The incidence of cardiovascular diseases in Sweden has decreased sharply since the late 1990s. These are the findings of a study from Sahlgrenska Academy which included almost three million adult Swedes. In relative terms, the biggest winners are persons with type 1 and type 2 diabetes.

"This is a huge improvement and a testament to the improvements in diabetes and cardiovascular care throughout Sweden," says Aidin Rawshani, medical doctor and doctoral student in molecular and clinical medicine.

The study, which was published in The New England Journal of Medicine, shows that the incidence of cardiovascular diseases and deaths among individuals with diabetes in Sweden dropped significantly between 1998 and 2014. The population in general exhibited the same trend, albeit to a smaller extent.

Among persons with type 1 diabetes, with an average age of 35 years, the incidence pf cardiovascular disease was reduced by 40 per cent during the period in question. In the control group of persons of similar age but without diabetes, the decrease was 10 per cent.

Among individuals with type 2 diabetes, with an average age of 65 years, the incidence of cardiovascular disease decreased by 50 per cent. Among control persons of similar age without diabetes, the decrease was 30 per cent.

Surprising results

"We were surprised by the results, specially for persons with diabetes. Some smaller studies in the past have indicated that numbers were improving, but nothing of this magnitude," says Aidin Rawshani.

In total, approximately 2.96 million individuals were studied, of which 37,000 had type 1 diabetes and 460,000 had type 2 diabetes. The results of the study are based on linked processing of data from the National Diabetes Register, the Cause of Death Register and the part of the Patient register that concerns inpatient care.

In addition to matching by age and gender, the groups that were compared were also matched geographically using register data from LISA (the longitudinal integration database for health insurance and labour market studies).

The deaths that took place in the groups during the study period were almost exclusively related to cardiovascular disease. Individuals with diabetes have previously shown to suffer a risk of cardiovascular disease and early death that was between two and five times as high as in the general population.

Better risk control

"One of the main findings of the study is that both deaths and the incidence of cardiovascular disease is decreasing in the population, both in matching control groups and among persons with type 1 and type 2 diabetes. One paradoxical finding is that individuals with type 2 diabetes have seen a smaller improvement over time regarding deaths compared to the controls, while persons with type 1 diabetes have made an equal improvement to the controls," notes Aidin Rawshani.

The positive trends that have been observed in the study are most likely due to an increased use of preventative cardiovascular medicines, advances in the revascularisation of atherosclerotic disease and improved use of instruments for continual blood sugar monitoring, and the fact that Swedish diabetes care has generally worked well with good treatment guidelines and quality assurance efforts.

"Out study and analysis does not include explanations of these trends, but we believe that it is a matter of better control of risk factors, better education patients, better integrated treatment systems for individuals with chronic illnesses and individual care for persons with diabetes. There is often an entire team working with a patient, ensuring that their needs are met," says Aidin Rawshani.

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Materials provided by University of Gothenburg. Note: Content may be edited for style and length.

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Decrease in cardiovascular diseases benefits persons with diabetes ... - Science Daily

CHICAGO Edwin Velarde is tackling his Type 1 diabetes with what he's calling an "epic" bike challenge that begins in Chicago next month.

Velarde, a former Chicago resident who now lives in Oak Park, Calif., will pedal his bike from the Adler Planetarium to Atlanta a journey of about 800 miles from May 30-June 8. He's raising money for the American Diabetes Association.

"I will do all I can during this ride to promote healthy lifestyles and inspire others to take control of their wellness," said Velarde.

He said he's excited to meet "people along the way and able to talk about diabetes, and how I manage my condition.

"Thats exciting as I hope there are possibilities of inspiring others," he said. "I change one life, it makes it worth the effort through all this."

Edwin Velarde

Velarde was diagnosed with diabetes when he was 29. He said he struggled with high blood glucose until a friend gave him a bike a few years ago. Since then, he's avoided thousands of insulin injections and kept his blood glucose levels stable.

His route will take him through Terre Haute, Ind., Evansville, Ind., Nashville and Chattanooga, Tenn. before arriving in Atlanta. He also posted information about his ride to The Chainlink site hoping for guidance on the safest routes from Chicago.

