers did not have gestational diabetes, according to the study.
Daughters were 5.5 times more likely to become overweight if their moms had gestational diabetes and were overweight before pregnancy, the study found. The daughters were also more likely to have higher amounts of body fat as well as abdominal obesity, according to the researchers. These associations were independent of other factors known to influence overweight/obesity in girls, including race/ethnicity, having an obese mother, and stage of puberty, the study noted.
"Glucose
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TUESDAY, Oct. 28, 2014 (HealthDay News) -- People newly diagnosed with type 2 diabetes who are initially given the drug metformin are less likely to eventually need other drugs to control their blood sugar, a new study suggests.
The study found that, of those started on metformin, only about one-quarter needed another drug to control their blood sugar. However, people who were started on type 2 diabetes drugs other than metformin often needed a second drug or insulin to control their blood sugar levels, the researchers said.
"This study supports the predominant practice, which is that most people are started on metformin," said lead researcher Dr. Niteesh Choudhry, an associate professor of medicine at Harvard Medical School in Boston. "Metformin might be more effective than others in controlling blood sugar," he noted.
"Metformin, which is one of the oldest drugs we have and which the guidelines recommend as being the first drug to use, is associated with a lower risk of needing to add a second drug or insulin compared to any of three other commonly used classes of drugs," Choudhry said.
The report was published in the Oct. 27 online edition of JAMA Internal Medicine.
A hallmark of type 2 diabetes is insulin resistance, according to the American Diabetes Association (ADA). That means the body doesn't effectively use the hormone insulin. Insulin is produced by the pancreas and helps usher sugar from foods into the body's cells to be used as energy. When people have insulin resistance, too much sugar is left in the blood instead of being used. Over the long-term, high blood sugar levels can lead to serious complications, such as heart and kidney disease, according to the ADA.
There are eight classes of oral type 2 diabetes medications, according to the ADA. Each class works a bit differently. For example, metformin makes the body's cells more sensitive to insulin. It also decreases the amount of sugar naturally produced in the liver, the ADA reports. Sulfonylureas, on the other hand, encourage the pancreas to produce more insulin, according the ADA.
For the current study, Choudhry's team collected data on more than 15,000 people starting treatment for type 2 diabetes from July 2009 through June 2013. The average follow-up time was slightly longer than one year.
Of those patients, almost 60 percent were initially treated with metformin, and about one-quarter began treatment with a sulfonylurea, such as Glucotrol, according to the study. Just 6 percent were started with a thiazolidinedione, such as Actos, and 13 percent with a DPP-4 inhibitor, such as Januvia, the report indicated.
The researchers found that around 40 percent of people taking a sulfonylurea, a thiazolidinedione, or a dipeptidyl peptidase 4 inhibitor (DPP-4 inhibitor) added a second drug to their diabetes treatment regimen during the study. Just 25 percent of those on metformin added an additional oral drug during the study period.
In addition, 5 percent of those started on metformin later added insulin to their treatment, according to the study. About 9 percent of those who started on a sulfonylurea, 6 percent started on a DPP-4 inhibitor and 6 percent started on thiazolidinediones, also took insulin, the investigators found.
Choudhry said that many patients are being started on other drugs, but this study indicates that treatment should start with metformin.
"These findings emphasize the use of metformin as the first-line drug for type 2 diabetes," he said.
Dr. Jodi Segal, co-director of the Center for Drug Safety and Effectiveness at Johns Hopkins Bloomberg School of Public Health and co-author of an accompanying journal editorial, said, "It is already well established that metformin is the preferred first-line option for patients who can tolerate it."
But, she added that doctors should pay more attention to their patients' worries about needing to intensify therapy when choosing medications.
"Doctors might want to help their patients understand that intensifying therapy does not mean that the patient has failed," Segal said.
Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, doesn't think that metformin alone is sufficient to treat type 2 diabetes. He believes that treatment needs to aggressively lower blood sugar.
"We don't start treatment with a single drug," Zonszein said. "We use a combination from the get-go."
Zonszein said even this study shows that treatment with a single drug doesn't work. "So why do we wait to intensify treatment rather than treating more aggressively?"
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MONDAY, Oct. 27, 2014 (HealthDay News) -- The rate of type 1 diabetes has increased substantially among elementary school-age white children in the United States, a new study shows.
The study of young white people found nearly 6,000 new cases diagnosed in teens and kids ages 19 and younger between 2002 and 2009. Youngsters between 5 and 9 years old accounted for most new cases, while no increase was seen among kids younger than 4, the authors said. Boys were slightly more affected than girls.
Type 1 diabetes -- previously called juvenile diabetes -- is the predominant form of diabetes diagnosed in childhood. People with the disease lose their ability to produce insulin, a hormone needed to convert food into energy for daily life.
