Category Archives: Diabetes

TOLEDO As a former Type II diabetic, Norm Baird admits that he used to abuse dairy. For years, the retired engineer enjoyed eggs and loved yogurt. He used to cut off little pieces of cheese to nibble on as he passed through his kitchen. His diet resembled a typical Americans: high in sugar, processed foods, meat and scant on vegetables.

But the silver-haired Toledo resident and cancer survivor no longer looks like a dairy abuser, having shed about 65 pounds and his diabetes diagnosis after adopting a plants-based diet in February 2016.

The 72-year-old is one of a small but growing number of people who have opted to go vegan or near-vegan as a first-line treatment for chronic weight- and diet-related illnesses such diabetes.

With more than two-thirds of American adults considered to be overweight or obese, diabetes is one of the leading causes of death in the country. The number of people with Type II diabetes is expected to double by 2030, according to the Centers for Disease Control and Prevention. In Washington, Cowlitz County ranks 10th among the states 39 counties in prevalence of the disease. About 13 percent of Cowlitz residents are living with the condition, according to a chronic disease report by the Washington State Department of Health. Thats more than a third higher than the statewide average of 9 percent.

Things first started to change for Baird when he was diagnosed with cancer, and they snowballed from there.

As you get older it feels like doctors have two columns of health conditions, Baird said. Every year that passes it seems they move another one over from the list of possible conditions into the column of ones you have.

During his cancer treatment Baird started injecting himself with insulin to counteract a steroid he was taking that drove up his blood sugar.

After chemotherapy, Baird stopped taking his insulin until he was diagnosed with Type II diabetes. At a follow-up visit, Dr. Robert Ellis, an oncologist at the Kaiser Permanente Clinic in Longview, proposed the idea of adopting a vegetarian diet.

Ellis is a passionate champion of plants-based eating. In an interview, he noted that the top health conditions in the United States cancer, heart disease and obesity are all preventable and treatable through diet and nutrition.

One of the first things I go over with patients is their diet, he said. If you had a high-performance car and I told you that it needs high performance gas, would you really drive to Costco and put that crappy gas in your car?

In 2013 Kaiser issued a nutritional update for physicians urging health care providers to recommend plants-based diets to patients. Its now one of the most-cited scholarly journal articles ever published on the subject.

As one of the nations largest not-for-profit health plans and the largest managed care agency in the United States, with 10.2 million members, its in Kaisers interest to keep its patients healthy.

Ellis said he has serious discussions about diet with about 80 percent of his patients. Of that number, about 40 percent to 50 percent say theyre actually going to change the way they eat, he said. And the percentage that go full crazy on you and adopt a vegan diet like Bairds is around 10 percent to 20 percent, he said.

Were not hiding something, Ellis said. This isnt quantum physics.

A person can dramatically lower their blood sugar by eating plants and whole foods while avoiding meat and other animal products that are high in fat, he said.

Some of the biggest impediments to adopting this kind of diet are socioeconomic. Not having much money for food and living far away from grocery stores that sell quality produce can make it hard for people to commit, Ellis said.

But Baird is one of the few who has bought into the eating program. With a referral from his primary physician in hand, he next met with Andrea Ferreiro, a Portland-based Kaiser nutritionist who specializes in healthy eating plans.

Norm was kind of the ideal patient, Ferreiro said in an interview. Norms an engineer and hes pretty analytical, so we just kind of told him exactly what to do and how to do it and he implemented it precisely.

Baird proceeded to cut out all meat, dairy and other animal products from his meals. In a mere five weeks, his A1C score a measure of blood sugar dropped to 6.1, placing him below the 6.5 or above score used to classify a person as diabetic.

Baird was able to stop injecting himself with the insulin he had been using twice daily for two years. He also stopped taking an oral prescription medication for diabetes and went from monitoring his blood sugar four times a day to just two.

Its exceptional its a really big deal, Ferreiro said of Bairds progress.

Ellis said he had to revise Bairds medication regimen to compensate for the chemistry changes that can occur within the body after just a few days of vegetarian meals.

The rest of Bairds follow-up visits were conducted by phone by one of Ferrieros assistants, and he still receives a weekly call to review his numbers.

They call once a week to make sure nothings out of whack, he said.

Baird said he still fixes himself a plate with some meat on special occasions like Christmas and Thanksgiving but only one.

No seconds and no leftovers, he said.