The Centers for Disease Control and Prevention considers the area the "Diabetes Belt" of America because 11.7 percent of the people within it have diagnosed diabetes, compared to 8.5 percent outside the belt.

Velarde will arrive in Chicago a few days early to train on the Lakefront Trail and near his former home in North Park.

"I am doing this ride to give back by raising awareness about diabetes and modest funds for the American Diabetes Association," he said. "I am hoping to meet other cyclists around the places I pass through. Theres this bond I think among cyclists and would like to expand my circle. Maybe they can spread the word also about what Im trying to do, maybe even ride with me parts of my epic journey."

For more information on Velarde's challenge, click here.

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800-Mile Ride Through 'Diabetes Belt' Takes Cyclist From Chicago To Atlanta - DNAinfo

Diabetes continues to be a growing problem among our nations children. Did you know that every year there are more than 25,000 children diagnosed with diabetes?

To begin with there are two different types of childhood diabetes, type 1 and type 2; and while both cause an elevated blood sugar, they also differ in many ways.

Type 1 diabetes was formerly called juvenile onset diabetes and is typically diagnosed in children and adolescents. Only 5 percent of those with diabetes have type 1. Many parents worry that their child may develop diabetes because they eat too much sugar. While eating sugar is not good for you, it does not directly cause type 1 diabetes.

Type 1 diabetes is an autoimmune disease in which the immune system attacks and destroys the beta cells (insulin producing cells) of the pancreas. Scientists are not exactly sure why this occurs, but it seems to be a combination of genetic and environmental factors, and actually has nothing to do with diet.

Type 1 diabetes comes on suddenly and causes dependence on insulin for the rest of the childs life. The symptoms of type 1 diabetes usually include extreme thirst, frequent urination (day and night), increased appetite and sudden weight loss. Children who develop type 1 diabetes appear tired, thin and sick. To many parents who worry that their child is diabetic, I tell them that they really cannot miss the symptoms and that just drinking a lot of water will not be the only symptom.

Fortunately, the ways in which insulin is given continues to improve and most children now use an insulin pump, which delivers insulin in a more consistent manner than in previous years. But, even with new insulin delivery systems and the hopes for pancreas transplants, type 1diabetes is challenging for a family to manage.

Type 2 diabetes, which was previously called non-insulin dependent diabetes, differs in that it was previously typically diagnosed in adults, but it is now rising in children. In type 2 diabetes, the body isnt able to use insulin in the right way and the glucose in the blood stream is less able to enter the cells. This is called insulin resistance. So, the pancreas tries to produce even more insulin to keep blood sugar levels normal. Over many years the pancreas may wear out completely. Type 2 diabetes is sometimes controlled with an oral medication rather than insulin.

Type 2 diabetes seems to develop more frequently in those children who are overweight, less active and often have a parent with diabetes. As more children in this country have developed obesity, the number of cases of type 2 diabetes has also continued to rise. In many cases, if a child changes their lifestyle, eating a healthy diet, losing weight and exercising, the body may be able to restore normal insulin balance. In this way, type 2 diabetes differs from type 1 diabetes.

If you are concerned that your child is showing any signs of diabetes, make sure to consult your doctor. Continue to promote healthy eating habits and daily exercise.

Sue Hubbard, M.D. /The Kids Doctor; the kidsdr.com

Original post:
The Kid's Doctor: Why is childhood diabetes on the rise? - Chicago Sun-Times

(Sen. Yvanna Cancela speaks with Majority Leader Aaron Ford and diabetes patients.Courtesy Yvanna Cancela) The state of Nevada is taking a new approach to tackling the rising price of prescription drugs with a new bill.

The bill, introduced in March by state Senator Yvanna Cancela, has already faced opposition from lobbyists and nonprofit patient groups that disagree with the bill's approach to reining in prescription drug spending.

Nevada is one of 23 states with proposed legislation to take on the rising cost of prescription drugs. But unlike others that focus on drug prices in a general sense, Cancela's bill focuseson two specificgroups of drugs that are used to treat diabetes: insulin and biguanides.

