Type 1 diabetes arises when the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. What triggers this autoimmune reaction isn't clear. But new research indicates that children of women who experience stressful adverse life events appear to be prone to develop type 1 diabetes.

Results of a Swedish study, involving nearly 6000 children and their families, shows that mothers' experience of divorce or violence raised the risk of diabetes-related autoimmunity in children at age 2.5 years by roughly threefold. The research is published in the current issue of the journal Diabetes Care.

The thinking is that kids become stressed too, raising their level of the stress hormone cortisol, which may lead to insulin resistance.

Summary of the study available here.

 According to new research on the elderly, diabetes may substantially raise the risk of falls among older adults living in nursing homes. The study findings are published in the September issue of the Journal of Gerontology.

In a study of 139 nursing home residents, researchers at Columbia University in New York found that men and women with diabetes were four times more likely than those without the disease to suffer a fall. Falls are a major cause of disability and death among the elderly.

In all, 78 percent of diabetic residents fell during the study period, compared with 30 percent of those without diabetes.

Summary of the study available here.

 Dietary supplements made of resistant starch can help improve the body's response to insulin. That is according to a new study published in the current issue of the American Journal of Clinical Nutrition.

Insulin resistance, or loss of insulin sensitivity, is a key phase in the development of diabetes. The condition is often referred to as "pre-diabetes." After taking the supplement daily for four weeks, healthy people showed up to a one-third increase in insulin sensitivity. Study participants tolerated the supplement well, the researchers say and they are now planning to test the supplement in diabetics.

Summary of the study available here.

  Current research is showing that gastric-bypass surgery for severe obesity, also referred to as bariatric surgery, is safe for older patients. A recent study from Columbia University's Center for Obesity Surgery in New York found that patients over the age of 60 got the same benefits from weight-loss surgery and had no worse postoperative complications than younger people who underwent the same surgery.

A similar study involving 27 gastric-bypass patients aged 65 and older who had surgery at the University of South Florida and the University of Miami showed the procedure produced good results and improved quality of life with about the same rate of mortality and complications as seniors who have heart-bypass and hip replacement surgery.

Quoted by the Associated Press, Dr. Michael Murr, a bariatric surgeon at the University of South Florida summed up the new research findings regarding the surgery: "We know it corrects the diabetes, it corrects the hypertension, it takes away the sleep apnea, it fixes the heartburn reflux, it makes their knees and joints last longer."

 An FDA advisory committee today recommended approval of the first inhaled form of insulin. The recommendation came despite questions about use of the drug in people who have lung disease or were exposed to secondhand smoke.

The committee offered no specific restrictions for Exubera, but FDA officials said smokers probably would not be able to use the drug. Their blood sugar could fall dangerously low with Exubera because they absorb much more inhaled insulin in their lungs than do nonsmokers.

 People with diabetes are always at risk for kidney damage, particularly when their blood pressure is high. European researchers have found that the addition of the drug spironolactone to standard blood pressure-lowering therapy for these patients helps lower both blood pressure and the amount of albumin protein in urine, a measure of kidney damage. Study finding are reported in the medical journal Diabetes Care.

Spironalactone was added to the anti-hypertensive medical regimen of study patient who were already taking two types of anti-hypertensive drugs. During spironolactone treatment, urinary albumin levels fell by 33 percent, and their upper and lower blood pressure readings fell by 6 and 4 points.

Reportedly, the treatment was well tolerated. Researchers say that further studies are indicated, but feel that, in the short term, spironolactone may offer beneficial kidney and cardiovascular protection.

Summary of the study available here.

 Members of the FDA's Endocrinologic and Metabolic Drugs Advisory Committee are in the process of questioning the makers of inhaled insulin on its effects on the lungs, and whether it is safe in the long-term for diabetics who use it.

During clinical drug trials, researchers found that inhaled insulin was generally as effective as insulin injections in controlling blood sugar levels. However, some patients who took inhaled insulin developed coughing and a small decrease in their breathing capacity.

The developers of the drug, Exubera, see it as a way to persuade diabetics who are reluctant to take injections to get the insulin they need. The inhaled form of insulin is being developed by Pfizer, Sanofi-Aventis and Nektar Therapeutics.

Tomorrow, the advisory committee will consider another Type 2 diabetes treatment, muraglitazar, developed by Bristol-Myers Squibb. Tablets would be sold under the trade name Pargluva and would control blood sugar levels.

According to Reuters, if Exubera is approved, Pfizer intends to launch a patient-monitoring program to assess the product's safety after it is available for use.

 An editorial in the current issue of the British Medical Journal proposes that cardiovascular disease in women is under-diagnosed and under-treated compared to cases in men.
 
Factors leading to that situation include the fact that, for many women, the biggest fear is that of breast cancer and they are unaware that coronary heart disease is actually the major health threat for women. Additionally, women account for only 30 percent of participants in most research studies and medical trials in cardiology, and healthcare professionals seem insufficiently aware of cardiovascular disease in women.