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A plants-based cure for diabetes - Longview Daily News

June 22, 2017 by Elin Bckstrm High-resolution model of six insulin molecules assembled in a hexamer. Credit: Isaac Yonemoto/Wikipedia

Some insulin is still produced in almost half of patients that have had type 1 diabetes for more than ten years. The study conducted by researchers at Uppsala University in Sweden has now been published online by the medical journal Diabetes Care.

Type 1 diabetes, a chronic disease mainly debuting during childhood or adolescence, has previously been considered to result in full loss of the patients' insulin production. However, by the use of sophisticated insulin assays that have been introduced in recent years, this has now been shown to not be true in all cases.

In a study from Uppsala University more than one hundred type 1 diabetes patients at Uppsala University Hospital have been investigated. Almost half of the adult patients that have had type 1 diabetes for at least ten years still produced some insulin.

The study showed striking differences in the immune system between patients with full loss of their insulin production and patients that still produced some insulin. Patients with remaining insulin production had much higher blood levels of interleukin-35, a recently discovered anti inflammatory signal protein of the immune system. They also had many more immune cells that produce interleukin-35 and dampen immune attacks.

It is still not known if the patients had higher levels of interleukin-35 already at the onset of their disease, or if those levels had increased over the years, stopping immune attacks towards the insulin producing cells as a result. A previous study by the same research group has shown that both patients newly diagnosed for type 1 diabetes and patients with long-standing disease on average have lower levels of interleukin-35 when compared to healthy individuals. The previous study also showed that diabetes development could be prevented, and that fully developed diabetes could be reversed, through interleukin-35 treatment in animal models with type 1 diabetes.

The results of the present study in Diabetes Care may increase the interest to develop interleukin-35 into a drug for the treatment of type 1 diabetes. The discovery that almost half of the patients with type 1 diabetes have some remaining insulin production also makes it attractive to let the patients test new treatments that can induce regeneration of their remaining insulin producing cells. Such a study has now been initiated at Uppsala University Hospital.

Explore further: Mislocalized calcium channel causes insulin secretion defect in diabetes

More information: Daniel Espes et al. Increased Interleukin-35 Levels in Patients With Type 1 Diabetes With Remaining C-Peptide, Diabetes Care (2017). DOI: 10.2337/dc16-2121

Journal reference: Diabetes Care

Provided by: Uppsala University

Researchers from Uppsala University have studied beta cells of type-2 diabetic donors, and find that a mislocalized calcium channel contributes to the failed insulin secretion associated with the disease.

A Yale-led research team identified how insulin-producing cells that are typically destroyed in type 1 diabetes can change in order to survive immune attack. The finding may lead to strategies for recovering these cells in ...

A small pilot study in which researchers attempted to slow attacks mounted by the immune system on insulin-producing cells in type 1 diabetes has given promising results. The study by researchers at Linkping University ...

A significant finding has been made by the 3U Diabetes Consortium, of Dublin City University, Maynooth University and the Royal College of Surgeons in Ireland (RCSI), which has the potential to contribute to the identification ...

(HealthDay)For patients with atrial fibrillation (AF), diabetes requiring insulin, but not diabetes without insulin treatment, is associated with an increased risk of stroke/systemic embolism, according to a study published ...

Type-1 diabetes occurs when immune cells attack the pancreas. EPFL scientists have now discovered what may trigger this attack, opening new directions for treatments.

Some insulin is still produced in almost half of patients that have had type 1 diabetes for more than ten years. The study conducted by researchers at Uppsala University in Sweden has now been published online by the medical ...

Heart disease is a leading cause of death worldwide and exacerbated by type 2 diabetes, yet diabetes treatment regimens tend to focus primarily on blood sugar maintenance. This common approach to type 2 diabetes management ...

A team of researchers from Sweden, the U.S. and Switzerland has found that treating rat liver cells with a compound called sulforaphane, which is found in cruciferous vegetables, reduced production of glucose. In their paper ...

(HealthDay)For many people with diabetes, low blood sugar levels are a serious health risk, but researchers report that a new nasal powder quickly reverses the effects of this dangerous condition.

An inexpensive first-line treatment for type 2 diabetes may also reduce heart disease in those with type 1 diabetes, according to a new global trial led by the University of Glasgow.

In a landmark study, UNC School of Medicine researchers have shown that blood glucose testing does not offer a significant advantage in blood sugar control or quality of life for type 2 diabetes patients who are not treated ...

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Many diabetes patients produce some insulin - Medical Xpress

Since her diagnosis of Type 1 diabetes in 1989, Madyi Stangl has felt that the disease has placed a cloud on her life limiting her ability to travel and live life.

