New research finds tuberculosis (TB) is more difficult to treat if the patient has type 2 diabetes. The study examined 737 Indonesians with tuberculosis screened for type 2. Nearly 15 percent had type 2, and initially, their TB was as severe as the non-diabetics. After two months of treatment, TB sputum tests were positive 18.1 percent for those with type 2 and only 10 percent in non-diabetics. At the six month mark, 22.2 percent of type 2s had positive sputum results compared to 9.5 percent of the non-diabetics.

The story in Reuters does not address why people with TB and type 2 diabetes do not respond as well to TB treatment. Tuberculosis is a serious infectious disease. Over one-third of the world carries the TB bacterium, and one in ten latent infections will progress to active TB disease. Untreated, active TB is a real threat, it kills more than half of its victims. Experts are examining how rising rates of type 2 are impacting TB control and prevention worldwide.

I just finished reading an excellent book about Dr. Paul Farmer's inspirational work treating tuberculosis in impoverished communities worldwide -- Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World -- masterfully written by Tracy Kidder. I wonder what Dr. Farmer has to say about people with type 2 and TB.

Previous studies have examined visual impairments of Caucasians with type 1 diabetes, but this is the first study analyzing vision loss for African Americans with type 1.

The vision and associated risk factors of approximately 500 African Americans with type 1 were studied over a 6-year period. At follow-up, 4.3 percent of patients realized vision loss in their better eye (visual acuity of 20/40 or worse) and 0.6 percent became blind in their better eye (visual acuity of 20/200 or worse). Nearly 10 percent lost 15 or more letters on the eye chart due to a doubling of the visual angle in their better eye. Another 13.5 percent had this doubling in either eye, which the researchers stated was "particularly high".

Independent predictors of vision loss over the six years were identified as poor blood sugar control, older age, high protein levels in the urine (symptomatic of kidney disease) and diabetic retinopathy, a common degeneration of the retina seen in people with diabetes.

Shhh. Big Pharma scientists hard at work. On what, you ask? Why, on Novo's new "baby" - a drug designed to treat type 2 diabetes. Liraglutide, a hormone analogue, is supposed to improve blood sugar control. It's also supposed to get you that coveted magic bullet (a la Byetta): weight loss. Ooh, baby. Now that's medication!

Novo Nordisk has been working on Liraglutide for a while now. Here's the latest: Novo announced Monday that two Phase III studies were successful in demonstrating the aforementioned blood sugar control and weight reduction. Novo is riding high on the news: its shares rose six percent on the announcement. According to a pharmaceutical industry analyst quoted by Reuters, the shares surged so healthily because the positive news was expected.

The powers-that-be at the drug giant say they hope Liraglutide can be submitted for regulatory approval by mid-2008. They hope it will become another blockbuster, with estimated annual sales topping one billion. Stay tuned.

Japanese researchers published an interesting case in the Journal of Neurology, Neurosurgery and Psychiatry. The case involved a wheelchair-bound 57-year-old man with serious diabetic neuropathy. The patient had type 2 diabetes for 10 years, and experienced pain and progressive loss of muscle and strength in both legs. He also lost a lot of weight.

Researchers at Nagoya University School of Medicine treated this gentleman with intravenous immune globulin (IVIg) for 5 days. The patient initially realized marked improvements in pain and muscle weakness, but the pain crept up again over the following three weeks. A repeat course of IVIg infusions reduced the pain once again. For a man who could not previously stand, he can now walk with a cane. Dr. Gen Sobue stated IVIg therapy can treat some diabetic patients with nerve damage whose pain can be ameliorated. I wonder how the patient will respond long-term.

Intravenous immune globulin is currently used for a variety of FDA-approved indications, as well as many off-label conditions such as chronic inflammatory demyelinating polyneuropathies and multifocal motor neuropathy. I don't know, but is IVIg a potential new therapy for certain diabetics with nerve damage? Read more in Reuters.

Menopause. It stinks. Usually the word evokes a passionate spouting of menopausal war stories. The hot flashes, the weight gain, the realization you have to twist your neck around to see life's halfway mark. Although here is a comical list of menopause positives!

Menopause also has other serious side effects such as high blood pressure, insulin resistance (a risk for type 2 diabetes) and loss of memory. You mean my mommy fog may get worse? Researchers are looking at the powers of polyphenols (plant estrogens) as a post-menopausal therapy. Polyphenols are found in grapes, soy and kudzu. Estrogen-depleted rats given kudzu root extract realized reduced blood pressure. Kudzu also lowered blood sugar, insulin levels and leptin, a fat hormone.

Dr. J. Michael Wyss, a physiologist at the University of Alabama at Birmingham, stated kudzu has estrogen-like elements, and soy-based botanicals sold in health food stores contain lots of kudzu. My mom swears by soy supplements for hot flashes. The isoflavones in soy possess weak estrogen-like effects. The Mayo Clinic recommends breast cancer survivors talk to their doctor before taking a soy supplement. Getting back to those post-menopausal rats, grape seed also protected against high blood pressure. Now Dr. Wyss and his team is studying the effects of adding polyphenols to traditional treatments for diabetes and high cholesterol. Read more in Reuters.

