Cyndrome

Posts Tagged ‘diabetes news’

Talking about diabetes, this is how shocking the rise of obesity has become: according to the Surgeon General’s office, the number of obese or overweight adults in this country is around about fifty percent higher than it was just ten years ago. The latest studies have estimated that about a third of the children born in 2010 will develop Type 2 Diabetes, which was once called adult-onset diabetes and is for the most part driven by excessive weight. And possibly most troubling of all: over the last ten years the number of deaths directly related to obesity-inspired diseases has risen by a whopping thirty three percent.

Obesity is a big contributor to diabetes, heart disease, and stroke. Diabetes leads to a heightened risk of limb amputation, blindness, heart disease, and kidney problems. The close relationship between excessive weight and diabetes cannot be ignored. Which is why it’s so essential for those who have pre-diabetes or have Type 2 Diabetes to keep an eye on their body mass index?

Diabetes – What is BMI?

Body mass index also known as just BMI, what is it exactly?  It is a simply calculated number which tells you the percentage of your of body weight that comprises of fat. Although this number is not a hundred percent accurate, particularly when the calculation is based solely on height and weight, it’s a good educated guess. Surely good enough to use as a guide if you get on a weight loss program. Other factors that are normally taken into consideration are sex and age.

The most precise way to find out your body mass index is by working with your doctor. Not only can he give you some additional insight into the meaning of the number, he can recommend the best way you can go about losing weight, you can find more information regarding the same on a good diabetes blog.

Nevertheless, if you want to know where you stand on the BMI scale, it is quite easy to find a BMI calculator on the internet . The quickest way to finding a calculator is by doing a search for the term “BMI” or “body mass index” on a search engine such as Google.

Diabetes – What does your BMI tell you?

After you have found your BMI number, you will want to know what it means. As a rule of thumb, for adults a body mass index of less than 20 means that the person is underweight, and if the BMi happens to be more than 25 it is overweight, and over 30 is obese. For a more detailed idea of where you fall in the index, the National Heart, Lung and Blood Institute will give you a complete Body Mass Index Table for your convenience.

All said and done: if you happen to be overweight, you are at risk of getting diabetes. Diabetes symptoms are not easily detected, yet it can cause kidney failure, heart disease, a stroke and one might even have to amputate a limb. This is why, to keep diabetes at bay, it’s so essential to keep a close eye on your weight and particularly your body mass index.

Meet Johnny, a middle-aged employee who has a busy life with no room for complications. He has been taking medications since he was diagnosed with type 2 diabetes few years ago but he is now starting to lose his battle against glycaemic control and for the first time his blood glucose is higher than 7.0 percent.

Diabetes (diabetes mellitus) is a serious, lifelong disease and is a disorder of metabolism — the way our body uses the food we eat for growth and energy. Most of the food we consume is broken down to glucose, the main form of sugar in the blood.

Glucose is our body’s primary energy source. After digestion, glucose passes into the bloodstream where it is used by cells for growth and energy. Insulin, a hormone that is produced by the pancreas, must be present in order for glucose to get into our cells. When we eat, the pancreas produces the right amount of insulin to act as carriers to deliver glucose to our cells.

In people with diabetes, the pancreas produces either little or no insulin, or the cells do not respond appropriately to the insulin being produced.  Glucose builds up in the blood, overflows into the urine and passes out of the body, thus, the body loses its main energy fuel.  The cause of diabetes continues to be investigated, and both genetic and environmental factors such as obesity and sedentary lifestyle appear to play a role.

Diabetes is associated with long-term complications that affect almost every part of the body and may lead to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage.

Patients like Johnny are in need of extra help, and gladly, people at AstraZeneca and Bristol-Myers Squibb have introduced the new DPP-4 inhibitor saxagliptin, a prescription medicine for type 2 diabetes mellitus to improve glycemic control in combination with other prescription such as metformin as an intial combination therapy, paired with diet and exercise.

For people like Johnny, the risk of developing diabetes complications such as kidney failure, heart attack and stroke among others run high.  It is a sad fact that more than half of Filipino patients with type 2 diabetes are unable to achieve optimal blood sugar control with their lifestyle modification such as diet and exercise, thus requiring additional medications.

“Saxagliptin is a welcome addition to the current range of oral anti-diabetes drugs and can help provide that added control some patients may need,” said Dr. Leilani Mercado-Asis, President of Philippine Society of Endocrinology and Metabolism.

In a country such as the Philippines, with its growing population, the ratio of type 2 diabetes is around seven to one, so given that our country has 92 million inhabitants, people with type 2 diabetes can be pegged somewhere between 5.5 to 6.5 million, a very scary number.

According to Dr. Araceli Panelo, executive director of UERMMMC-Institute for Studies on Diabetes Foundation (ISDF), the management of diabetes is now much better compared to the last decades.

“With the increased awareness for disease prevention and the importance of lifestyle change, patients are now better informed and really work towards improving their diabetes condition,” said Dr. Panelo.

For people at risk of developing diabetes complications, the key is to keep blood sugar levels within the normal parameters. Saxagliptin belongs to a novel class of oral anti-diabetec drugs called DPP-4 inhibitors. DPP-4 is an enzyme that inactivates the natural hormones in the body called incretin.

Incretins decrease elevated blood sugar or glucose by increasing the body’s utilization of sugar, mainly through increasing insulin production in the pancreas, and by reducing the liver’s production of glucose.  The US Food and Drug Administration (FDA) approved saxagliptin in July 2009 based on results of clinical studies involving 5,000 patients, more than 4,000 of whom received saxagliptin while the remaining participants received placebos.