Women with diabetes have 2.6 times the risk of dying of coronary heart disease than women without diabetes compared to a 1.8-fold rise in the risk among men. Women often do not present with the classic symptoms of cardiac problems and instead complain of back pain, burning in the chest, abdominal discomfort, nausea and fatigue—symptoms which are often attributed to non-cardiac causes.

Excerps of editorial available here.

In a review of records for 15,440 patients who had undergone coronary artery bypass grafting (CABG), researchers found that women are nearly twice as likely as men to die from complications of the surgery. In general, the study found, female patients who had CABG were older and more likely than men to have other medical problems such as diabetes and advanced heart failure. The research was published in the current issue of the journal Circulation.

Women’s typically smaller body size may be one of the reasons for the difference in survival rates. Researchers found that patients with a relatively smaller "body surface area" were at greater risk of dying from heart bypass surgery, and in general, women have smaller bodies than men. Body surface area is an indication of the size of a person's coronary arteries, and smaller vessels can make the surgery technically more difficult, researchers said.

The study involved patients who underwent CABG at one of 31 hospitals in the Midwestern U.S. in 1999 and 2000. Overall, women were 90 percent more likely than men to die during or soon after surgery.

 The FDA has approved Japanese pharmaceutical company Takeda Pharmaceutical’s new drug for diabetes treatment. Takeda will selling it in October, the company said in a press release today.

The product, Actoplus Met, is a single tablet that combines Takeda's two existing diabetes drugs, Actos and Metformin.  Actos is used to improve insulin resistance and Metformin is used to control the level of glucose produced by the liver.

The American Diabetes Association and European Association for the Study of Diabetes released a joint statement today questioning the existence of metabolic syndrome, a group of risk factors that is considered a predictor of cardiovascular disease. The two organizations said the syndrome was poorly defined, inconsistently used and in need of further research.

According to research which will be published in the September issue of Diabetes Care and Diabetologia, and which was cited in the organizations’ statement, healthcare providers should refrain from diagnosing people with the syndrome, or treat it as a separate condition, until the science behind it is clear.

The strongly worded warning could prove to be a setback for drug maker Sanofi, which hopes to position its anti-obesity drug Acomplia as a medicine to treat metabolic syndrome, because it also helps with risk factors such as lipid levels.

 Eating as little as five ounces of fish per week may reduce the risk of having a heart attack and other "acute coronary syndrome" (ACS) events such as heart-related chest pain, also called angina.

Researechers in Greece at Harokopio University, Athens analyzed fish consumption among 848 patients who had experienced an ACS and 1078 similar subjects who had not.

Fish consumption was associated with a 38 percent reduced risk of ACS. Additionally, fish consumption was tied to an 11 percent reduced risk of developing ACS among smokers and a 24 percent reduced risk among diabetics, two groups with high risks of heart disease. The benefit was only seen when no more than 150 grams (about 5 ounces) of fish was consumed each week.

The results are published in the International Journal of Cardiology. Summary of the article available here.

People who suffer a heart attack, or have severe coronary heart disease, often also have diabetes. However, in these patients diabetes often goes unrecognized--and untreated. That is according to new research published in the American Journal of Cardiology.

Researchers found that the majority of patients who present to emergency rooms with a heart attack, or heart-related chest pain, have impaired glucose metabolism. However, in most cases no testing is done to uncover the condition.

Among 1,199 heart patients who were treated at two hospitals in Kansas City, Missouri, 57 percent had abnormal glucose levels. Of these, 27 percent had known diabetes. Among the remaining patients, 14 percent had new-onset diabetes, based on their fasting blood glucose level. However, two-thirds of those who met criteria for new diabetes were not diagnosed or treated as such by the physicians who managed them.

Summary of the article available here.

 Diabetic autonomic neuropathy is a common and serious complication of diabetes.  The condition affects the nerves that control the heart, regulate blood pressure, and control blood glucose levels. It also affects other internal organs, causing problems with digestion, respiratory function, urination, sexual response, and vision. There are few effective treatments, mainly because scientist don’t clearly understand the root cause of the problem.

Now, European researchers have found that autoantibodies that attack the body's own nerve cells are associated with the subsequent development of autonomic neuropathy in diabetic patients, particularly those with Type 1 diabetes.

Their findings are published in the current issue of Diabetes Care. Summary of the article available here.

 Eli Lilly announced today that one of its experimental drugs has proven to be effective against diabetic retinopathy, a vision-endangering complication of diabetes. The drug, however, failed in late-stage trials against diabetic retinopathy, or nerve damage, caused by diabetes.

According to Lilly, the drug, ruboxistaurin, reduced vision loss in a trial among patients with diabetic retinopathy, a condition in which chronic high blood-sugar levels causes progressive damage to tiny blood vessels in the eye. That damage often leads to bleeding.

Lilly plans to seek FDA approval of the drug to treat the condition later this year. Reportedly, no significant safety issues were tied to the medication in the trials. If successful, the company will market the drug under the brand name Arxxant.

The drug would be the first orally administered medicine for diabetic retinopathy, which is sometimes treated by laser surgery to seal the leaking blood vessels and prevent permanent damage to the retina.