I was intrigued by a recent Swedish study reporting that people on a so-called "Stone Age" diet had more stable blood sugar levels than those on a Mediterranean diet. An intriguing claim, because it's so often said that Mediterranean-style eating is super-healthful. Let's also admit it is a delicious way to eat: yes, pasta and bread is there, but it's balanced out by tons of fresh fruits, vegetables, fish and olive oil. The Stone Age way is a bit more spare: we're talkin' meat, fish, and lots of whole grains, berries and nuts. Nary a sliver of Parmesan in sight.

However, the results of yet another study, this time from Australia, indicates Mediterranean-style eating is a good choice, especially for diabetics. Researchers from the University of Melbourne say Mediterranean-born immigrants in Australia are less likely to die from heart disease than other Australians. The researchers have concluded it's all down to dietary patterns. More than forty thousand people participated in the study over a period of ten years. The numbers revealed those who ate the most Mediterranean-style foods had a thirty percent lower risk of dying from heart disease. For diabetics, the researchers speculate, the benefits could be even higher, reducing the risk of death due to ischemic heart disease.

Results have been published in The American Journal of Clinical Nutrition. Visit Reuters for a discussion of the study.

French researchers say a slender waistline can pay big dividends for your health. Specifically, weight loss that whittles the waist lowers the risk of metabolic syndrome, which in turn decreases your chances of developing Type 2 diabetes, not to mention heart disease.

Even if you are otherwise healthy with a normal body mass index, having a wider-than-average waist automatically puts you at higher risk for metabolic syndrome. So says Beverley Balkau, the study's lead author, in an interview with Reuters. Balkau and her colleagues found that men and women whose waistlines grew by three or more inches over a period of nine years experienced a measurably greater risk for metabolic syndrome.

The good news is that losing just a little weight can help a lot. Women who lost even an inch or more around the waist during the study period ended up with a reduced risk for metabolic syndrome, unlike those whose waist measurements stayed the same. In addition, many women who began the study already diagnosed with metabolic syndrome but who managed to lose an inch or more from their waists during its course ended up free of symptoms.

The study has been published in Diabetes Care (July 2007).

The beta-blocker carvedilol does not cause weight gain in diabetic patients, declares a new study just out. Significance? It means the drug does away with a problematic side-effect of other (earlier) beta-blockers, which are medications prescribed to correct high blood pressure. The study has been published in the American Journal of Medicine (July 2007) and was conducted by researchers at St. Luke's-Roosevelt Hospital Center in New York.

Around eleven hundred patients participated in the study, all of whom have Type 2 diabetes and also suffer from high blood pressure. Some took the new drug carvedilol, while others were given the standard metoprolol. Over the course of five months the patients on metoprolol gained an average of 1.19 kg/2.6 lbs, whereas those on taking carvedilol experienced an average gain of 0.17 kg/0.37 lbs, which is considered insignificant.

Weight gain is an undesirable side-effect of medications in virtually any circumstance. However, it is particularly true for people with Type 2 diabetes or those at risk for T2 because overweight and obesity contributes to insulin resistance. In other words, weight gain will likely increase your chances of developing T2 if you're already predisposed or it will make your T2 worse if you already have it...putting you more at risk for the kinds of heart problems that beta-blockers are prescribed to treat! So it's no surprise that Franz H. Messerli, the lead author of the study, told Reuters that doctors should "avoid traditional beta-blockers such as atenolol and metoprolol in the diabetic hypertensive patient or in the hypertensive patient at risk for diabetes."

A new study has shown that taking selenium supplements elevates the risk of Type 2 diabetes. Around twelve hundred participants were involved in the study. Some took 200 micrograms of selenium daily, while others got a placebo. After nearly eight years had gone by, the researchers found that those taking the selenium were at an increased risk of nearly fifty percent for Type 2 diabetes.The finding raises the question: does supplementation of the diet with bottled vitamin pills or fortified food products do as much, or possibly even more, harm than good? The Washington Post contains quotes from both Larry Deeb of the American Diabetes Association and Eliseo Guallar of Johns Hopkins University expressing concern at Americans' propensity for vitamin pill-popping.

Oddly, the reason that selenium supplementation was undergoing examination in the first place was because medical experts believed it might in fact be beneficial in diabetes prevention. The theory was that the antioxidant properties in selenium which aid metabolism could aid in blood sugar control for people at risk for Type 2 diabetes. These antioxidant properties have been found to be beneficial in the treatment of other conditions ranging from cold sores to arthritis and multiple sclerosis. Some also believe selenium can slow the aging process and even aid in cancer prevention. Given this history as a health-boosting wonder-substance, the result of this particular study came as a surprise.

The findings have just been published in the online edition of the journal Annals of Internal Medicine. You can also read more in the Washington Post's website or visit Reuters online. The pic at right shows selenium in its nuggety form, as you might find it in a high school chemistry lab or similar.

