Category Archives: Diabetes

People who undergo gastric bypass surgery are more likely to experience a remission of their diabetes than patients who receive a gastric sleeve or intensive management of diet and exercise, according to a new study. Bypass surgery had already shown better results for diabetes than other weight-loss methods in the short term, but the new research followed patients for five years.

We knew that surgery had a powerful effect on diabetes, says Philip Schauer of the Bariatric & Metabolic Institute at the Cleveland Clinic. What this study says is that the effect of surgery is durable. The results were published online February 15 in the New England Journal of Medicine.

The study followed 134 people with type 2 diabetes for five years in a head-to-head comparison of weight-loss methods. At the end of that time, two of 38 patients who only followed intensive diet and exercise plans were no longer in need of insulin to manage blood sugar levels. For comparison, 11 of 47 patients who had a gastric sleeve, which reduces the size of the stomach, and 14 of 49 who underwent gastric bypass, a procedure that both makes the stomach smaller and shortens digestion time, did not need the insulin anymore. In general, patients who had been diabetic for fewer than eight years were more likely to be cured, Schauer says.

Even those surgical patients who still needed to take insulin had greater weight loss and lower median glucose levels than others in the study. This study was also one of the few to show that bariatric surgery could help those with only mild obesity, defined as a body mass index between 27 and 34. How bariatric surgery might improve diabetes is still unknown, but scientists have pointed to effects on the bodys metabolism (SN: 8/24/13, p. 14) and gut microbes (SN: 9/5/15, p. 16).

Over five years, gastric bypass patients showed bettercontrol ofblood sugar levels than patients whoused a gastric sleeve or medical management such as intensive diet and exercise plans.

The same research team had published similar results at one and three years after surgery, but few studies looked further, says Kristoffel Dumon, a bariatric surgeon with the University of Pennsylvania Health System in Philadelphia. The criticism of bariatric research has been that there are no good long-term results. With weight-loss surgery, you often see rapid initial results, but you want to see that to a five-year time point.

Dumon also notes that the patients who received only intensive medical therapy did not report an improvement in their quality of life, and their emotional well-being worsened. People in the surgical group reported improvements in quality of life, but not in emotional well-being, a finding that Schauer says has more to do with stress management and other characteristics that wouldnt necessarily be affected by surgery.

Schauer hopes to have even longer-term data in the future. His team will combine their results with those from similar research at three other U.S. sites with the goal of following patients for up to 10 years.

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Gastric bypass controls diabetes long term better than other ... - Science News

PHOTO PROVIDED A class like this one to help residents at risk of diabetes will begin a 25-class series on March 2 at the Bellefonte YMCA.

BELLEFONTE It is one of the most slowly progressing diseases that often falls under the radar, but the YMCA of Centre County is starting a program to help prevent it.

Starting Thursday, March 2, from 6 to 7 p.m. at the Bellefonte YMCA, the YMCA of Centre County will be offering a diabetes prevention program that will consist of 25 class sessions throughout the year that will focus on topics that are crucial when it comes to diabetes prevention, such as nutrition and physical activity, according to Naomi Engelken, community health and wellness director at the State College YMCA.

Its really looking at preventing it from even happening, because we find that about one in three adults has prediabetes, meaning that theyre at high risk for developing type 2 diabetes, Engelken said. A program like this can reduce their risk of type 2 diabetes by about 58 percent.

Currently, there are more than 86 million adults in the United States who have prediabetes, and nine out of 10 are not aware that they have it, according to the Centers for Disease Control and Prevention (CDC).

Since last year, the YMCA of Centre County has been working toward implementing the diabetes prevention program, which started about 18 years ago as a study done by the CDC and the National Institutes of Health, Engelken said. Today, more than 200 YMCAs across the United States have implemented the program.

To qualify for the program, individuals must be at least 18 or older and have a BMI over 25 or be considered overweight, Engelken explained. The YMCA is also requesting that interested participants also get a blood test from their physician, as there is a certain blood value that indicates a high risk for developing type 2 diabetes.

There will be a cost to participate in the program, which will depend on a person-to-person basis, and the YMCA does offer financial assistance for the program, Engelken said. Most participants will receive an incentive to join the program, so if a participant is not a YMCA member, they will receive a YMCA membership for the duration of their participation in the program.

Engelken said that a typical class will consist of reviewing topics discussed in the previous class, looking at the weekly tracking of physical activity and nutrition, tracking weight, and afterward, participants will move onto the next educational topic. For the first four months of the program, there will be 16 weekly sessions, and the remaining nine will taper off into monthly maintenance sessions. Each session in the program will be an hour long, with sessions following the March 2 one being held on a rolling basis once at least eight people register for a session.

