Category Archives: Diabetes

Eric Fenar is a Type 1 diabetic whoexercises regularly,rigorously measures his blood sugar levels and takes othersteps to stayhealthy.

Still, he says,"In life, it's tough to eat tofu and salad and grilled chicken every day."

He likes Asian food, pizza and beer too much for that.

This is why Fenar has become one of the biggest volunteer pitchmen in the country for an inhalable insulin drug called Afrezza a drug that has helped the 34-year-old Buffalo public school teacher reach the most stable blood glucose levels he's had since he was diagnosed at age 10.

"There is a little bit of a learning curve," he said, "but now I have the power to fight those high blood sugars. Life is much more flexible."

Fenar discovered Afrezza during one of his routine online searches about better diabetes management. He testified at a 2014 federal Food and Drug Administration hearing to tout the promise of Afrezza for those like himself before he'd even tried the drug. He met Al Mann, the creator, before the billionaire businessman died in February 2016.

[RELATED STORY: Floored by diabetes diagnosis, Richard Fink fought back]

Fenar grew up in Lancaster. He remembers the weekend he was diagnosed with Type 1 diabetes, because he watched on a hospital television set on Oct. 23, 1993, as Joe Carter hit a home run to help the Toronto Blue Jays win the World Series.

His diagnosis meant that his body produced no insulin to help him break down food. It also meant a lifetime of insulin injections and great sacrifices as he kept vigilant watch on his blood sugar levels or so it seemed at the time.

"I want people to be aware of this option," Eric Fenar says. "This is what I needed: a faster insulin."

"My family has always been up to date on the latest technologies," he said. "I was up to date on the shots for two years and mom read about the insulin pump. Back then it was only for people 18 and over. At this point, I was about 12."

His mother, Susan, a nurse, convinced doctors and health insurers that Fenar was capable of using a pump to monitor his glucose levels and give himself insulin without dispensing a potentially fatal overdose.

Years later, he started to use a Dexcom, a Bluetooth-compatible device that reads blood sugar without the need to do a finger-prick blood test. This allowed him to use his pump, or an injection, to push the correct amount of insulin into his bloodstream.

The challenge, Fenar said, is the lag time that comes with injectable insulin. It can take 45 minutes to an hour for the effect to take hold causing damage from high blood sugar and running the risk of an insulin crash or overflow, particularly an hour or so before or after meals.

"The thing that got me is Afrezza starts to work in 12 to 15 minutes," he said.

Dr. Howard Lippes, a Williamsville endocrinologist, assistant clinical professor with the University at Buffalo medical school and owner of R&B Medical Group, prescribes the inhalable drug to about 15 to 20 percent of his Type 1 adult diabetic patients.

Some use it regularly, others intermittently "to correct high glucose," he said. "There are pros and cons. It's not better. It's different."

Lippes doesn't count Afrezza's inhalability as a big advantage, "given the ease of today's insulin pen devices, which are simple and painless," he said. But he and patients who use it appreciate the speed in which it can control blood sugar levels.

For example, those like Fenar who enjoy pizza. When someone without diabetes eats pizza, or other food or drink loaded with carbs, the pancreas starts making insulin right away to compensate for the spike in blood sugar, which can cause inflammation and damage the cardiovascular system.

"If you're diabetic and eat a meal, you've got to give the insulin a running start if you want to catch the blood sugar before it goes up," Lippes said. "The timing of the meal can be a bit daunting. The Afrezza works really quickly, so that is an advantage for some patients."

It also has a shorter "tail" than injectable insulins, leaving the bloodstream faster so the danger of a lingering low blood sugar reaction diminishes, the doctor said.

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Lippes prescribes Afrezza almost exclusively for those with Type 1 diabetes. It costs about the same as injectable insulin and is covered by most health insurance plans, he said.

Those with a cough or cold may not want to use it, Lippes said, and it is not recommended for those with asthma or chronic lung diseases like COPD. Its use is discouraged by those who smoke, "not that any diabetic should do that," Lippes said.

A small percentage of patients who try Afrezza get a throat irritation or cough, though the majority of patients tolerate it well.

Despite its advantages, the inhalable drug has yet to reach a critical mass in the diabetes drug industry.

