Women who developed gestational diabetes while pregnant are at a higher risk for pancreatic cancer. Unfortunately, that's the word from a new study. According to this report from Canada's CTV News, past studies have linked type 2 diabetes with increased pancreatic cancer. And, of course, having gestational diabetes puts you at risk for type 2 diabetes. However, this is the first time a link has been made between GD and pancreatic cancer.

The study involved an analysis of health records for a whopping 40,000 women, all of whom gave birth in Jerusalem between 1964 and 1976. Phew, that's a lotta diapers... Of 410 women diagnosed with GD, five developed pancreatic cancer in later years. None of the 137 women with type 1 diabetes went on to develop pancreatic cancer. Want the full story? Results have been published in BMC Medicine.

Now, don't panic if you have had GD. Says lead researcher, Mary Perrin of NYU's School of Medicine, the absolute risk for pancreatic cancer is still very low. Nevertheless, she points out that even a small statistical difference is significant since obesity is on the rise. The implication? If trends continue, we can expect to see more and more moms-to-be with GD in the future.

According to a RAND Corporation study, fewer and fewer diabetics are going undiagnosed these days. Specifically, the gap has closed dramatically over the last twenty-five years. So much so that Hispanics and African Americans are now no more likely than whites to be undiagnosed. Good news, to be sure.

And the news is especially good for men. James P. Smith, who authored the study, says that twenty-five years ago about fifty percent of men with diabetes did not even know they had the disease. Jump forward to 1999-2002, however, and the number drops to about twenty percent.

Smith concludes that even though ethnic and gender disparities remain, we are certainly doing a lot better at getting people diagnosed and into treatment. Diabetes programs that target minorities can take a lot of the credit for this shift, Smith believes.

On the down side, the less-educated people among us are much more likely to go undiagnosed and, when diagnosed, are less likely to successfully incorporate lifestyle changes required to manage the disease. Also of concern, Smith says, is the fact that even though obese people are at a high risk for diabetes, they nevertheless are more likely to have undiagnosed diabetes than are slimmer people.

It's a complicated little world, isn't it? For example, type 2 diabetes is a growing problem in Australia, particularly in rural areas. Recently, however, some good news appeared: immigrants from Mediterranean regions living in Australia who stuck with a traditional Mediterranean diet over long periods of time, enjoyed much better health than other segments of the population. And that includes less diabetes.

But now, there's news that Australia's ethnic minorities suffer from type 2 diabetes at much higher rates than the rest of the population. Hardest hit are Asians, Pacific Islanders and people originally from the Middle East. The finding results from a survey of 11,000 Australians. There are some good reasons why immigrants suffer from diabetes more. First, those affected the worst were not able to maintain their traditional lifestyles in the new country. Fatty foods and lack of exercise are a big problem. Second, there are psychological factors contributing to poor overall health, especially the stress involved in learning to live in a new culture with a different language.

Gastric bypass or banding surgery has become known as an effective measure for treating type 2 diabetes. What has put it in the news, of late, is the fact that gastric bypass is incredibly successful. Many recipients who've gone under the knife respond not only with extreme weight loss (of course - that's what the surgery is designed to do!), but also a normalization of blood sugar levels. Sometimes the reaction is so positive that patients can stop taking blood sugar controlling meds.

Case in point: Marlene Zytcer (57) and her daughter Aimee (31) of Phoenix, Arizona. Marlene and Aimee recently both had gastric banding surgery at the University of California, San Diego Medical Center. Prior to the surgery, both mom and daughter were doing poorly health-wise. They were both obese and fighting heart disease and type 2 diabetes. They say they both have a genetic predisposition to those conditions.

Far from being inert and unchanging, a mere scaffolding to which the body's muscles and organs attach themselves, bones change constantly. Old bone cells die. New ones are born. But that's not all. According to an exciting new discovery, bones play a role in regulating blood sugar levels and fat deposits.

How is this possible? Bones act like a kind of endocrine organ, releasing osteocalcin, a hormone that influences bone formation. This hormone also increases both insulin production and the body's insulin sensitivity. It also reduces fat stores. Basically, osteocalcin levels in the bones are linked to blood sugar and body fat levels, and there is some sort of interaction back and forth.

It's a surprising finding for the uninitiated. However, some scientists are saying it makes sense when you think about it. Says Ronald Kahn, director of Harvard's Joslin Diabetes Center, "Obviously there does need to be some coordination between skeletal growth and body mass. If you carry around extra weight, your bones need to hold up under the extra pressure, so it's not surprising that your bones have a sense of body fat."

Type 2 diabetes, mate? By crikey. Australia's diabetes epidemic continues to be a problem. News this week indicates the spread of obesity, and with it associated conditions like Type 2 diabetes, in rural areas is far worse than previously realized. A survey of 806 randomly selected adults (okay, not the biggest sample, admittedly) found that a great many are affected by the disease.