But that cloud has lifted for the Minneapolis resident, thanks to a special golden retriever named Willy.

Willy is a diabetes assistance dog that was given to Stangl by Can Do Canines, a New Hope-based nonprofit that trains dogs to help people who live with diabetes, autism, seizures, hearing loss and mobility issues.

Madyi and Willy graduated in a class of 14 on June 10.

Willy was named by Wilma Audrey Loken, who donated money to Can Do Canines. She died before Willy graduated, but her two daughters, their husbands and her son attended the graduation ceremony. One daughter, Beth Brostrom, and her husband are members of the White Bear Lions Club.

Willy can detect changes in Stangls blood sugar levels by scent. He alerts Madyi to high or low blood sugar levels by touching her with his paw. If she doesnt respond, he will whine or whimper and eventually do whatever he needs to do to get her attention. He is trained to bring glucose tablets or even a cell phone to Stangl.

Recently, Stangl had a scary low of 36 during the night. When she failed to respond to Willys touches, he laid over her body until she woke up, checked her blood sugar levels and ate food to bring her levels back up to normal.

Can Do Canines has produced nearly 600 teams of dogs and their human companions since opening in 1989, according to Sarah Schaff, client services coordinator.

The organization can give away the dogs, which are sold by other organizations for $20,000 or more, because of volunteers and many donors, Schaff says.

Funding comes from donations from individuals, companies and grants. Schaff reports that the organization does not receive any state or federal funds, relying solely on donations, fundraisers and bequests.

Puppies are bred in a cooperative program with other certified service dog organizations and raised by volunteers. Many receive their initial training in six Minnesota and two Wisconsin prisons.

Schaff notes that the prison environment is good for the dogs as well as the inmates.

It gives dogs a 24/7 taste of what life will be like when they are working, she says, adding that there are many studies pointing to the therapeutic benefits for the inmate handlers as well.

The organization has a screening process to find suitable candidates to match with dogs that are in the system or are in training.

It takes two years to raise and train a dog to be an assistance animal, Schaff said.

Madyi works as the operations lead for the University of Minnesota Physicians and Willy accompanies her to work. He alerted a diabetic co-worker of Stangl to a low blood sugar level.

Stangl grew up with dogs and reports that having Willy around is like having a big security blanket that I carry with me all the time. She is now more confident as well.

Even though Im going to continue on as this girl with this physical reminder of my disability, Im a little prouder because Im able to shed light on diabetes. Diabetes is an invisible illness, something that needs to be seen because its not something to be taken lightly, she said.

Even though Willy is a beautiful and friendly dog, Stangl asks that people refrain from touching him or any other assistance dog without permission of the owner.

When we are out in public and Willy is wearing his vest, its important not to make eye contact or distract him, Stangl says. He is working for me, and if he gets distracted, he stops working, and that could be dangerous.

Schaff says that Can Do Canines is in need of volunteers to raise and train Labrador, collie and poodle puppies for two years and return them to the company for further training. For more information, go to http://www.can-do-canines.org.

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'Lifting the cloud' of diabetes with a special dog - Press Pubs

June 21, 2017 Credit: Medical University of Vienna

The islets of Langerhans in the human pancreas produce and release insulin to regulate blood glucose levels. Insulin, which is specifically produced in b-cells, serves to prompt cells to take up glucose circulating in blood. Thus, insulin release lowers the level of glucose in blood. In diabetes, this cycle is disrupted by the premature death of b-cells. Working with an international team of researchers, Katarzyna Malenczyk from the Department of Molecular Neurosciences at MedUni Vienna's Center for Brain Research showed in the study published in the EMBO Journal today that the loss of a key protein, secretagogin, triggers the death of b-cells and, conversely, that these cells can be protected by increasing the amount of this protein in those suffering from diabetes.

"Although researchers have been trying for decades to find effective means of protecting b-cells in diabetes, we still haven't found curative therapies. Understanding the mechanism that could lead to the development of a medication is therefore of enormous value," says Dr. Malenczyk, lead author of a new study. "We were able to show in animal models and also in b-cells from diabetic donors that, in disease conditions the level of secretagogin is significantly reduced, suggesting a direct correlation between this protein and the severity of the disease," explains Tibor Harkany, Head of the Department of Molecular Neurosciences of MedUni Vienna's Center for Brain Research. "If we find molecular tools to keep b-cells active, we could also ensure their survival."