There are two main goals of the program to help individuals reduce their risk of diabetes. One is to reduce body weight by seven percent over the course of the program, and the other is to increase physical activity to an optimal level of 150 minutes per week, Engelken said.

The program will be unlike others and aims to have a lasting impact on participants lifestyles.

Because its a smaller environment, you have a supportive environment, you really get to know the people in the class, and it really allows you to kind of take control of your health versus someone leading you through an exercise program, Engelken said.

She added that the program will really focus on teaching individuals why they need to maintain these types of things so that they can have a healthy lifestyle, and it will allow them to carry on that lifestyle beyond the programs duration.

After the YMCA finishes with this years program, Engelken said that it plans to continue to help prevent diabetes in the community. The YMCA of Centre County has been working closely with the national YMCA office and they have a implementation program set for at least the next five years.

Theres no reason that so many people should be suffering from a disease like this when its preventable with relatively easy measures, Engelken said.

For program registration and/or inquiries about the program and financial assistance, please contact Naomi Engelken at either 814-237-7717 or nengelken@ymcaocc.org. People should register by Feb. 28.

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Home Diabetes Diabetes linked to DNA: Study

Researchers have found a link between certain variations in DNA and the development of type 2 diabetes that may explain why some individuals get the disease while those with similar lifestyles do not.

A team of scientists has published their findings in the Proceedings of the National Academy of Sciences, stating that some genetic defects associated with diabetes change the way certain cells in the pancreas read their genes. This is the first bit of evidence that many of the DNA changes associated with the development of type 2 diabetes are linked with a DNA reading molecule called Regulatory Factor X, or RFX. This new research shows that the ability of RFX to bind with islets in the pancreas is affected by the DNA changes characteristic of diabetes, resulting in reduced cell function. Islets are responsible for the cells that create hormones like insulin and glucagonthe hormones necessary for the management and regulation of blood sugar.

Dr. Stephen C.J. Parker, a senior co-author of the study, explained We have found that many of the subtle DNA spelling differences that increase risk of type 2 diabetes can appear to disrupt a common regulatory grammar in islet cells. RFX is probably unable to read the misspelled words, and this disruption of regulatory grammar plays a significant role in the genetic risk of type 2 diabetes.

To conduct their research, the team examined DNA from islet samples gathered from 112 participants. Differences were characterized in DNA sequences, the modification and packaging of DNA by nongenetic factors, and levels of gene expression that allowed scientists to determine how often a gene had been read. Following these multiple points, researchers were able to track the effects of RFX and other transcription factors left on unpackaged DNA.

This research has linked the risk of developing type 2 diabetes to a genetic factor, helping to explain why some people may be more prone than others who lead the same lifestyle. Researchers hope this new information may lead to the development of more personalized treatment methods for diabetes.

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Diabetes linked to DNA: Study - Bel Marra Health

Published Feb 15, 2017 at 11:08 am (Updated Feb 15, 2017)

Chris Gildea, with sons Austin and Henry, volunteering at an American Diabetes Association event. Photo provided by Katie Gildea.

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By Meghan Byers

SPARTA For the Gildea family, diabetes isn't just a disease; it's a daily battle. Sparta residents Katie and Chris Gildea, along with their two young sons, ages 3 and 7, will volunteer this June at the American Diabetes Association's upcoming Skylands Tour de Cure, an event which helps fund diabetes research. Chris Gildea, who has type 1 diabetes, has volunteered with the ADA for 10 years. This year, the Gildea family plans to help out at each Tour de Cure event in New Jersey.

"It's a 24-hours-a-day, seven-days-a-week job, living with diabetes," said Katie Gildea. "Diabetes robs you of your ability to lead a care-free life."

The Tour de Cure is the ADA's biggest fundraiser. The Skylands event, which will be held at Waterloo Village, will include both a cycling portion and "fun run & walk" for non-cyclists.

While raising money for a cure is a top priority, Katie Gildea believes that education is equally important, especially when it comes to confronting the social stigma often associated with diabetes.

"A lot of people don't realize that Type 1 diabetes is separate from Type 2 diabetes, and that anyone can have it. A lot of people think it's a choice," she said. "People always tell my husband, 'You look so healthy.' But diabetes doesn't look a certain way. It can affect anyone of any age, any lifestyle."

Chris Gildea, who works at Becton-Dickinson, a company that provides diabetes care products, enjoys an athletic lifestyle despite his disease. "My kids think he's a superhero," said Katie Gildea. "He always tells them never give up, never surrender, and that's how we are with this never give up, never surrender."