Based on their findings from that survey, researchers calculate that almost three-quarters of Aussie men living in rural areas are overweight. They think women in rural areas may be slightly better-off - around two-thirds may be overweight. This puts rural Australians at a very high risk for T2DM. The conclusion, stated in the Medical Journal of Australia: "urgent population-wide action is required to tackle the problem."

As is the case in the US, a big concern is how to treat all those people as they age and their overall health worses. Specifically, what will become of Australia's public healthcare system? "We might get a whole generation, now in their 40s, 50s and 60s, who will do markedly worse than their parents," predicts lead researcher for the study, Professor Edward Janus of Melbourne's Western Hospital.

Hot on the heels of my previous cat-related post comes yet more kitty news from the UK. This time it's about the extent to which diabetes is affecting British cats, and the news isn't good. A study conducted at Edinburgh University reports that one in 230 pet cats in the UK is diabetic. Neutered, overweight male cats are most at risk, apparently. Hmm, at least our hefty male friends don't have to contend with the one of those risk factors! Like humans, however, the more sedentary the cat, the greater the risk.

Overall, being overweight ups the risk of diabetes in felines by three times. There are now around five times more diabetic cats in the UK than there were back in the 1970s. Says Professor Danielle Gunn-Moore of the veterinary program at Edinburgh University, "The lifestyle of cats, just like their owners, is changing. Unfortunately, just like people, cats will overeat if they are offered too much tasty food, particularly if they are bored. While cats would naturally exercise outside, many cats are now housebound, so they have little to do all day but eat, sleep, and gain weight."

Yikes, this describes our own chunky kitty Kato to a T. He is getting older, is sedentary, and weighs in at around 19 pounds last time I checked. Like many people, I'm reluctant to let my cats out in case they get lost, hit by a car, stolen, trapped and impounded...the list goes on and on. Then there's the killing of backyard birds to consider. So: what's a cat lover to do?

Fat. Never a good thing, right? At least not in the US, where food is super-abundant. Instead of being rightly grateful for all that food, we blame it for our weight woes. Yes, there's a growing sense that food is the enemy. Food leads to weight gain, which leads to obesity, which leads to heart disease, type 2 diabetes, and on and on. (Read Michael Pollan's The Omnivore's Dilemma for more on what he terms "our national eating disorder.")

But apparently there's a silver lining in all that fat. Says journalist Natalie Angier for The New York Times, "to castigate fat for getting too big and to blame it for high blood pressure or a wheezing heart is like a heavy drinker blaming the liver for turning cirrhotic." That is, if the body couldn't convert energy to fat cells in an efficient manner we'd really be up the proverbial creek. In fact, evolutionary biologists have even speculated that humans' ability to store good-sized quantities of fat has aided the survival of the species and made it possible for our big brains to grow so big and, um, brainy. The fat, you see, helps us through hard times. Food for thought, huh?

I really don't get this, but here goes: according to a report summarized on the website DiabetesHealth, weight gain reduces the severity of heart disease in type 1 diabetics. Huh? How can that be possible, I'm wondering? After all, we live in a world where weight gain is considered a great evil, a threat to individual health, a drain on our healthcare resources etc. etc. And now this!?

The findings come from the Pittsburgh Epidemiology of Diabetes Complications Study, which was conducted over a period of sixteen years and involved the participation of 225 type 1 diabetes patients. The Pittsburgh people agree more fat on the bones adds up to one heck of a big risk factor for heart disease. However, they also say that if you're type 1 and do get heart disease, carrying extra weight makes the heart disease less severe. They also report that this effect is especially true for women. So, the big question: why? The researchers think it's because heavier people may have better insulin control. But don't run for the local Burger Barn; weight gain is not desirable as it does more harm than good in the long run.

Ever noticed that people tend to be around the same weight as spouses and friends? Well, it's not your imagination. A study just out in the New England Journal of Medicine reports that obesity, a major risk factor for type 2 diabetes, acts somewhat like a contagious disease - so when one person puts on weight, others around them follow suit. This, the researchers say, helps explain why Americans have gotten so fat in recent decades.

The study, a summary and discussion of which is featured in The New York Times, involved the analysis of a social network of 12,067 people over a period of thirty-two years (from 1971 to 2003). Researchers tracked not only the health and weight loss/gain of these people, but also who knew whom, who was friends with whom, and who was related to whom. Over time, it became clear that those whose friends became obese were much more likely to grow obese themselves. The likelihood, in fact, tripled in the case of close friends. Interestingly, friendship mattered more as a determining factor than did being related or being neighbors with someone.

It works like this: people tend to share the lifestyle habits of their family and friends. Folks who consider salads delightful and who enjoy frequent jogs around the park generally surround themselves with similarly-minded folks, and it shows in their trim physiques. Likewise, fast-food munchers who enjoy lots of TV tend to hang out with a similar crowd...and their thighs - not to mention waistlines, hearts, blood sugar levels etc. - suffer the consequences. Another factor, says researcher Nicholas Christakis, is the perception of the self in relation to others: "You change your idea of what is an acceptable body type by looking at the people around you."