So far, research on the protein secretagogin has been limited. Yet, Dr. Malencyzk and an international team led by the Department of Molecular Neurosciences at the Center for Brain Research have now discovered that the presence of this protein is critical for bcells to remain healthy, and therefore represents a target for the development of an effective treatment for diabetes whether prevention or therapy at clinical onset is considered.

Mechanism explained

The most important outcome of this study is to show that secretagogin regulates whether and how b-cells shed all those proteins that are no longer required or useful to maintain their physiological integrity and functions. Professor Harkany remarks: "If secretagogin is turned off, toxic proteins as waste products can rapidly accumulate in bcells and this inevitably leads to their death." And so, if levels of secretagogin in b-cells could be boosted in diabetes to remain near-physiological, this would offer an attractive avenue of their self-protection.

Secretagogin a Viennese discovery

The protein secretagogin was first identified by Ludwig Wagner (Department of Medicine III), who is also co-author of the current paper, in Vienna in 2000. Seventeen years later, the present study demonstrates the exact role of this protein. Professor Wagner says: "It is nail-biting to see that our continued study of this single protein has reached a stage where the molecular understanding of its function can realize the development of new treatment options."

Fuelling secretagogin levels

But how can cellular levels of this protein be boosted in diabetes? Dr. Malenczyk and the international research team around her showed that the protein can be retained in diabetes and its activity increased by stimulating TRPV ion channels. TRPV1 is a transmembrane protein that besides the nervous system is also expressed in pancreatic beta-cells. If this receptor is stimulated, more secretagogin is being produces in b-cells. TRPV1 is easiest stimulated by capsaicin, an alkaloid that occurs in various types of bell and chilli pepper. Capsaicin binds directly to TRPV1 ion channels and by stimulating them has a profound effect on b-cell biology. Dr. Malenczyk notes: "In a first step, our discovery could be an efficient treatment for diabetes but, of course, this requires follow-up studies in human sufferers. We are cautious to suggest that that diabetics could improve their diets by consuming more peppers or chillies. TRPV1 is a promising target for potential drugs, because, in diabetes, it continues to be found with its levels largely unaltered in b-cells.

Explore further: 'Trigger' for stress processes discovered in the brain

More information: A TRPV1-to-secretagogin regulatory axis controls pancreatic beta-cell survival by modulating protein turnover. Katarzyna Malenczyk, Fatima Girach, Edit Szodorai, Petter Storm, sa Segerstolpe, Giuseppe Tortoriello, Robert Schnell, Jan Mulder, Roman A. Romanov, Erzsbet Bork, Fabiana Piscitelli, Vincenzo Di Marzo, Gbor Szab, Rickard Sandberg, Stefan Kubicek, Gert Lubec, Tomas Hkfelt, Ludwig Wagner, Leif Groop and Tibor Harkany, EMBO Journal, 2017. DOI: 10.15252/emboj.201695347

At the Center for Brain Research at the MedUni Vienna an important factor for stress has been identified in collaboration with the Karolinska Institutet in Stockholm (Sweden). This is the protein secretagogin that plays an ...

Pancreatic beta cells help maintain normal blood glucose levels by producing the hormone insulinthe master regulator of energy (glucose). Impairment and the loss of beta cells interrupts insulin production, leading to ...

Type-1 diabetes occurs when immune cells attack the pancreas. EPFL scientists have now discovered what may trigger this attack, opening new directions for treatments.

Diabetes continues to be a global health problem, with the number of cases projected to rise from 285 million in 2010 to nearly 400 million by the year 2030. Diabetes is the fourth leading cause of death worldwide.

Research led by a Johns Hopkins University biologist demonstrates the workings of a biochemical pathway that helps control glucose in the bloodstream, a development that could potentially lead to treatments for diabetes.

The significant role of beta cell 'hubs' in the pancreas has been demonstrated for the first time, suggesting that diabetes may due to the failure of a privileged few cells, rather than the behaviour of all cells.

Heart disease is a leading cause of death worldwide and exacerbated by type 2 diabetes, yet diabetes treatment regimens tend to focus primarily on blood sugar maintenance. This common approach to type 2 diabetes management ...

A team of researchers from Sweden, the U.S. and Switzerland has found that treating rat liver cells with a compound called sulforaphane, which is found in cruciferous vegetables, reduced production of glucose. In their paper ...

(HealthDay)For many people with diabetes, low blood sugar levels are a serious health risk, but researchers report that a new nasal powder quickly reverses the effects of this dangerous condition.

