When blood sugar is falling, the stopper built into the body is the release of glucagon from the alpha cells of the pancreas which stimulates the release of glucose from the liver (but only if your adrenaline is flowing). However, when hypoglycemia is due to injected insulin - the stopper isn't entirely in place. Scientists explain how epinephrine (adrenaline) plays a major role in regulating glucose in times of low blood sugar and how this response could be adversely affected by the use of beta-blockers.

During insulin-induced hypoglycemia in dogs, the roles of adrenaline and glucagon were evaluated. The dogs fasted overnight to remove excess glucose from the blood. The dogs also had their adrenal glands removed. The adrenal glands are the source of adrenaline. Adrenaline is released into the bloodstream in response to physical or mental stress,to initiate the stimulation of glucose, among many other functions. Adrenaline and insulin were released at two different rates: a basal rate or a variable rate to simulate an adrenaline response. When the blood sugar fell to 42 mg/dL, the dogs in the basal rate group failed to release glucagon, but the simulated adrenaline response group increased normally. The liver response to releasing glucose fell in the basal group but increased in the simulated adrenaline response group. The researchers conclude that adrenaline must be responsible for this critical response to insulin-induced hypoglycemia.

Beta blockers are a common class of prescription drugs that counteract the stimulatory effects of adrenaline. Diabetics who inject insulin and take beta-blockers should be extra cautious of hypoglycemia. Hypoglycemic unawareness is already established for diabetics injecting GM insulin (genetically modified human insulin). Given the side effects of beta blockers, there is greater reason to be more aware of hypoglycemis unawareness -- yes, oxymoron. Those individuals who are on the brink of diabetes should avoid beta-blockers at all costs, according to a study in The Lancet (January 2007) beta-blockers used for hypertension increase a patient's risk of developing diabetes.

Mad Money is a stock show on CNBC hosted by Jim Cramer - a well-known iron fist on Wall Street. He has a following of stock enthusiasts who regard his recommendations (buy or sell) as gospel. Why is he so good at what he does? He just wants to help you make money.

And to this end -- the reason I bring Cramer's passionate drive to The Diabetes Blog is simple: last week he called Novo Nordisk as a SELL. Cramer said he's beginning to worry about a backlash on drug stocks. He advised that viewers should not be greedy and should take gains in Novo Nordisk (NVO).

Perhaps the NY Times article raised some eyebrows at Big Pharma. It appears doctors are receiving handsome gifts and stipends for handing out samples of drugs that were not all that safe for most patients. The payments give physicians an incentive to prescribe the medicines at levels that might increase patients' risks of heart attacks or strokes. In light of this blood curdling synopsis Novo got a dishonorable mention. Novo Nordisk professes to operate their company in two parts: biopharmaceuticals and Diabetes Care. The Diabetes Care segment provides insulin analogues, human insulin and insulin-related products, and oral antidiabetic drugs.

The cross examination of the C-peptide disappearing act and mysterious insulin auto-antibodies appearing where they shouldn't is just getting started. Thanks for making them sweat, Cramer!

Novocell is the first company to use polyethylene glycol (PEG) to encapsulate clusters of insulin-producing cells. This biocompatible substance allows glucose and insulin to pass freely through the coating while preventing the body's immune system from destroying the islets.

The encapsulated islets release human insulin through natural mechanisms in response to the recipient's blood glucose. The islet cells used in this study are isolated from human cadavers. The implant procedure is performed under local anesthesia and the encapsulated islets are injected into a surgically formed micropocket in the subcutaneous tissues of the thigh or lower abdomen of the recipient. The patients received temporary low dose cyclosporine (50-100 ng/ml 12hr trough) and did not receive any other form of immunosuppression.

At the American Diabetes Association 66th Annual Scientific Session in June -- Novocell announced the progress of the study. No adverse events had occurred -- no news is good news. In addition, the company also has the fortune of existing in California - where they can prosper on further stem cell research. Novocell has developed a process that efficiently converts human embryonic stem cells into insulin-producing cells. Novocell believes this study will demonstrate the safety and efficacy of the encapsulation technology that can be used with the unlimited source of insulin-producing cells developed from stem cells to treat patients with diabetes.

The journal Diabetes Care reports obese adults who lost a substantial amount of weight through lifestyle modification and dieting regained less weight when they took the diet drug Xenical, This approach was also associated with a reduced occurrence of type 2 diabetes.

Xenical burns fat while you are eating by inhibiting the absorption of dietary fat from your food. Studies have shown that the drug promotes more weight loss than lifestyle modification alone. The study examined the effectst of Xenical in preventing weight regain in 383 obese adults who had lost an average of 31.7 pounds (14.4 kg) on an 8-week protein-rich, very-low-energy diet. The 309 participants who lost 5% or more of their bodyweight then received lifestyle counseling for 3 years while taking either Xenical or a placebo pill daily. Both groups regained some weight. Xenical patients regained an average of 10 pounds, while placebo patients put back an average of 15 pounds.

Most importantly, during the 3-year study period only 8 of 153 in the Xenical group developed type 2 diabetes compared with 17 of 156 in the placebo group. That's remarkable. Twice as many people were diagnosed with type 2 diabetes, in addition to regaining one and a half times the weight. As an aside (and not to be a whistleblower) but one of the warnings on the label says the drug should not be taken for more than 2 years. Just an FYI.