It's the latest milestone in government actions at the local, state, and national levels that attempt to change the way wespend money on prescription drugs.

Diabetes is a group of conditions in which the body can't properly regulate blood sugar that affects roughly 30 million people in the US. And for many people living with diabetes including the1.25 million people in the US who have Type-1 diabetes injecting insulin is part of the daily routine.

insulin prices humalog novolog V2

(The list price of Humalog and Novolog, two short-acting insulins, over 20 years. The list prices don't factor in any rebates or discounts the drugmaker pays out.Andy Kiersz/Business Insider) Insulin, a hormone thathealthy bodies produce, has been used to treat diabetes for almost a century, though it's gone through some modifications. In the past few years, the list price of insulin has increased routinely.

The list price of the most commonly used insulins have increased roughly 300% over the last decade. Technically, there's no "generic" insulin, though a cheaper version of a long-acting insulin did come on the market in 2016. There are cheaper medications forbiguanides, such as metformin, which are used to treat Type-2 diabetes.

Before becoming a state senator, Cancela workedas a director for the Culinary Workers Union in Las Vegas, which represents about 60,000 workers. The union pays for its members health insurance through a self-funded trust, which Cancela told Business Insider gave the organization a lot of access to details about how its health funds were being spent. One of the drugs she noticed was becoming a problem for members was insulin.

There are roughly 281,000 adultsliving in Nevada, or 12% of the total population, that have one of the two types of diabetes, with another 39% in the prediabetes stage, in which blood glucose levels are elevated but not to the point of type-2 diabetes. Because diabetes is one of the biggest medical problems in Nevada, Cancela said, it made for a perfect starting point to introduce legislation.

The Nevada bill, known as SB265, takes four mainapproaches to confronting the drugmakers that make insulin and biguanides to treat diabetes.

Like most legislation that tries to rein in prescription drug spending, SB265 is facing its fair share of pushback and criticism.

Cancela said there's been around 70 lobbyists who have come in for the session to oppose the bill, which is more than double the number present for Nevada's 2015 session,according to The Nevada Independent. There's also been a number of patient groups that have spoken out as well, including those representing people with lupus and epilepsy.

"Proposed legislation in the Nevada State Senate unfairly targets people with diabetes, would be a major windfall for health insurance companies, and leaves patients wondering whos next," Lupus of Nevada said in a Facebook post. "Were specifically worried that Nevadans with Lupus could be singled out."

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(A Type 1 diabetes patient holds up bottles of insulin.Reuters/Lucy Nicholson) Nine pharmaceutical companies submitted lettersin opposition to the bill, as well as pharma's lobbying group PhRMA and biotech's lobbying group BIO. Many brought up their opposition to disclosingmore information about how they set their prices.

A letter from Novo Nordisk a company that manufactures insulin and other diabetes medications argued that the bill doesn't take into account the rebates drug companies pay out to middlemen. That issue was raised in a number of the letters opposing the bill.

"This proposal would impose significant new, complex and punitive requirements on drug manufacturers when manufacturers already provide competitive discounts to payers and represent only a single component of the enormously complex US drug pricing and distribution system," the company said in the letter. "This complexity, which the proposed legislation fails to address, has resulted in confusion around what patients pay for medicines."

To be sure, there's more to the story than just the list price a manufacturer sets. Along the way, there are as many as five companies that have a stake in the price of a medication. But there's a lack of transparency about the portion each player gets. To counter that, some drug companies have started disclosing their net prices, or the amount it actually receives in return for the drug after factoring in any rebates or discounts paid out to middlemen.

Sanofi noted in its opposition letter that its net price for Lantus, a long-acting form of insulin, fell over five years.

Sanofi said in a statement to Business Insider:

"Sanofi believes this legislation will fail to achieve its intended purpose and may actually restrict patients access to important medications. As a company founded on and committed to science and improving health, we understand that affordability and access to our products is critical for patients and society, and we are committed to working with all stakeholders to ensure patients have affordable access to the treatments they need in a system that is sustainable and continues to promote ongoing investments in science and innovation."