An inexpensive first-line treatment for type 2 diabetes may also reduce heart disease in those with type 1 diabetes, according to a new global trial led by the University of Glasgow.

In a landmark study, UNC School of Medicine researchers have shown that blood glucose testing does not offer a significant advantage in blood sugar control or quality of life for type 2 diabetes patients who are not treated ...

Low-income Hispanics with Type 2 diabetes who received health-related text messages every day for six months saw improvements in their blood sugar levels that equaled those resulting from some glucose-lowering medications, ...

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'Protective shield' for beta-cells suggests new option to treat diabetes - Medical Xpress

June 20, 2017 Credit: CC0 Public Domain

Heart disease is a leading cause of death worldwide and exacerbated by type 2 diabetes, yet diabetes treatment regimens tend to focus primarily on blood sugar maintenance. This common approach to type 2 diabetes management can leave patients at risk for heart attack and stroke. But results from four recent randomized clinical trials suggest that using medications that offer glucose control while reducing the risk for cardiovascular disease could improve patient outcomes.

"Strong evidence provided by the four recent trials published within the past 1.5 to 2 years in the New England Journal of Medicine has shown that some of the modern available therapeutic agents that control blood glucose also help reduce the risk for cardiovascular disease," said Faramarz Ismail-Beigi, MD, PhD, Professor of Medicine at Case Western Reserve University and Endocrinologist at University Hospitals Cleveland Medical Center and Louis Stokes Cleveland VA Medical Center. "Based on this evidence, we propose that we must shift from our previous paradigm with its monocular focus on control of blood glucose and hemoglobin A1c, to one of control of blood glucose plus preventing cardiovascular disease and death from cardiovascular causes." Hemoglobin A1c is a common test used to determine a patient's average blood sugar levels over the previous 2-3 months.

Ismail-Beigi helped conduct three of the four clinical trials, and he and his collaborators recently reviewed trial results in the Journal of General Internal Medicine. The trials each tested a blood sugar-lowering medicationpioglitazone, empagliflozin, liraglutide, or semaglutidebut recruited patients with heart disease or stroke. The goal was to determine whether or not the drugs were safe, but in each study, researchers were surprised to find participants with or at risk of type 2 diabetes also experienced cardiovascular improvements.

"For the first time we have seen glucose-lowering medications that can improve cardiovascular outcomes," Ismail-Beigi said. "It is highly possible that newer agents in these classes of medications, used singly or in combination, will prove to be more efficacious in the management of type 2 diabetes and prevention of cardiovascular disease, even in patients at earlier stages of the disease process."

Previous studies focused on tight control of blood sugar have not shown major cardiovascular benefits for diabetes patients. "Strict control of blood glucose levels has shown minor, if any, positive effect on prevention of cardiovascular disease," said Ismail-Beigi. "In fact, a large NIH-funded clinical trial on type 2 diabetes management failed to show that strict control of blood glucose levels had any positive effect on cardiovascular outcomes or mortality, and in fact, may be harmful."

The new trial results could help address a major dilemma for clinicians looking for ways to control heart disease and reduce mortality, while simultaneously managing blood glucose in patients with type 2 diabetes.

Said Ismail-Beigi, "Our review focuses on the need for a paradigm shift on how we should think about management of type 2 diabetes. I believe it will necessitate a rethinking of goals and approaches by guideline committees. We also hope that the FDA might consider approving new medications for management of type 2 diabetes not only based on their safety profile and their efficacy to control blood glucose, but also whether the medication reduces overall mortality and cardiovascular-related mortality."

Explore further: Major study heralds new era in treatment of type 2 diabetes

More information: Faramarz Ismail-Beigi et al, Shifting Paradigms in the Medical Management of Type 2 Diabetes: Reflections on Recent Cardiovascular Outcome Trials, Journal of General Internal Medicine (2017). DOI: 10.1007/s11606-017-4061-7

A drug that lowers blood sugar levels for people with type 2 diabetes has also been revealed to significantly reduce the risk of both cardiovascular and kidney disease.

More work needs to be done to examine the real world effects of the commonly prescribed diabetes drug empagliflozin, new research in the journal Diabetes Therapy finds.

Researchers have shown that the glucose-lowering drug liraglutide safely and effectively decreases the overall risk of heart attack, stroke, or cardiovascular death for people with type 2 diabetes. These patients are at high ...

The health risks and mortality associated with prediabetes seem to increase at the lower cut-off point for blood sugar levels recommended by some guidelines, finds a large study published in The BMJ today.