"The incidence has been rising in many other countries, particularly in Europe, but data from large populations in the U.S. were limited," said the study's lead author, Jean Lawrence, of the Kaiser Permanente Southern California department of research and evaluation.
More research is needed to better understand why the prevalence of type 1 diabetes among American children is on the rise, and what racial and ethnic differences exist, the researchers said.
The findings were culled from one of the largest U.S. studies of diabetes in children -- the SEARCH for Diabetes in Youth registry -- involving data on more than 2 million children and teens living in diverse parts of the United States.
From 2002 to 2009, the rate of type 1 diabetes jumped from 24.4 per 100,000 children to 27.4 per 100,000 youths, according to the study published Oct. 23 in Diabetes.
Although children between 5 and 9 years old accounted for most new cases of type 1 diabetes, smaller increases were also found among children and teens between 10 and 19 years old.
"This project provides a much larger and more geographically diverse sample than previous studies in the U.S.," said Lawrence in a Kaiser Permanente news release. It involved centers in California, Colorado, Ohio, South Carolina and Washington.
Only about 5 percent of all people with diabetes have type 1, according to the American Diabetes Association. Young people diagnosed with the disease will require ongoing specialized medical care.
This includes insulin injections and other treatments to manage their condition and delay or prevent diabetes-related complications that often affect the eyes, nerves and kidneys, according to background information from the release.
-- Mary Elizabeth Dallas
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SUNDAY, Nov. 2, 2014 (HealthDay News) -- Weight-loss surgery significantly lowers an obese person's risk of developing type 2 diabetes, researchers report.
This reduced risk was independent of other factors such as smoking, high blood pressure and high cholesterol, according to the study in the Nov. 3 issue of The Lancet Diabetes & Endocrinology.
"Our results suggest that bariatric surgery may be a highly effective method of preventing the onset of new diabetes in men and women with severe obesity," study author Martin Gulliford, a professor of public health at King's College London, said in a journal news release.
"We need to understand how weight-loss surgery can be used, together with interventions to increase physical activity and promote healthy eating, as part of an overall diabetes prevention strategy," he added.
Being overweight or obese is a major risk factor for diabetes, and up to 3 percent of severely obese people develop diabetes each year, the study authors noted in the news release.
This study included more than 2,100 obese adults without diabetes who underwent weight-loss surgery -- such as gastric bypass or gastric banding -- and the same number of obese adults who did not have weight-loss surgery or other obesity treatments.
The participants were followed for up to seven years (median 2.8 years). The investigators found that those who had weight-loss surgery -- also called "bariatric" surgery -- were 80 percent less likely to develop diabetes than those who did not have the surgery.
In an accompanying commentary, Dr. Jacques Himpens of Saint Pierre University Hospital in Brussels, Belgium, pointed out that while the findings "bring us a step closer to confirming the effect of bariatric surgery on the incidence of
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Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
View Full Profile Medical Editor: William C. Shiel Jr., MD, FACP, FACRRobert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.
View Full Profile Medical Editor: William C. Shiel Jr., MD, FACP, FACRDRUG CLASS AND MECHANISM: Glucose also known as dextrose is a simple sugar (monosaccharide) that is used to increase the level of blood sugar (glucose) when the level falls too low (hypoglycemia). Glucose in this form increases the level of the blood sugar, so it is a glucose-elevating agent. Other glucose-elevating agents are diazoxide (Proglycem) and glucagon.
Glucose is the primary fuel used by most cells in the body to generate the energy that is needed to carry out cellular functions. When glucose levels fall to hypoglycemic levels, cells cannot function normally, and symptoms develop such as nervousness, cool skin, headache, confusion, convulsions, or coma. Ingested glucose is absorbed directly into the blood from the intestine and results in a rapid increase in the blood glucose level.
GENERIC: yes
PRESCRIPTION: no
PREPARATIONS:
Chewable Tablet: 1 gm, 4 gm, 5 gm; Tablet: 4 gm,; Oral Gel/Jelly: 15 gm; Intravenous solution/Injection: 2.5 %, 5 %, 10 %, 20 %, 25 %, 30 %, 40 %, 50 %, 70 %STORAGE: Glucose should be stored at room temperature, 15 C - 30 C (59 F - 86 F) in a tight container.
Medically Reviewed by a Doctor on 11/6/2014Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
View Full Profile Medical Editor: Melissa Conrad Stöppler, MDAnd sometimes, too much - is too much. High blood glucose levels, or hyperglycemia, cause a cascade of effects that are damaging to the body in the short and long-term. In the long-term, abnormally high blood sugar causes damage to blood vessels leading to a variety of potential catastrophes; including but not limited to any system that has a blood supply, potentially leading to heart attack, stroke, kidney failure, blindness, and amputations. Add the increased risk of infection associated with hyperglycemia and there is great incentive to keep blood sugars tightly under control.