According to the ADA, 1.4 million Americans are diagnosed with diabetes each year, and approximately 1.25 million Americans have type 1 diabetes. In 2010, diabetes was the seventh leading cause of death in the United States.

"When you have something like this that can affect your children," said Katie Gildea, "you'll do anything in your power to rid the world of it."

The Skylands Tour de Cure will take place June 4 at Waterloo Village in Stanhope, with a kickoff event taking place on March 23 at Czig Meister Brewery in Hackettstown.

More information and event registration is available at http://www.diabetes.org/skylands, and anyone interested in volunteering can email Katie Gildea at katiehug@hotmail.com.

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Sparta family raises diabetes awareness - The Sparta Independent

Researchers have found that abdominal fat may either cause or relate to the cause of type 2 diabetes and coronary heart disease. People who are genetically at a greater risk of having a higher waist-to-hip ratio adjusted for body mass index are likely to have an increased risk of developing these conditions.

New research detailing these findings was published in JAMA.

Body mass index (BMI) is used to measure body fat based on height and weight, and it is a common method of working out whether a person is overweight or obese. Obesity is a major risk factor for both type 2 diabetes and coronary heart disease.

Regardless of BMI, body fat distribution can vary from one person to the next. Some people carry more fat around their visceral organs, called abdominal adiposity (fat), while others carry fat on their thighs and hips.

Previous observational studies have indicated that abdominal fat is associated with type 2 diabetes and coronary heart disease. However, it remains unclear whether these associations represent a causal relationship.

Dr. Sekar Kathiresan, of Massachusetts General Hospital in Boston, and colleagues conducted a study to investigate whether being genetically inclined to have an increased waist-to-hip ratio (WHR) adjusted for BMI (a measure of abdominal fat) was linked to cardiometabolic traits (such as lipids, glucose, insulin, and systolic blood pressure), and type 2 diabetes and coronary heart disease.

The team gathered data from four genome-wide association studies conducted between 2007 and 2015, which included up to 322,154 participants, and individual-level, cross-sectional data from the UK Biobank collected between 2007 and 2011, which included data from a further 111,986 people. Estimates for cardiometabolic traits were based on this combined data set.

Analysis did show that being genetically predisposed to a higher WHR adjusted for BMI was connected with increased levels of quantitative risk factors, including lipids, glucose, insulin, and systolic blood pressure, and a greater risk of developing type 2 diabetes and coronary heart disease.

Kathiresan and co-authors say that the results permit several conclusions. Firstly, the findings agree with previous studies that associate abdominal fat with cardiometabolic disease.

Secondly, the findings suggest that the distribution of body fat, beyond BMI measurement, could partly explain the disparity in risk of type 2 diabetes and coronary heart disease that is reported in both individuals and subpopulations.

"For example, increased abdominal adiposity at a given BMI has been proposed as an explanation for the excess risk of coronary heart disease observed in South Asians," the authors explain. "Similarly, greater abdominal adipose tissue at a given BMI has been proposed to underlie the excess risk of coronary heart disease at a given BMI among men compared with women," they add.

Lastly, WHR adjusted for BMI may lead to novel therapeutic strategies for the reduction of abdominal fat and decreasing the risk of type 2 diabetes and coronary heart disease.

"Although a substantial focus of drug development has been toward therapeutics to reduce overall adiposity, there has been little effort toward the development of therapies that modify body fat distribution to reduce abdominal adiposity," say the authors. Kathiresan and team conclude:

"These results provide evidence supportive of a causal association between abdominal adiposity and the development of type 2 diabetes and coronary heart disease."

Limitations of the study include the fact that there is a small chance that the findings from the study represent a "shared genetic basis" between WHR adjusted for BMI and coronary heart disease, instead of a causal relationship.

Learn how obesity may lead to heart attacks and stroke.

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Abdominal fat may cause type 2 diabetes, heart disease - Medical News Today

Researchers have discovered a way to reprogram mouse liver cells into precursor pancreatic cells by changing the expression of a single gene. They suggest that the finding is an important step toward showing that reprogramming liver cells might offer a way forward for the treatment of type 1 diabetes in humans.

The team - led by researchers from the Max Delbrck Center for Molecular Medicine in Berlin, Germany - reports the study in the journal Nature Communications.

Diabetes is a chronic disease that develops either when the body cannot make enough insulin, or when it cannot effectively use the insulin that it does make. Insulin is a hormone that regulates blood sugar, or glucose, and it helps to convert glucose from food into energy for cells.

Uncontrolled diabetes leads to high blood sugar, or hyperglycemia, which over time causes serious damage to many parts of the body, including the heart, blood vessels, nerves, eyes, and kidneys.