It's often said that serving food on smaller plates makes a diner inclined to eat less. Well, a Canadian researcher decided to put that theory to the test. Sue Pedersen, who is an endocrinologist at the University of Calgary, conducted a study designed to evaluate the efficacy of a specially designed "portion-control plate." The plates, designed by Diet Plate Limited of England, are marked with lines indicating how much of the day's main meal should be divided amongst the various food groups.

For six months, sixty-five study participants ate their food from regular dishes, while sixty-five others ate their food from the portion-control plates. All of the participants were type 2 diabetics and clinically obese. End result? The plates worked quite well at getting subjects to curb their appetites. After six months, those using the plates lost an average of 1.8 percent of their body weight, whereas the control group lost an average of only 0.1 percent. Interestingly, those on insulin regimens did the best of all, with an average of 2.5 percent weight loss.

The fatal flaw? What happens when the white lab coat crew aren't charting your intake any more? Call me a naysayer, but I'm predicting some major snacking in the future of those study subjects. Because special plate or not, you have to have the will to cut portion intake, and it's hard to maintain that will long-term.

The results of Pedersen's study have been published in the Archives of Internal Medicine (June 2007). Check out the Diet Plate website too.

Did you hear about renowned Harvard scientist Barbara Kahn's latest published research? I blogged about it recently. Kahn and colleagues state, in a report published in Cell Metabolism (July 2007), that it's possible to use a simple blood test to detect the presence of a specific protein called RBP4. Kahn et al say the presence of RBP4 can be used to measure accumulations of deep belly fat. Underpinning this research is a belief that such accumulations of belly fat increase risk for metabolic syndrome, leading to various maladies including heart disease and diabetes.

However, not everyone accepts this point of view. A Yale research team says that deep belly fat may not be so evil after all. The researchers, who are based at Yale University School of Medicine in Chevy Chase, Maryland, assert that metabolic syndrome is caused not by belly fat but by insulin resistance in skeletal muscle. This resistance, they state, makes it tough for the body to manufacture glycogen, so - in people who are insulin resistant - energy that cannot be stored as glycogen gets diverted into fatty acid production, which then contributes to metabolic syndrome.

The team compared abdominal fat levels in young and healthy individuals, some of whom were insulin sensitive and some of whom were insulin resistant. The result? "There is absolutely no difference in the volume of abdominal fat," states Yale's Gerald I. Shulman, who was lead author of the study. Abdominal fat, says Dr. Shulman, "may come later in the course of the disease [metabolic syndrome], but it's not a primary, underlying factor."

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."

Diabetes-related health complications can cause severe nerve and tissue damage to the lower limbs. In the worst cases (and, unfortunately, this happens all too often), this necessitates amputation. The medical research field is working on ways to prevent or heal such damage before such drastic action is required. But what of those who do lose feet or legs? The next step is learning to use prosthetics. And, as the LA Times reports today, the prosthetic industry is experiencing a boom as diabetes rates soar.

Let's look at some numbers to illustrate just how much demand has grown: there are now 1.9 million amputees in the US, reports the Times article, and approximately sixty percent of those are diabetes-related. Compare this, says reporter Daniel Costello, with the 630 veterans of Iraq and Afghanistan who have undergone amputation. A shocker, isn't it? It's also estimated that around five of every one thousand diabetics eventually require amputation of damaged feet and/or legs.

These days, "there's no such thing as a slow day," remarks William Yule, prosthetist and manager of Hanger Prosthetics & Orthotics in Downey. "It can be hard because you can't help thinking a lot of these people don't need to be here," says Yule, alluding to the fact that so many of his clients are overweight Type 2 diabetics. Times reporter Costello spoke with Yule and others in the prosthetic industry and found that the upswing in business is an across-the-board phenomenon that some say is unrivaled since the Civil War, when maimed soldiers returning from battle brought about an unprecedented demand for prosthetics.

The Times article also includes a photo gallery that's worth checking out.

When it comes to issues of health, perhaps the most encouraging factoid out there is this: you don't have to lose a whole lot of extra weight to experience major health benefits. This info is nothing new, of course. Heck, I remember watching Oprah espouse that very principle on her show back in the 90s. If you can't run, walk, she'd say. If you can't walk far, just walk around the block...or even the front gate. Do something for your health today!

So, what's new on this front, you ask? Well, a major study has now confirmed that modest weight loss can dramatically improve the health of people with Type 2 diabetes. The Look AHEAD (Action for Health in Diabetes) study found that overweight people with Type 2 diabetes who were able to achieve around 7 to 10 percent weight loss over the course of a year experienced the following health benefits: 1.) improved blood sugar control and 2.) a reduced dependence on medications. The study involved over five thousand participants, some of whom were put on the weight-loss regimen, while others received standard medical care (that is, without an emphasis on healthy eating and exercise).

Here's the problem as I see it: how do you transfer these results to everyday life? The participants in this study who lost all that weight did so by agreeing to join the study, and they attended group meetings, ate a specially designed diet, and received advice on exercise and even had sessions with behavioral psychologists. Problem is, there's no behavioral psychologist around when you're alone at home and reaching for that second helping of pasta!