Others, like Ken Thorpe, the chairman of the Partnership to Fight Chronic Disease (a group that partners witha number of healthcare companies and patient organizations) and a health policy professor at Emory University, criticizedthe idea that the bill is a way to help those living with diabetes. He argued in a piece in the Nevada Appeal that the price capswon't keep people from getting diabetes.

"If they're really trying to get the cost of healthcare to grow at a slower rate, this is not the way," he told the Appeal. Instead, he said, there should be more of a focus on preventing diabetes.

Cancela said that's something she's working on as well, calling SB265 "one piece of the puzzle." She has another piece of legislation that would promote urban agriculture to increase access to healthy foods in low income communities.

The bill is still with the Health and Human Services committee, meaning it needs to clear the Assembly and Senate before it makes its way to the governor.

But of course, drug price bills have failed in the past. In November 2016, Californians voted against a proposition that would've capped prescription drug prices at what the Department ofVeterans Affairs pays for them.

Cancela understands that it's not going to be an easy ride.

"We're trying to do something that's never been done before," Cancela said.

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One in 7 people in Nevada are living with diabetes, and the state is now pushing a new approach to tackle the cost ... - Yahoo Finance

Posted: 4:20 p.m. Monday, April 24, 2017

Years of testing remain, but UT Health San Antonio researchers say theyve cured Type 1 diabetes in mice.

In peer-reviewed paper, they say a gene transfer can wake up cells in the pancreas to produce insulin.

Health researchers at the University of Texas think they have found a way to trick the body into curing Type 1 diabetes.

The immune system of a person with diabetes kills off useful beta cells, but the UT researchers say they have found a way to make other cells in the pancreas perform the necessary work. Their approach, announced earlier this month in the academic journal Current Pharmaceutical Biotechnology, not only would have implications for Type 1, formerly called juvenile diabetes, but also could help treat the far more common Type 2 variety, also known as adult-onset diabetes.

The researchers have cured mice, which are genetically similar to people but different enough that new rounds of animal testing and millions of dollars more are needed before human trials can begin. The researchers approach is sure to garner skeptics, at least in part because it is a significant departure from the many other attempts at curing diabetes, which typically involve transplanting new cells and/or suppressing the immune systems attempts to kill off useful ones.

By contrast, were taking a cell that is already present in the body its there, and its happy and programming it to secrete insulin, without changing it otherwise, said Ralph DeFronzo, chief of the diabetes research at the UT Health Science Center at San Antonio.

Diabetes is a disease characterized by a persons inability to process carbohydrates, a condition that if untreated can lead to often-catastrophic health consequences: lethargy, diminished eyesight, heart attacks, strokes, blindness and a loss of circulation in the feet that could lead to amputation. The Centers for Disease Control and Prevention estimate that in 2014, about 29 million Americans almost 1 in 10 had diabetes.

The core problem is insulin. Most people naturally secrete that substance when they eat something with carbohydrates, such as bread, potatoes and candy bars. Insulin acts like a concierge that escorts the sugar from the bloodstream into the cells, providing the cells with the energy to function. In most people, the body is continually monitoring blood sugar and producing insulin as needed.

In Type 2 diabetes which makes up 9 out of 10 diabetes cases and is generally associated with older people and weight gain the cells reject the insulin, causing sugar to build up in the bloodstream even as cells are starved for energy. Type 2 is often treated with pills that tell the cells to let in the insulin. But in Type 2 diabetes, the body also often gradually loses the ability to produce insulin, requiring insulin injections.

In Type 1 the type the researchers studied the body has simply stopped producing insulin. This type often manifests in children, though it can sometimes develop in adults as well.

The reason the body stops producing insulin is that it kills off the pancreas beta cells, which produce insulin. People with Type 1 diabetes must get their insulin from injections or occasionally inhalation, a cumbersome and often imprecise task. Too little insulin and blood sugar levels stay high for extended periods, potentially damaging the body; too much and blood sugar levels crash, possibly causing a person with diabetes to faint or experience an even worse problems, such as a stroke.