This new type 2 diabetes drug has been approved by FDA Philippines in May 2010.  Astra Zeneca is the sole marketing company for saxagliptin in the Philippines.  And for patients like Johnny, extra help is at hand in his fight to reach glycemic goals.

A study is underway in Europe to assess the feasibility and impact of the “chronic care model” as a framework for managing patients with Type 2 diabetes.

The trial, known as “CARAT” (The Chronic CARe for diAbeTes study), was launched in Switzerland in February 2010 and is employing a cluster randomized design. The trial design and rationale are published in the open-access journalCardiovascular Diabetology.

“Chronic conditions and multimorbidity represent the major challenge for the health care systems in the industrialized world,” explain Anja Frei (University of Zurich) and fellow CARAT investigators.

“The chronic care model provides a proactive, patient-centred, evidence-based approach to face this challenge.”

Recent studies in a range of chronic diseases have demonstrated that treatment strategies incorporating elements of the chronic care model lead to improved outcomes for both patients and healthcare systems.

To date, however, most of these studies have been performed in the USA, which has a very different healthcare system to that of Europe.

The CARAT trial aims to address this gap by adapting the chronic care model approach to the Swiss healthcare system. A total of 28 general practitioners (GPs) in Switzerland will be randomly assigned to either intervention or control; each GP will enrol 12 patients with Type 2 diabetes.

The intervention will entail the GP and practice nurse working as a team to deliver comprehensive diabetes care tailored to the needs of the individual patient; the control group will receive care as usual.

The primary endpoint is the change in glycated hemoglobin between baseline and 1 year. Secondary endpoints include control of of blood pressure, glycated hemoglobin, and low-density lipoprotein cholesterol; quality-of-life; and quality indicators of diabetes care.

“This study challenges the hypothesis that the chronic care model can be easily implemented by a practice-nurse-focused approach,” write Frei et al.

“If our results will confirm this hypothesis, the suggestion arises whether this approach should be implemented in other chronic diseases and multimorbid patients and how to redesign care in Switzerland.”

Men with diabetes have a significantly reduced risk for prostate cancer compared with their nondiabetic peers, report researchers.

The team notes that there was a borderline significant trend for a greater inverse association with well versus poorly differentiated cancers.

“Observational studies suggest that diabetes is associated with a decreased risk of prostate cancer, but few are population based or have investigated associations with cancer stage or duration of diabetes,” say Richard Martin (University of Bristol, UK) and colleagues.

They report the results of a nested case-control study of 1291 men with histologically confirmed prostate cancer, aged 50–69 years, and 6479 age- and general practice-matched controls from the ProtecT (Prostate testing for cancer and Treatment) study based in the UK.

They found that the prevalence of diabetes was significantly lower in men with prostate cancer than controls, at 6.9% versus 8.6%. Presence of diabetes reduced the relative risk for prostate cancer by 22%.

There was weak evidence for the inverse association being greater for well versus poorly differentiated cancers, which was still borderline significant after adjustment for family history of prostate cancer.

Adjustment for body mass index weakened the inverse association slightly, but it was still statistically significant. There was no evidence for a greater reduction in prostate cancer risk with longer time since diabetes diagnosis.

The authors suggest that low insulin levels in men with diabetes “may suppress prostate carcinogenesis directly or by reducing levels or activity of insulin growth factor-I, a putative risk factor for prostate cancer.”

They conclude in the International Journal of Cancer: “These data add to the evidence of the association of diabetes with prostate cancer in the prostate specific antigen era.”

Women with Type 2 diabetes have significantly increased risk for genital and digestive cancers compared with their nondiabetic peers, show study results.

However, men and women with diabetes have significantly reduced risks for prostate cancer and skin cancer, respectively.

“Type 2 diabetes mellitus has been associated with an increased risk of a variety of cancers in observational studies, but few have reported the relationship between diabetes and cancer risk in men and women separately,” write Gabriel Chodick (Tel Aviv University, Israel) and team.

They therefore followed up 16,721 Type 2 diabetics and 83,874 nondiabetics (52.6% male) for 8 years for incidence of cancers by gender.

In total, 1639 and 7945 cases of incident cancer were reported in diabetic and nondiabetic participants, respectively, over the study period. Women with diabetes had a significant 23% increase in risk for total cancer compared with nondiabetic women, but no such increase in total cancer risk was seen in diabetic versus nondiabetic men.

Regarding different cancer subtypes, women with diabetes had a significant 96% and 41% increase in relative risk for cancers of the genital and digestive organs, respectively, compared with nondiabetic women.

Conversely, diabetic women were a significant 62% less likely to develop skin cancer than nondiabetic women.

Men with diabetes had a significant 47% reduction in relative risk for prostate cancer compared with nondiabetic men, but no risk increases for any cancer subtypes were observed in men with versus without diabetes.

The reduction in risk for prostate cancer in diabetic men is supported by previous research, as reported by MedWire News.

“For men, this study is good news,” said Chodick. He added that the opposite is true for women and continued: “The interaction of diabetes and female hormones appears to exaggerate the risk, and make certain organs like the uterus and ovaries more receptive to certain kinds of cancer.”

The authors conclude in the journal Cancer Causes and Control that their results “support the development of primary and secondary prevention programs aimed at women with diabetes and increased awareness of diabetes mellitus patients and healthcare personnel to the importance of cancer prevention efforts.”