A new study shows that the drug fenofibrate might reduce the risk of cardiovascular events in patients with type 2 diabetes who have high levels of triglycerides and low levels of "good" cholesterol, despite being treated ...

Why is heart failure not more rigorously assessed in clinical trials of antidiabetes drugs? In a Personal View, published in The Lancet Diabetes & Endocrinology journal, Professor John McMurray of The University of Glasgow ...

Heart disease is a leading cause of death worldwide and exacerbated by type 2 diabetes, yet diabetes treatment regimens tend to focus primarily on blood sugar maintenance. This common approach to type 2 diabetes management ...

A team of researchers from Sweden, the U.S. and Switzerland has found that treating rat liver cells with a compound called sulforaphane, which is found in cruciferous vegetables, reduced production of glucose. In their paper ...

(HealthDay)For many people with diabetes, low blood sugar levels are a serious health risk, but researchers report that a new nasal powder quickly reverses the effects of this dangerous condition.

An inexpensive first-line treatment for type 2 diabetes may also reduce heart disease in those with type 1 diabetes, according to a new global trial led by the University of Glasgow.

In a landmark study, UNC School of Medicine researchers have shown that blood glucose testing does not offer a significant advantage in blood sugar control or quality of life for type 2 diabetes patients who are not treated ...

Low-income Hispanics with Type 2 diabetes who received health-related text messages every day for six months saw improvements in their blood sugar levels that equaled those resulting from some glucose-lowering medications, ...

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

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Researchers call for paradigm shift in type 2 diabetes treatment - Medical Xpress

Science is increasingly uncovering new ways toreversediabetes, achronic condition that affects the way the body processes blood sugar, and which has more than doubled in prevalence over the past 20 years, according to the Centers for Disease Control and Prevention. Scientists arealso increasingly aware of whos most at risk for the disease: According to a new study looking at the demographics of diabetes in this country, the highest risk can be found among racial and ethnic minorities, people with low incomes or lower educational levels, and people living in rural areas. In one scary finding, the research, which was published in theInternational Journal of Environmental Research and Public Health,showedthat across the country, women with diabetes were at a higher risk of foregoing medical care.

Ifyoure among the more than 29 million Americans or8.5percent of the global population withthe disease, you absolutely can live a healthy, happy lifeif you take care of yourself and follow certain diabetes guidelines.

Whether youve just been diagnosed or have been managing the disease your whole life, this handy infographic from Vitality spells out the absolute must-dos for optimum diabetes care. Follow it exactly tominimizediabetes complications and achieveyour best quality oflife. And dont miss these simple tricks for living well with diabetesfrom people who have it.

Courtesy Tips for Living Well from Vitality

Source:Tips for Living Well from Vitality

Excerpt from:
This Infographic Is Like the 10 Commandments of Diabetes - Reader's Digest

June 19, 2017

An FDA advisory committee will meet today to discuss the results of an outcomes trial for Novo Nordisk's Victoza, an add-on treatment for diabetes, and whether the drug's label should include that it reduces the risk of death from heart attack and stroke.

The agency's meeting is part of a larger trend in diabetes, in which drugmakers are working to demonstrate that their drugs can reduce, or at least not raise, the risk of cardiovascular disease, which affects a disproportionate amount of diabetes patients. Lowering blood sugar is no longer enough.

The case for the health system is clear: adults with diabetes are twice as likely to die from heart attack or stroke compared to those without, according to the Centers for Disease Control and Prevention.

See also:BI and Lilly face a new challenge: how to market a diabetes drug to cardiologists

Drugmakers' pursuit of labels touting positive outcomes is unsurprising, given the shift towards outcomes-based contracts between drugmakers and health plans. A recent study from Avalere Health found that one in four health plans now have at least one outcomes-based contract with a drugmaker. Under these agreements, drugmakers are often paid based on the quality of care received from a product rather than its mere use.

The FDA will convene to discuss if the results from Victoza's LEADER trial change the risk-benefit profile of the drug, whether the data establish that Victoza does not increase the risk of cardiovascular disease, and if the drug proved that it reduces the risk of a heart attack or stroke in patients with existing cardiovascular disease. The trial's results were initially reported last year, revealing that Victoza cut the risk of those cardiovascular events by 13% versus placebo. Novo Nordisk filed an application in October to include the data on Victoza's label.