Creator Mann ran 17 companies that helped improve pacemakers, cochlear implantsand insulin pumps. He put $1 billion of his own money into Afrezza before he died, at age 90, and also was at work on developing an artificial retina.

Lippes blamed lagging Afrezza sales on the relatively small size of the drug-making company, MannKind, as well as the first inhalable drug, Exubera, which Pfizer introduced more than a decade ago, then pulled from the market in 2007. In that case, the inhalation device was so big, it couldn't fit into a purse and looked like something you'd use to smoke illegal drugs. It proved too cumbersome for most who tried it, Lippes said.

He described the Afrezza inhaler as "a little whistle device," which dispenses powdered insulin in 4-, 8- and 12-unit doses.

The Afrezza inhaler is a whistlelike device, which dispenses powdered insulin in 4-, 8- and 12-unit doses.

Fenar needs a basal insulin injection once a day, to keep his sugar levels stable while he sleeps. Otherwise, he has found reliability in the drug and delivery method he advocates.

"With Afrezza, I was able to get off my insulin pump," he said. "I used to carry what I called a diabetic man purse," with extra pump supplies and extra insulin. "Now, when I leave the house, I have a tenth of what I used to carry.I'm not connected to anything. And for my insulin needs, I take Afrezza.

"I want people to be aware of this option. This is what I needed: a faster insulin."

For Lippes, the drug represents one of several exciting new changes in diabetes treatment.

The next, he said, is the sensor augmented insulin pump. Medtronics Corp. which recently hit the market with its variety, the 670G Pump refers to it as "the artificial pancreas."

"It's not quite there yet," Lippes said, "but we're on the threshold of big changes with these new glucose sensor devices that can tell the insulin pump what to do in real time. I have patients lined up to get it."

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Buffalo teacher a key advocate in breakthrough diabetes drug - Buffalo News

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Designing better drugs to treat type 2 diabetes Science Daily "Type two diabetes is characterised by resistance to insulin with subsequent high blood sugar which leads to serious disease. It is usually associated with poor lifestyle factors such as diet and lack of exercise," says lead researcher Dr John Bruning ... Soon, Anti-Diabetes Drugs to Replace Painful Insulin JabsNDTV New diabetes drug may soon replace insulin jabsDeccan Chronicle Suffering from diabetes? Here's some good news for youEconomic Times Diabetes.co.uk -Zee News all 12 news articles »

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Designing better drugs to treat type 2 diabetes - Science Daily

All signs seem to suggest Apple is gearing up to release a special blood sugar trackerfor the Apple Watch.

As it turns out, none other than CEO Tim Cook has been spotted wearing what appeared to be an Apple Watch-connected glucose tracker in the vicinity of the company campus, CNBC reports.

Unfortunately, details remain pretty scarce as of now with the exception that the new wearable module is directly connected to the Watch.

Assuming the Big A manages to fine-tune the rumored blood sugar tracker, the technology could become a must-have for millions of people suffering from or at risk of getting diabetes.

Apple was first rumored to be working on a dedicated diabetes wearable back in April, when CNBC reported the company has assembled a secret super-team of bioengineers to craft a solution for tracking blood sugar levels with the Watch.

Speaking at the University of Glasgow earlier in February, Cook said he had been wearing a continuous glucose monitor for a few weeks but stopped short of making any significant revelation about the gadget.

One thing the Apple chief clarified though is that the device would also make it easier for people to responsibly monitor their blood sugar levels and avoid health complications.

Its mentally anguishing to stick yourself many times a day to check your blood sugar, he commented. There is lots of hope out there that if someone has constant knowledge of what theyre eating, they can instantly know what causes the response and that they can adjust well before they become diabetic.

on CNBC

Read next: Microsoft's new Surface Pro just leaked, but it's not a 'Pro 5'

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Tim Cook is reportedly testing Apple Watch-connected diabetes tracker - TNW

A diabetes journal has issued two notices of concern for papers co-authored by a researcher who took another publisher to court after it did the same thing but ultimately lost.