In the United States, an estimated 29.1 million people have diabetes, including 8.1 million who are undiagnosed.

The most common type of diabetes is type 2, in which the body cannot use insulin effectively. Type 1 diabetes, in which the body does not make enough insulin, accounts for around 5 percent of diabetes cases in adults.

The new study is likely to interest researchers developing treatments for type 1 diabetes. In people with type 1 diabetes, the immune system attacks the insulin-producing beta cells of the pancreas.

Researchers in regenerative medicine are exploring ways to generate new populations of pancreatic beta cells as a possible avenue for the treatment of type 1 diabetes.

Fast facts about type 1 diabetes

Learn more about type 1 diabetes

The new study concerns a method called cell reprogramming, in which it is possible to convert one type of cell into another type of cell, by tweaking genes.

An obvious source of cells for reprogramming into insulin-producing beta cells might be other types of cell in the pancreas.

In their study paper, the researchers mention other research that shows such pancreatic cells display a high degree of the necessary "cellular plasticity."

However, the researchers chose to focus on liver cells because, from a clinical perspective, they offer important advantages over pancreatic cells; for example, they are more accessible and abundant.

They also cite studies that have partially corrected hyperglycemia in diabetic mice by reprogramming liver cells into pancreatic beta cells.

The new study shows how just by changing the expression of a single gene called TGIF2, the team was able to coax mouse liver cells to take on a less specialized state and then stimulate them to develop into cells with pancreatic features.

When the researchers transplanted the modified cells into diabetic mice, the animals' blood sugar levels improved, suggesting the cells were behaving in a way similar to pancreatic beta cells.

The researchers identified TGIF2 (Three-Amino-acid-Loop-Extension homeobox TG-interacting factor 2) by running gene expression profiling tests on immature liver and pancreas cells isolated from mouse embryos as the cells differentiated toward their particular cell fates.

They found that at a particular differentiation branchpoint, the expression of TGIF2 changes in opposite directions as the cells commit to either liver or pancreatic fates.

The authors note that their study shows that "TGIF2 is a developmental regulator of pancreas versus liver fate decision," and when expressed in adult mouse liver cells, it suppresses the transcription program for liver cells and induces a subset of pancreatic genes.

There is still a lot of work to do to investigate whether the results with mice translate to humans. The team has already started working on human liver cells.

"There are differences between mice and humans, which we still have to overcome. But we are well on the path to developing a 'proof of concept' for future therapies."

Senior author Dr. Francesca M. Spagnoli, Max Delbrck Center

Learn how type 1 diabetes kills some insulin-producing cells but not others.

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Type 1 diabetes: Reprogramming liver cells may lead to new treatments - Medical News Today

Endocrinology Advisor

How Does Psoriatic Arthritis Affect Diabetes Risk? Endocrinology Advisor The prevalence of diabetes is higher in patients with psoriatic arthritis (PsA), with greater PsA activity correlating with a higher risk of developing the disease, according to recent research published in The Journal of Rheumatology. Psoriatic ...

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How Does Psoriatic Arthritis Affect Diabetes Risk? - Endocrinology Advisor

ELKINS The West Virginia University Extension Service in Barbour and Randolph counties will be offering free Dining with Diabetes classes in Philippi and Elkins.

Elkins classes will be held from 6 to 8 p.m. on March 13, 20, 27 and April 3 at the WVU Randolph County Extension Office. Philippi classes will be held from 10 a.m. to noon on March 14, 21, 28 and April 4 at the Philippi Senior Center.

Dining with Diabetes is a once-a-week class that runs for four weeks with a three-month follow-up class in May. This class is open to those with diabetes and their family members. The classes are free, but space is limited and pre-registration is required by March 8. Participants are encouraged to attend all class sessions.

Those in the class will learn how to prepare meals that are healthy, easy and tasty. Recipes will be demonstrated and participants will have the opportunity to taste each one. Participants will also learn up-to-date information on nutrition, meal planning and exercise as well as how to understand common diabetes-related medical tests. Recipes and handouts will be given to each participant.

Diabetes is a very serious and costly disease, but research has shown that those who learn to manage their blood glucose (sugar) levels, eat healthy and exercise regularly can lower their risk of complications and lead a healthier and more productive life.

The WVU Extension Service cooperates with Davis Medical Center registered dieticians to deliver the program.

For more information or to register for the morning Philippi classes, call the WVU Barbour County Extension office at 304-457-3254 by March 8. For more information or to register for the evening Elkins classes, call the WVU Randolph County Extension office at 304-636-2455 by March 8.

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Dining and Diabetes classes offered - The Inter-Mountain

Nacho Fernandez came through the ranks at Real Madrid.