Positive outcomes data is not just a requirement for GLP-1 agonists like Victoza, either. At the American Diabetes Association's annual meeting last week, drugmakers unveiled new outcomes data for SGLT-2 inhibitors Farxiga (AstraZeneca) and Invokana (Johnson & Johnson).

See also:When it comes to diabetes, will marketers break with tradition?

J&J's Invokana showed the exact same benefit 14% fewer patients saw a heart attack or stroke compared to placebo in its CANVAS trial compared to fellow SGLT-2 inhibitor, Eli Lilly's Jardiance. That result should boost the entire SGLT-2 class, Credit Suisse analyst Vamil Divan wrote in an investor note. That boost, though, will likely come at Merck's expense, he added, explaining that the new data may entice doctors to use SGLT-2 inhibitors earlier in treatment and displace Merck's DPP-4 inhibitor, Januvia.

We expect the enthusiastic response to the efficacy data driving use of the SGLT-2 class earlier in the course of treatment, while concurrently pushing the DPP-4's further back, Divan wrote.

Nonetheless, Lilly's Jardiance may be the big winner in any overall boost to the SGLT-2 class due to Invokana's safety issues. The FDA slapped Invokana with a box warning in May for an increased risk of foot and leg amputations. Jardiance also has a leg up in terms of timing: last December, it became the first diabetes drug approved by the FDA to reduce cardiovascular death.

See also:Two new therapies made by Sanofi and Novo Nordisk to compete in crowded diabetes market

Invokana saw sales of $284 million in the first three months of 2017, a 12% drop from the year-ago period. Jardiance generated sales of $74 million during the same three-month period.

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For diabetes drugs, lowering blood sugar may no longer be enough to stay competitive - Medical Marketing and Media

Posted on June 20, 2017 | 10:43 a.m.

Ocho Pasos program targets nutrition, treatment, exercise, monitoring, stress management

Jenifer Swartzentruber, l, Wendy Bevier, Mary Conneely, Ellen Goodstein of William Sansum Diabetes Center. (William Sansum Diabetes Center)

The William Sansum Diabetes Center'sOcho Pasos a la Buena Salud (Eight Steps to Better Health) was selected to be showcased in a moderated poster discussion at the recent American Diabetes Associations 77th Scientific Sessions in San Diego.

The presentation, led by WSDC diabetes educator Mary Conneely, was part of the ADA tour titled Community Strategies to Improve Care Delivery.

More than 15,000 physicians, scientists and health care professionals from around the world convene annually at the ADAs Scientific Sessions to unveil cutting-edge research, treatment recommendations and advances toward a cure for diabetes.

It was a great experience for me personally and it was just overwhelming with how much information there was at the conference, said Conneely who attended the conference for the first time this year.

During the conference Conneely said she experienced an impressive example of just how far reaching WSDCs Ocho Pasos education is across the globe.

Conneely, who is from Bolivia, met two conference attendees, also from Bolivia. When she told them about the WSDCs presentation they said they'd already downloaded WSDCs Ocho Pasos program, even before they met Conneely that day.

More than anything, it was so amazing to show other people what we are doing at William Sansum Diabetes Center and what works to better the lives of the community, Conneely said.

The moderated poster presentation detailed how Ocho Pasos is a culturally-relevant diabetes education program designed for low-income, monolingual Latino participants with or at risk for type 2 diabetes.

The eight weekly sessions focus on nutrition, treatment, monitoring, exercise and stress management. The results of Ocho Pasos were on display, highlighting the dramatic A1C reduction by taking the class.

It is incredibly empowering, energizing and awe inspiring to be around the nearly 15,000 talented and dedicated physicians, researchers, engineers, educators and others all making incredible progress in the fight against this dreadful disease," said Ellen Goodstein, WSDC executive director.

"To hear the progress being made in so many areas of diabetes research gave me genuine hope for the future. We will beat this disease, she said.

Dr. David Kerr, who attended the event, said, "The ADA showcases the best and the brightest for diabetes research and innovation, and this year the center was especially prominent because of the cutting-edge work we are involved with right now."

Diabetes affects nearly 30 million children and adults in the United States and contributes to the deaths of more than 230,000 Americans each year.

The American Diabetes Association estimates the total cost of diagnosed diabetes in the U.S. is more than $177 billion.

Published studies suggest that when additional costs for gestational diabetes, prediabetes and undiagnosed diabetes are included, the total diabetes-related costs in the U.S. exceeds $322 billion annually.

William Sansum Diabetes Center attendees included: Goodstein, Conneely, Ceara Axelrod, Wendy Bevier, Jenifer Swartzentruber, Kerr, Dr. Jordan Pinsker, Laura Lindsey and Mei Mei Church.