The notices are for two papers co-authored by Mario Saad who, after losing his legal battle with the American Diabetes Association, has since accumulated 12 retractions. Both notices from the journal Diabetologia, published by Springer and the the European Association for the Study of Diabetes (EASD) say they have alerted Saad to their concerns about some of the images in the papers, and the university where he is based was asked to investigate more than one year ago. Since the journal has not yet received any information from the University of Campinas in Brazil, however, it decided to issue expressions of concern for the two papers.

Heres the text of the first notice:

On the basis of the recommendation of the EASDs Scientific Integrity Panel, the Editor-in-Chief is issuing this expression of concern to alert readers to questions about the reliability of some of the data in the article cited above.

In particular it appears that the immunoblots for total IKK in Fig. 4g and k of this paper may have been duplicated.

In line with guidelines issued by the Committee on Publication Ethics (COPE), the journal has informed the corresponding author, Mario Saad, of this concern. The authors response was considered unsatisfactory and the low resolution of the images provided to us prevented further analysis to conclusively confirm or refute this possible duplication. The University of Campinas (So Paulo, Brazil) was asked, in March 2016, to undertake an institutional investigation. As no results from this investigation have been forthcoming this expression of concern is being issued to alert readers to exercise caution when interpreting the content and conclusions of this article. This expression of concern will remain in place until such a time as further evidence is available.

Modulation of gut microbiota by antibiotics improves insulin signalling in high-fat fed mice has been cited 88 times since it was published in 2012, according toClarivate Analytics Web of Science, formerly part of Thomson Reuters.

Heres the text of the second notice:

On the basis of the recommendation of the EASDs Scientific Integrity Panel, the Editor-in-Chief is issuing this expression of concern to alert readers to questions about the reliability of some of the data in the article cited above.

In particular, it appears that the bands for -tubulin in Fig. 4b are the same as the first three bands for total p70S6K in Fig. 6k in Ropelle ER et al (2008) (A central role for neuronal AMP-activated protein kinase (AMPK) and mammalian target of rapamycin (mTOR) in high-protein diet-induced weight loss. Diabetes 57(3): 594605. DOI:10.2337/db07-0573).

The journal has been unable to obtain the high resolution image used in Ropelle et al from the corresponding author, Dr Carvalheira, and the editorial office of Diabetes no longer had a copy of this image. It has therefore not been possible to use image forensics to conclusively confirm or refute this concern.

In line with guidelines issued by the Committee on Publication Ethics (COPE), the journal has informed the corresponding author, Mario Saad, of this concern. The University of Campinas (So Paulo, Brazil) was asked, in March 2016, to undertake an institutional investigation. As no results from this investigation have been forthcoming this expression of concern is being issued to alert readers to exercise caution when interpreting the content and conclusions of this article. This expression of concern will remain in place until such a time as further evidence is available.

Aspirin attenuates insulin resistance in muscle of diet-induced obese rats by inhibiting inducible nitric oxide synthase production and S-nitrosylation of IR/IRS-1 and Akt has been cited 28 times since it was published in 2009.

The Diabetes paper referenced in the EOC was retracted earlier this year.

We contacted Saad; he acknowledged our email, but did not respond to our questions.

This isnt the first publisher to question the University of Campinass actions regarding Saad as part of his lawsuit against the American Diabetes Association, it was revealed that the ADA askedthe school to reinvestigate fourarticles that the university had concluded were healthy, and refused to accept any papers from itsfaculty until the issues were resolved. The publisher eventually retracted the papers earning it the first-ever Doing The Right Thing Award from our co-founders.

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Journal flags two more papers by diabetes researcher who sued to stop retractions (and now has 12) - Retraction Watch (blog)

Photo: Carol Kaliff / Carol Kaliff

File photo of Huckleberry Hill Elementary School in Brookfields JDRF Kids Walk for Diabetes in April 2014.

File photo of Huckleberry Hill Elementary School in Brookfields JDRF Kids Walk for Diabetes in April 2014.

Bethel kids to walk to cure diabetes

BETHEL Students will walk to raise awareness for diabetes this Saturday.

Bethel High School is hosting its first JDRF Kids Walk to Cure Diabetes to help kids and families affected by type 1 diabetes. Registration begins at 10:30 a.m., with the walk and activities running from 11 a.m. to noon at the high school track.