Real Madrid defender Nacho Fernandez has said he was told at the age of 12 that he would not be able to have a career in football because of his type one diabetes.

Nacho, 27, made his 100th senior appearance for the Liga leaders in Saturday's win at Osasuna.

But it once seemed his dream of playing professionally would never happen, he told UEFA in quotes reported by Madrid's official website.

"I had been playing for two years at Real Madrid and it was a tough time," he said. "I remember, when I went into the hospital, the doctor who saw me wasn't the one who should have seen me.

"That doctor told me that I couldn't continue playing football and it was a really bad weekend for me.

"But three days later I saw Dr Ramirez, someone I'm very fond of. He told me the opposite -- that I had not finished with football at all."

Asked whether being diabetic meant there were limits on what he could do, Nacho said: "I am lucky to play football, I like to play all kinds of sports, exactly because of that, because it is very important to do physical activity.

"I have no limitations. There are meals that I have to be a little more careful with but I eat everything and I am lucky to have it well controlled.

"It makes you be a more responsible person and take more care of yourself."

Nacho has spent his whole career at the Bernabeu after coming through the ranks and said that meant "you know that when you wear this shirt you have that responsibility."

"You are playing for the best team in the world and, from a young age, you are learning things that the club teaches you," he added.

"When you reach the first team, the dimensions are much greater and people look at you through a magnifying glass."

He praised coach Zinedine Zidane, saying he was doing "a very good job."

"I like him because he's a bit like me, a quiet person that does not get bothered when a problem comes along," he said. "Thanks to him we have achieved important things, and I hope it continues this way."

Dermot Corrigan is a Madrid-based football writer who covers La Liga and the Spain national team for ESPN FC. Follow him on Twitter @dermotmcorrigan

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Real Madrid's Nacho Fernandez feared diabetes would end football dreams - ESPN FC

A recent study reported that diabetes is the third leading cause of death in the United States, up from seventh in 2010.

This study also reported that life expectancy has slowed down or even decreased, mainly due to the rise of diabetes and obesity in our country. Per recent Centers for Disease Control statistics, 21.95 million people in the United States, or 9.3 percent of the population, in 2014 had diabetes. In those 65 years old and older, more than 25 percent have diabetes, and that percentage is expected to double by 2050 if current trends continue.

If glucose levels are high over long periods of time, heart disease, blindness, kidney disease, nerve damage and other complications can result. But prevention of these complications is possible. The American Diabetes Association recommends that most non-pregnant adults with diabetes maintain a hemoglobin A1c (a 3-month blood sugar average) less than 7 percent, with daily blood sugars less than 130 mg/dl after fasting and less than 180 mg/dl two hours after eating.

Diabetes costs $245 billion a year; $69 billion of those costs are indirect, such as lost productivity and increased absenteeism from work. Patients with diabetes have medical costs twice as much as those without diabetes. The risk of death in adults with diabetes is 50 percent higher than for adults without diabetes. Prediabetes (often a precursor to type 2 diabetes) currently has a prevalence of 86 million, or 30 percent of the population, and nine out of 10 of those folks are unaware they have it. In the Medicare population, more than half have prediabetes, based on estimates from the Centers for Disease Control.

Recent statistics estimate that 90 percent of the cases of type 2 diabetes can be prevented through lifestyle change, specifically Diabetes Prevention Programs. Structured DPPs are effective interventions lasting one year and taught by a lifestyle coach. Participants in the DPP learn about healthy eating, ways to incorporate exercise, how to manage stress and set up their environment and life for success.

The goal of the DPP is to have participants lose 7 percent of their body weight over the course of a year through nutrition interventions and exercising at least 150 minutes per week. The results from the DPP suggest over a 50 percent reduction in acquiring type 2 diabetes for those at risk. In 2018, Medicare will pay for the DPP as long as the program goes through the CDC accreditation process.

The potential is there to slow the rate of type 2 diabetes in our country. If you or someone you love is concerned about having prediabetes, ask your doctor to do a simple blood test such as a hemoglobin A1C or take the CDC risk test found at cdc.gov/diabetes/prevention/pdf/prediabetestest.pdf.

We can turn the tide of diabetes in our country by screening all people with risk factors for diabetes and getting them into a DPP. Such opportunities exist in Missoula and Western Montana. As Robert Ratner, M.D., chief scientific officer for the American Diabetes Association once said, We must prevent diabetes or our health system will be consumed by it. Now is the time!

Jennifer Troupe, MS, RD, is the manager of Providence Endocrinology, Diabetes and Nutrition Center

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Nurse's Notes: The state of diabetes in America - The Missoulian