DeFronzos partner, Bruno Doiron, decided to see whether the body could reliably produce insulin without transplanting new cells. He used a gene transfer technique on mice, delivered via a virus, that activated insulin production in cells already in the pancreas for instance, those that produced certain enzymes.

Were not fundamentally changing the cell, DeFronzo said. Were just giving it one additional task.

The mice immune systems did not attack the new insulin-producing cells. Most important, according to the findings: The cells produced the right amount of insulin: not so much that they sent a mouse into a blood sugar free fall, not so little that blood sugar levels stayed high. The mice have shown no sign of diabetes for more than a year, according to the findings.

Quite a bit of work remains before testing will start on people. If they can raise enough money they estimate $5 million to $10 million they can proceed to testing on larger animals, such as pigs, dogs or primates, a next step that would be planned in conjunction with the U.S. Food and Drug Administration.

They hope to start human trials in three years.

DeFronzo and Doiron said they expect skepticism but said much of it will be driven by how unconventional their work is. Doiron added that, although the technique is unconventional in the context of diabetes, using a virus to deliver a gene transfer is an established technique, having been approved dozens of times by the FDA to treat diseases.

We can use the cells the body has naturally, Doiron said. This will simply wake up the cells to produce insulin.

Type 1 and Type 2 diabetes

The work of Bruno Doiron and Ralph DeFronzo focuses on Type 1 diabetes, not Type 2.

Both diseases involve a problem with insulin, the substance that healthy bodies produce to take sugar from the bloodstream into the cells and power the body.

Type 2 is far more common. The main issue is that the cells reject insulin, causing sugar to build up in the bloodstream. The common treatment is a pill that makes the cells accept the insulin (and sugar it carries into the cell). But over time, people with Type 2 diabetes often lose the ability to produce insulin.

With Type 1 diabetes, people simply stop producing insulin. Their bodies kill off the cells in the pancreas that produce it.

Those with Type 1 diabetes must inject or ingest insulin. People with Type 2 often grow increasingly dependent on insulin injections, though Type 2 can sometimes be cured or controlled through diet and exercise.

Original post:
Texas scientists closer to diabetes cure with unconventional treatment - MyStatesman.com

Research has shown that people diagnosed with prediabetes can make lifestyle changes to reduce their chances of developing Type 2 diabetes. To help those at risk, YMCA Buffalo Niagara next week will start its next session of the National Diabetes Prevention Program at four of its branches.

Weve seen great results with the Diabetes Prevention Program," said Kelly Standage, association director of membership and wellness programs for the regional Y. Most participants have decreased their risk and met their weight loss goals, while developing behaviors necessary to maintain their health.

The 12-month program starts with 16 weekly, one-hour sessions covering nutrition, exercise, and behavior modification. Participants then meet monthly for continued support and instruction.

[RELATED STORY: Gradual changes in diet, activity can help reduce risk of diabetes]

The program is being offered at the following YMCA branches:

Independent Health Family Branch YMCA: 7 p.m. Mondays, 150 Tech Drive, Amherst.

Ken-Ton Family YMCA: 9:30 a.m. Saturdays, starting May 6, 535 Belmont Ave., Town of Tonawanda.

Southtowns Family YMCA: 7 p.m. Tuesdays and 11:30 a.m. Saturdays, starting May 6, 1620 Southwestern Blvd., West Seneca.

William-Emslie Family YMCA: 5:30 p.m. Tuesdays, starting May 9, 585 William St.

To qualify for the program, registrants must be at high risk for developing Type 2 diabetes. A physicians referral is preferred, but not mandatory for participation. Fees are covered in full for most participants with BlueCross BlueShield of WNY. Independent Health members are required to pay a $50 registration fee. Grants are available for eligible participants whose insurance does not cover the program.

For more information or to register, stop at your local YMCA branch, call 565-6000, or visit ymcabn.org.

email: refresh@buffnews.com

Twitter: @BNrefresh

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YMCA Buffalo Niagara to launch new diabetes prevention programs - Buffalo News