My family is no stranger to severe hypoglycemic episodes. With four type 1 diabetics living busy, active lives, serious low blood sugars have resulted in pleading cries to "please drink the o.j., now!" ... to emergency glucagon kits, calls to 911, even a cast for broken bones. Whether or not consciousness was lost, episodes of severe hypoglycemia rattle the family cage. It is scary to witness your loved one out of control both physically and mentally. Beyond mental confusion, severe hypoglycemia can even trigger seizures or coma.

A study published this month in Diabetes Care reveals type 1 diabetics who smoke have a 2.6-fold increase in severe hypoglycemic episodes. The study examined 537 participants enrolled in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Experts hypothesize smoking's effect on the regulation of hormones and insulin can result in severe hypoglycemia. Whatever the case, smoking and diabetes are not a good mix, they are a molatov cocktail when it comes to your health. Smoking is associated with increased risk for diabetic retinal defects, nerve damage and impaired-kidney function.

I am downright angry my family has to deal with severe low blood sugars, especially the hypoglycemic unawareness brand. Read more on the study in Reuters.

We do not live forever, nor do most of us live independently forever. Many elderly with diabetes will spend a portion of their later years in a nursing home.

A recent study of 11 nursing homes in Ohio and West Virginia reveal a failing grade in several areas of diabetic resident care. Care for the 108 study participants with type 1 and type 2 diabetes was compared against the American Diabetes Association standards for adults living on their own with diabetes, as no standards have been developed specifically for residents in nursing homes.

Most of the residents with diabetes had their blood pressure measured within the past year, but only half had their blood pressure under control. Measurement and control of cholesterol followed this same trend. Nearly all residents had their blood sugar control monitored, but only 38 percent had their blood sugar under control, and one-third of patients did not meet A1C goals. This is dismal! Study authors stress substandard care heightens the risk for heart disease and a variety of other complications from diabetes.

On a more encouraging note, study authors have now developed a set of diabetes treatment guidelines for this special population, and a second study is in the works to evaluate if they improve patients' quality of life.

The study was undertaken by researchers at the Ohio University College of Osteopathic Medicine. Here is the abstract from the journal Diabetes Care and an article in Reuters.

I've always wanted to try Tai Chi, so a new Reuters headline about the ancient and beautiful Chinese practice caught my eye. According to a new study published in Diabetes Care (September 2006), Tai Chi is an excellent hobby for older people with Type 2 diabetes who are also struggling with weight problems. Basically, it's a wonderful way to restore muscles that have become weakened through lack of use. Improving muscle strength also leads to further health gains: better mobility and balance. The experts behind the study say it could be a good form of exercise for older, very sedentary and overweight folks with Type 2 diabetes. These people are particularly hard to motivate when it comes to getting the kind of exercise that could slow or reverse declined physical function.

There's more: while Tai Chi is good, combining Tai Chi with other low-intensity (but regular) stretching and calisthenics will bring you maximum improvement. The study took a bunch of men and women, all of whom were around sixty-five years old. They all participated in fifty-five minute exercise classes twice a week for a period of sixteen weeks. Some were given Tai Chi to do, while others were assigned to a calisthenics and stretching class. The finding? Everyone's balance and walking speed improved, however the Tai Chi group also experienced better muscle control.

Today's Scary Statistic: a Denmark study indicates that Type 1 diabetics are more than - get ready - three (!) times more likely than non-diabetics to develop multiple sclerosis.

According to the researchers, there are indications that MS and Type 1 diabetes may be somehow linked within what one might call 'disease families.' Why? Because Type 1 diabetes and MS are both autoimmune diseases, which cause the body to attack its own tissues. In the case of Type 1 diabetes, the body reacts against insulin-producing cells, whereas in the case of MS it attacks the myelin shealth that surrounds neurons in the brain.

Previous studies have indicated a link between Type 1 diabetes and MS, however, this is the first large-scale study to investigate the connection.

See the following Reuters report to learn more. The full results of the study have been published in the latest Archives of Neurology (July 2006).

As diabetes rates rise, the market for diabetes-related drugs and devices gets hot, hot, hotter. Hey, there's big bucks to be made. Reuters just put out a piece on the burgeoning market for diabetes devices which is worth a look if (like me) you're interested in keeping tabs on this industry.

According to Reuters, blood glucose monitor manufacturer DexCom Inc. is taking on Medtronic Inc., the company that produces blood sugar measuring devices and insulin pumps. Obviously not afraid of going out on a limb, DexCom's bosses assert that their monitoring device can be effective for seven days, while the glucose meter made by Medtronic is approved effective for just three days. The proof? They say that results of four studies can back up their claims. DexCom will be seeking seven-day status from the FDA based on these results.

Interestingly, Reuters also notes that Medtronic is the world's largest manufacturer of medical devices. Wow. I knew they were big, but that's really big. Still, the view of industry analysts is that little DexCom is giving the giant a run for its money. Says one analyst of DexCom: "They have a good product and there is plenty of room to split a $6 billion market."