The Juvenile Diabetes Research Foundation (JDRF) is the leading global organization funding type 1 diabetes research. More than 15,000 children in the United States are diagnosed with type 1 diabetes each year, according to the organization.

As of Thursday afternoon, the school had raised $480, just under half of its $1,000 goal. To donate or participate, visit the teams website at http://www2.jdrf.org/site/TR?team_id=234353&fr_id=6580&pg=team. Donations can also be brought to the walk.

For questions, contact Amy Gusitsch at agusitsch@gmail.com

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Bethel kids to walk to cure diabetes - NewsTimes - Danbury News Times

By Robert Preidt

HealthDay Reporter

WEDNESDAY, May 17, 2017 (HealthDay News) -- The type 2 diabetes prescription drug canagliflozin (brand names Invokana, Invokamet, Invokamet XR) appears to increase the risk of leg and foot amputations, the U.S. Food and Drug Administration says.

The FDA is requiring the medications to carry new warnings about the risk. The required warnings on the drug's labeling include the most serious and prominent boxed warning.

The agency's decision is based on data from two large clinical trials showing that leg and foot amputations occurred about twice as often in patients taking canagliflozin as among those taking a placebo.

Amputations of the toe and middle of the foot were the most common, but leg amputations below and above the knee also occurred. Some patients had more than one amputation, some had amputations involving both limbs, according to the FDA.

Type 2 diabetes occurs when the body becomes resistant to insulin. Insulin is a hormone that helps to usher sugar from foods into the body's cells. When this process doesn't work correctly, blood sugar levels rise. Left untreated, high blood sugar levels can cause a number of possible complications, including heart disease, kidney problems and amputations, according to the American Diabetes Association.

Canagliflozin is meant to be used with diet and exercise to lower blood sugar in adults with type 2 diabetes. It belongs to a class of drugs called sodium-glucose cotransporter-2 (SGLT2) inhibitors. These drugs lower blood sugar levels by causing the kidneys to remove sugar from the body through the urine.

It is available as a single-ingredient product under the brand name Invokana and also in combination with the diabetes medicine metformin under the brand name Invokamet.

Patients taking canagliflozin should immediately notify their health care providers if they develop new pain or tenderness, sores or ulcers, or infections in the legs or feet, the FDA said in a news release. Patients should not stop taking their medication without first talking to their health care provider.

Before prescribing canagliflozin to patients, doctors should consider factors that may predispose patients to the need for amputations, including a history of prior amputation, peripheral vascular disease, neuropathy, and diabetic foot ulcers, the FDA said.

In addition, doctors should monitor patients taking canagliflozin for the above signs and symptoms, and discontinue canagliflozin if these complications occur.

In a statement, Janssen Pharmaceuticals, the maker of canagliflozin, said the company had already shared the findings on amputation risk with medical professionals prior to this warning.

"While the incidence was low, the highest incidence of amputations across all treatments was seen in patients with prior amputation," Janssen said. "At Janssen, patient safety is our highest priority. We are working with FDA to include this information in the prescribing information for canagliflozin."

WebMD News from HealthDay

SOURCES: U.S. Food and Drug Administration, news release, May 16, 2017; statement, Janssen Pharmaceuticals

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Diabetes Drug Gets FDA Warning Due to Amputation Risk - WebMD

by Arkansas Business Staff on Thursday, May. 18, 2017 11:28 am

The University of Arkansas for Medical Sciences has been awarded another $2.1 million grant to attempt to reduce diabetes in the Marshallese community in northwest Arkansas.

The money comes from the Patient-Centered Outcomes Research Institute (PCORI). The three-year award will allow UAMS' Northwest Regional Campus to expand its research "a culturally adapted diabetes prevention program designed to reduce the risk of type 2 diabetes by teaching people who have pre-diabetes how to make modest lifestyle changes that can prevent diabetes."

The Marshallese have some of the highest documented rates of type 2 diabetes of any group in the world. UAMS said its health screenings found that 41 percent have diabetes, compared to 9.3 percent of the U.S. population.