Regina Ruiz for William Sansum Diabetes Center.

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Sansum Diabetes Program Takes Global Stage - Noozhawk

Some people don't like to eat their vegetables , but for obese people with type 2 diabetes , broccoli could hold the key to slowing, and potentially reversing, the disease, according to a new study.

Scientists used both computational and experimental research to zero in on a network of 50 genes that cause symptoms associated with type 2 diabetes. They also located a compound called sulforaphane which is found naturally in cruciferous vegetables such as broccoli , Brussels sprouts and cabbages that could turn down the expression of those genes, according to the findings, published today (June 14) in the journal Science Translational Medicine.

In the study, the scientists gave sulforaphane to obese patients , in the form of a concentrated broccoli sprout extract. They found that it improved the patients' systems' ability to control their glucose levels and reduced their glucose production two symptoms of diabetes that can lead to other health problems, including coronary artery disease , nerve damage and blindness, according to the Centers for Disease Control and Prevention .

"It's very exciting and opens up new possibilities for the treatment of type 2 diabetes ," Anders Rosengren, an assistant professor at the University of Gothenburg in Sweden, told Live Science.

Type 2 diabetes, the most common form of diabetes, affects more than 300 million people globally. For those with the disease who are obese, the excess fat in the liver makes the body less sensitive to the hormone insulin, which can make it difficult for the organ to help regulate blood sugar levels. Normally, insulin, which is produced by the pancreas , stimulates the liver to pull glucose out of the bloodstream and store it for later use.

People with type 2 diabetes are usually advised to change their diet to help control their blood sugar levels. " Lifestyle changes are at the core of type 2 diabetes treatment but often need to be complemented with drugs," Rosengren said.

Currently the main treatment option is the drug metformin . But not every person who needs it can take it. About 15 percent of type 2 diabetes patients have reduced kidney function and taking metformin can increase their risk for lactic acidosis, an unhealthy build-up of lactic acid, which can cause abdominal discomfort, shallow breathing, muscle pain or cramping, and tiredness.

About 30 percent of patients who take metformin develop nausea, bloating and abdominal pain.

Finding an alternative to metformin was one of the team's objectives. But there was also general frustration in the clinical community that research labs were having a difficult time developing new anti-diabetic compounds , Rosengren said.

One challenge is that researcherslooking to develop new drugs have traditionally studied single genes or individual proteins . But diabetes is much more complicated than that. It involves a large network of genes, so the scientists had to find a new, systematic approach that took a holistic view of the disease.

Study leader Annika Axelsson, a doctoral student at Gothenburg, and her colleagues began by analyzing liver tissue from diabetic mice who were raised on a "Western diet" containing 42 percent fat and 0.15 percent cholesterol. After several tests, the scientists identified 1,720 genes associated with hyperglycemia, a condition in which an excessive amount of glucose circulates in the blood.

After further analysis, the researchers narrowed the 1,720 genes to a network of 50 linked genes that together result in high bloodglucose levels . This network became the so-called disease signature for type 2 diabetes.

Next, the researchers used a database of existing drug compounds and employed a mathematical modeling program to rank those compounds for their potential ability to reverse the disease signature in other words, to turn down those overexpressed genes.

Sulforaphane had the highest ranking. The team ran several experiments to see if it could actually lower glucose levels in living systems. First, they tested the compound in cells growing in lab dishes, and found that it inhibited glucose production. Next, they tested it in rodents, and found that it improved glucose tolerance in animals on a high-fat or high-fructose diet.

Finally, the researchers tested sulforaphane in people. Over the course of 12 weeks, 97 patients with type 2 diabetes took a daily dose of concentrated broccoli sprout extract in powdered form. The dose was about 100 times the amount found naturally in broccoli . For those who were not obese, the sulforaphane did not have any affect.

But for those who were obese, the results were significant, the researchers reported. Typically, for people with type 2 diabetes, glucose levels in the blood stay high, even when they are fasting. But sulforaphane reduced fasting blood glucose in these patients by 10 percent compared to the participants in the study who took a placebo, according to the study. That amount is enough to lower a person's risk of developing health complications. And the compound did not cause gastrointestinal problems that metformin can cause, nor other side effects.

For the next phase of this study, Rosengren said the team would like to investigate the effects of sulforaphane on people with prediabetes to see whether it could improve their glucose control before type 2 diabetes develops.

Originally published on Live Science .

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