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Posts with tag PreventingDiabetesComplications

The specials tonight are fulminant and non- fulminant

A type 1 diabetic mystery is why do some Type 1s get complications and others seem to never get them? A massive Japanese study of Type 1 diabetics found that those with fulminant diabetes developed complications much faster and more severely than those with non-fulminant diabetes.

The difference between fulminant and non-fulminant is the speed and intensity at which the disease develops. Fulminant Type 1 diabetes typically develops suddenly with near total loss of beta cell function. This type of diabetes is confirmed with testing c-peptide levels. Non-fulminant type 1 diabetes has residual c-peptide levels that eventually taper to undetectable. Sometimes this is seen through many years of the Honeymoon Period.

This study may be the antithesis of conventional wisdom for preventing complications. Staking all hopes on blood sugar control is heavily optimistic. Yes controlling blood sugar does lessen the workload for existing beta cells, and thus extends the lifespan of each beta cell. Research suggests that c-peptide offers protection to beta cells, both from apoptosis (cell death) and encourages new cell growth. This new cell growth applies to beta cells and other cells of the body that endure long-term Type 1 diabetes complications.

Diabetics are instructed that maintaining normal blood sugars is the Holy Grail of preventing long-term complications. Yes and no. The truth is controlling your blood sugar will not allow complications of Type 1 diabetes to develop as quickly, presuming you still had some level of beta cell function upon diagnosis (i.e., c-peptide). That doesn't sound like a reward as much as it does a delayed punishment. I'd like c-peptide with my insulin, please. It's off the à la carte menu? That's fine - serve it up! I want to thank Klausen for bringing this study to my attention.

Why is hindsight 20/25 in diabetes?

Bev did a great job covering the study of obese mice having protection from elevated blood sugar due to a plethora of adiponectin. Adiponectin was shown to enhance insulin signaling which transported the excess glucose to less harmful areas of the body, rather than the cells which would endure diabetes complications. The results of this study created a condition called ratones mórbidamente obesos - which sounds better in Spanish because in English this means morbidly obese mice.

You know what they say about hindsight, right? A study from a year ago revealed some good news and some bad news. Good news first - turns out Type 2 diabetes drugs using troglitazone increased adiponectin. Rezulin was one of these drugs, but it was removed from the US market March 21, 2000. Now the bad news, the Type 2 diabetes drugs made with metformin were shown to reduce adiponectin. A few of the drugs that use metformin are Fortamet, Glucophage, Glucophage XR, and Riomet.

So why must diabetics be led with imperfect vision? Because the bottom line is researchers and doctors believe they are saving lives every day. Yes, they do. But there is a lot to behold when you tinker with His design. Remember the movie Malice? These lines don't make it into movies for nothing. Producers know human nature and they stretch it to the extreme. Whether or not you want to admit it - you know a few people with a complex like Alec Baldwins. Alec Baldwin says, "You ask me if I have a God complex. Let me tell you something: I am God". Click for the entire 1:30 scene, courtesy of YouTube.

New Immune Modulating Drugs

Just like a referee to normalize play throughout the game - DiaKine Therapeutics is developing ways to normalize the body's immune system.

The new drugs modulate cytokines, part of the body's immune system, which mistakenly attack normal organs and tissue and cause diseases such as: diabetes, multiple sclerosis and inflammatory bowel disease. Research by Dr. Nadler and his collaborators published in 2006 showed that controlling certain cytokines can arrest the progression of, or reverse, type 1 diabetes in an animal model.

The company's first product, IsletLifeLSF Media 1 is designed to improve the viability and insulin producing capabilities of harvested islet cells prior to transplant. This would potentially improve the success rate of the procedure. Additional therapeutics under development by DiaKine include: adjunct therapy to islet cell transplants, halting the progression of type 1 diabetes in newly diagnosed adults, treatment and prevention of Latent Autoimmune Diabetes of Adults (LADA), treatment and prevention of insulin requiring type 2 diabetic, treatment and prevention of diabetes complications.

It all sounds like good stuff in the works. Keep an eye on the progress and press releases of DiaKine, as well as their research partner - the Diabetes Research Institute. A lot is happening these days. What else have you seen or heard about in the autoimmune arena?

Reversal of fortune in the cost of diabetes complications

The Center for Disease Control announced that they will run a study to examine the cost-effectiveness of treatment interventions for type 2 diabetes. "People with diabetes are at considerable risk for heart disease, strokes and other serious health complications," said David Fleming, M.D. acting CDC director. "This study confirms that aggressive treatment interventions aimed at reducing the risks of cardiovascular disease increase life expectancy and, at the same time, may reduce lifetime health care costs," The footer of the Press Release where I got this story says:

CDC protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.

Here comes my spiel, so grab a seat. Remember that huge event back in 1993? I'm talking about the announcement of the DCCT study that proved tighter control reduces the complications of eye, kidney, and nerve diseases caused by type 1 diabetes. And 5 years later the UK reiterated these results for type 2 diabetes. The $2.5 billion question is (yes, diabetic complications cost the United States $2.5 billion in 2005): why are we still relying on an antiquated test that can only be administered every 3 or 6 months to tell us how well we are controlling our diabetes? If more accurate testing and earlier therapeutic intervention result in less diabetic complications - where is the holdup?

To those concerned at the CDC, in an effort to protect people's health and safety by preventing and controlling diseases and injuries why haven't we seen a new test that can monitor our overall diabetes control on a monthly basis, rather than waiting to test every 3 or 6 months? This would, in effect, allow tighter control, which has been proven to reduce the potential of diabetic complications. (Please note: the original issue of the sited press release was May, 2002). Just a thought - you could use that extra $2.5 billion for something else like promoting healthy living through strong partnerships with local, national, and international organizations.

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