Northwest Arkansas has more than 11,000 Marshallese in the region the largest community of Marshallese in the continental U.S.

"The goal of this research is to reduce disparities related to type 2 diabetes within the Marshallese community," said Pearl McElfish, associate vice chancellor for the UAMS Northwest Regional Campus, co-director of the Center for Pacific Islander Health and the principal investigator on this project.

"This particular study was conceived by working with members of the community largely through churches to identify the health questions that the Marshallese in Arkansas most want answered," she said.

UAMS said the study will be implemented within Marshallese churches.

The Walmart Foundation is also supporting this research. In December, it awarded a $125,000 grant to the program.

Since 2014, more than $10 million has been awarded to the UAMS Northwest Regional Campus to reduce health disparities in both Marshallese and Hispanic residents of Benton and Washington counties.

PCORI is a nonprofit authorized by Congress to fund comparative clinical effectiveness research.

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UAMS Gets $2.1M to Fight Diabetes in Marshallese Community - Arkansas Business Online

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Improving drugs for type 2 diabetes Science Daily Type 2 diabetes, a prolific killer, is on a steep ascent. According to the World Health Organization, the incidence of the condition has grown dramatically from 108 million cases in 1980 to well over 400 million today. The complex disease occurs when ... and more »

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Improving drugs for type 2 diabetes - Science Daily

by: Darrell Greene Updated: May 17, 2017 - 10:40 PM

MEMPHIS, Tenn. - Diabetes is attacking younger Americans more often than ever before.

According to new research released by the New England Journal of Medicine, cases of both type 1 and type 2 diabetes rose dramatically between 2002 and 2012.

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Those new diagnoses crossed all racial boundaries in young people through age 20.

While a cure is still distant on the horizon according to researchers, new treatments are helping diabetics live longer and better lives.

Emily Fonville is your average 15-year-old learning to drive, playing high school sports, and of course dressing up for the prom.

What you can't see in her pictures, is her daily fight against type 1 diabetes.

"It's like the hidden disease," Emily said.

But that fight is becoming more and more winnable.

Just three weeks ago, Emily became the first person in the Mid-South and one of the first in the nation to begin wearing the artificial pancreas.

It's true name, Medtronic is the hybrid closed loop system.

It's comprised of an insulin pump which attaches to the patient's skin, and a sensor which monitors in real time the patient's blood sugar.

The sensor sends those readings to the pump and when the patient's blood sugar is high, the pump gives the patient a precisely measured dose of insulin.

If the patient's blood sugar is too low, it has the ability to suspend delivery of insulin automatically.

"It is a game changer," Emily exclaimed when asked about the new tool.

Dr. Kashif Latif is Emily's doctor. He's one of the leading endocrinologists in the nation.

"There's a lot of technology going on, but this breakthrough has been the best thing ever for people with type 1 diabetes," said Latif who operates the first insulin pump center in nation out of his practice in Bartlett.

And while he admits this is not a cure, he said it's the next best thing to come along to date.

"It kind of matches what our body or our pancreas does for us. It's a more physiologic delivery of insulin for high glucose or low glucose," said Latif.

That means a lot less worry about diabetes for Emily.

"I think it is life changing. Being on this pump I feel like a normal person. I don't have to pull out a shot and give it in the middle of a restaurant.

I can just look down, press a button, and it's done."

FOX13 spoke to representatives of Medtronic who said the company was somewhat taken off guard.

They applied to the FDA for approval of the system in 2015, understanding that the approval process can take years.

But the human trials of the system went so well, the hybrid closed loop system was approved late last year.

Medtronic is making the systems as quickly as they can to fill the need.

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Artificial pancreas helping people with diabetes - FOX13 Memphis

May 18, 2017 by Robyn Mills Credit: CC0 Public Domain

Research led by the University of Adelaide is paving the way for safer and more effective drugs to treat type 2 diabetes, reducing side effects and the need for insulin injections.

Two studies, published in the Journal of Medicinal Chemistry and BBA-General Subjects, have shown for the first time how new potential anti-diabetic drugs interact with their target in the body at the molecular level.

These new potential drugs have a completely different action than the most commonly prescribed anti-diabetic, Metformin, which acts on the liver to reduce glucose production, and are potentially more efficient at reducing blood sugar. They target a protein receptor known as PPARgamma found in fat tissue throughout the body, either fully or partially activating it in order to lower blood sugar by increasing sensitivity to insulin and changing the metabolism of fat and sugar.

"Type two diabetes is characterised by resistance to insulin with subsequent high blood sugar which leads to serious disease. It is usually associated with poor lifestyle factors such as diet and lack of exercise," says lead researcher Dr John Bruning, with the University's School of Biological Sciences and Institute for Photonics and Advanced Sensing.

"Prevalence of type 2 diabetes in Australia alone has more than tripled since 1990, with an estimated cost of $6 billion a year. The development of safe and more efficient therapeutics is therefore becoming increasingly important.

"People with severe diabetes need to take insulin but having to inject this can be problematic, and it's difficult to get insulin levels just right. It's highly desirable for people to come off insulin injections and instead use oral therapeutics."

The first study, in collaboration with The Scripps Research Institute in Florida, US, describes an honours research project by Rebecca Frkic, where 14 different versions of a drug which partially activates PPARgamma were produced. Partial activation can have the benefit of fewer side-effects than full activation.

The original drug, INT131, is currently being tested in clinical trials in the US but some of the versions produced at the University of Adelaide have increased potency compared to the original, with the potential to further improve the treatment of type 2 diabetes.

"A major finding of this study was being able to show which regions of the drug are most important for interacting with the PPARgamma receptor," says Dr Bruning. "This means we now have the information to design modified drugs which will work even more efficiently."

The second study, in collaboration with Flinders University, used X-ray crystallography to demonstrate for the first time exactly how a potential new drug, rivoglitazone, binds with the PPARgamma receptor. Rivoglitazone fully activates PPARgamma but has less side effects than others with this mode of action.

"Showing how this compound interacts with its target is a key step towards being able to design new therapeutics with higher efficiencies and less side-effects," says lead author Dr Rajapaksha, from Flinders University School of Medicine (now at La Trobe University). "Lack of structural information was hampering determination of the precise mechanisms involved."

Explore further: Researchers investigating ways to improve type 2 diabetes treatments

More information: Harinda Rajapaksha et al. X-ray Crystal Structure of Rivoglitazone bound to PPAR and PPAR Subtype Selectivity of TZDs, Biochimica et Biophysica Acta (BBA) - General Subjects (2017). DOI: 10.1016/j.bbagen.2017.05.008

Rebecca L Frkic et al. Structure-Activity Relationship of 2,4-dichloro-N-(3,5-dichloro-4-(quinolin-3-yloxy)phenyl)benzenesulfonamide (INT131) Analogs for PPAR-Targeted Antidiabetics, Journal of Medicinal Chemistry (2017). DOI: 10.1021/acs.jmedchem.6b01727

A better understanding of how the transcription factor Peroxisome Proliferator-Activated Receptor Gamma (PPARgamma) works is critical to find new ways to improve medications to treat type 2 diabetes. Drugs that activate PPARgamma, ...

Preventing weight gain, obesity, and ultimately diabetes could be as simple as keeping a nuclear receptor from being activated in a small part of the brain, according to a new study by Yale School of Medicine researchers.

When the body's cells don't respond normally to insulina condition known as insulin resistanceblood glucose levels can increase, resulting in type 2 diabetes. Researchers have long known that insulin resistance is linked ...

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Research led by the University of Adelaide is paving the way for safer and more effective drugs to treat type 2 diabetes, reducing side effects and the need for insulin injections.

Type 2 diabetes, a prolific killer, is on a steep ascent. According to the World Health Organization, the incidence of the condition has grown dramatically from 108 million cases in 1980 to well over 400 million today. The ...

A widely used diabetes medication could help people with a common inherited form of autism, research shows.

Scientists from the Diabetes Research Institute (DRI) at the University of Miami Miller School of Medicine have produced the first clinical results demonstrating that pancreatic islet cells transplanted within a tissue-engineered ...

A potential cure for Type 1 diabetes looms on the horizon in San Antonio, and the novel approach would also allow Type 2 diabetics to stop insulin shots.

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