Testing It Up

In a report issued by the International Diabetes Federation on Monday, it was indicated that at least 1 in 10 adults may suffer from diabetes by the year 2030.

Based on factors that include aging and demographic changes, an estimated 552 million people may develop diabetes over the next 20 years. This figure includes both Type 1 and Type 2 diabetes, as well as cases that remain undiagnosed.

According to the advocacy group, approximately one in 13 adults is suffering from diabetes, while information from the World Health Organization reveals that 346 million people across the globe have the disease. In addition, more than 80 percent of deaths due to diabetes happen in developing countries.

The WHO estimates that deaths due to diabetes may double by the year 2030, adding that the prediction given by the International Diabetes Federation is possible. Gojka Roglic, head of WHO’s diabetes unit, described the statistics as “a credible figure.” She also said: “But whether or not it’s correct, we can’t say.”

Roglic shared further that the estimated increase in diabetes cases is due to aging. Most cases of diabetes is that of Type 2 diabetes, the onset of which usually happens when patients are middle-aged, and is usually linked to weight gain and leading a sedentary lifestyle.

Most cases of the projected cases of diabetes are preventable, however, accoding to Roglic: “It’s worrying because these people will have an illness which is serious, debilitating, and shortens their lives… But it doesn’t have to happen if we take the right interventions.”

For those who are suffering from diabetes, the more common way of controlling the disease entails watching what they eat. A new research, however, indicates that structured exercise programs an also help improve blood sugar levels.

The research, which was published in the May 3rd issue of the Journal of the American Medical Association, involved an analysis of several previously-conducted studies. The researchers indicated that “exercise is a cornerstone of diabetes management, along with dietary and pharmacological interventions… current guidelines recommend that patients with type 2 diabetes should perform at least 150 minutes per week of moderate-intensity aerobic exercise and should perform resistance exercise three times per week.”

The study was conducted by scientists led by Daniel Umpierre, MSc, of the Hospital de Clinica de Porto Alegre in Brazil. The researchers analyzed various studies that looked into the effects of structured exercise programs, which last for at least 12 weeks, on reducing HbA1c. The study looked at data on 8,538 participants for various studies.

Structured exercise, the researchers determined, may be associated with a -0.67% decline in HbA1c levels when compared with participants in comparison groups.

Structured exercise programs that last more than 150 minutes each week could be associated with a 0.89% decline in HbA1c, when compared against those who work out for 150 minutes or less, which was associated with -0.36% reduction.

The researchers wrote: “Structured exercise, consisting of aerobic training, resistance training or a combination of aerobic and resistance exercise training for at least 12 weeks is associated with improved glycemic control in type 2 diabetic patients… Physical activity advice is beneficial only if associated with dietary recommendations.”

A feature on Time.com shared the results of a study that indicated that the drug pioglitazone, being sold as Actos, can be taken by people who are at risk of developing type 2 diabetes, in order to prevent the onset of the disease. Pioglitazone is a drug commonly used for diabetes treatment.

Experts warn, however, that this should not be taken to mean that anyone whose blood sugar levels are high should start taking the medication.

Diabetes starts from impaired insulin sensitivity. For quite some time, doctors have been searching for medications or lifestyle changes that can delay the onset of full-blown diabetes for as long as possible – or prevent its onset altogether.

A study led by Dr. Ralph DeFronzo, at the Texas  Diabetes Institute and University of Texas Health Science Center, determined that pioglitazone can be a useful tool to help patients control their blood sugar levels, and prevent the onset of full-blown diabetes.

Researchers found that among more than 600 patients who had elevated blood sugar levels and at least one other risk factor for diabetes, only 2% of those who took pioglitazone developed diabetes, as opposed to 7.6% in those who only took placebo. The study, which had a 2-year follow-up period, saw a 72% reduction in risk for those who took pioglitazone.

The study authors were quick to warn, however, that the encouraging results of the study should not be considered as a reason to prescribe the drug to anyone with a high risk of developing diabetes.

A new study revealed that blood tests can now predict the onset of diabetes ten years before symptoms become apparent.

According to a feature on WebMD, blood tests that screen for a group of five amino acids have the ability to accurately predict risk of developing type 2 diabetes, in both adults who have common risk factors such as obesity, as well as those who are healthy.

Researcher Dr. Thomas Wang, of the Cardiovascular Research Center of the Massachusetts General Hospital, shared the following in a news release: “These findings could provide insight into metabolic pathways that are altered very early in the process leading to diabetes… They also raise the possibility that, in selected individuals, these measurements could identify those at highest risk of developing diabetes so that early preventive measures could be instituted.”

The study followed 2,422 healthy adults for a period of 12 years, during which time 201 eventually developed type 2 diabetes. The blood samples of 189 participants who developed diabetes, and 189 who did not, which were taken at the beginning of the study, were compared. The tests screened for the levels 61 different metabolites.

Elevated levels of the following amino acids: isoleucine, leucine, valine, tyrosine, and phenylalanine, were associated with the development of type 2 diabetes, based on the results of the study.

The researchers determined that measuring combinations of the five aforementioned amino acids, as opposed to only a single amino acid, could predict future diabetes risk more accurately.

The study was published in Nature Medicine.

A study funded by manufacturer Novo Nordisk, and published in The Lancet, indicated that the drug degludec showed potential in reducing the frequency of insulin injections in type 1 diabetes patents.

The study documented the result of phase II trials of the drug, which consisted of the random assignment of receiving the drug metformin orally, in conjunction with any of the following regimens: degludec insulin once a day, degludec three times a week, or Lantus once a day for 16 weeks. Lantus (glargine), manufactured by Sanofi-Aventis, is the most widely used long-acting insulin. Study participants consisted of 245 adults with diabetes, or HbA1c levels between 7% and 11%.

The results of the study indicated that patients who were injected with degludec three times a week exhibited controlled blood sugar level as effective as daily injections of Lantus, and similar reductions in hemoglobin A1c (HbA1c) compared to daily injections of Lantus.

In addition, it was determined that the rates of hypoglycemia were at their lowest in patients who took degludec once a day, despite the fact that the rates were generally lower across all treatment groups.

Professor Bernard Zinman, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, gave the following comment: “Because of its ultra-long action profile, insulin degludec injected three times weekly appears to provide similar glucose control to insulin glargine once daily. This new basal insulin analogue might be a valuable addition to clinical practice…However the safety, efficacy, and optimum use of treatment regimens for insulin degludec will need to be established in larger phase 3 trials.”

So, you do not have diabetes – yet, but you have been diagnosed as having pre-diabetes. What does that mean?

Pre-diabetes, or borderline diabetes, is diagnosed among people whose glucose levels are not high enough to indicate diabetes, but are already higher than normal. A feature on WebMD shared that most people who have pre-diabetes do not suffer from diabetes symptoms, but have a higher risk of developing heart disease.

Pre-diabetes occurs when the balance between glucose and insulin is thrown off. Any of the following may occur: incoming glucose from the blood may not be cleared because the pancreas is unable to produce enough insulin after a meal, or cells may be insulin resistant, such that insulin is unable to escort glucose from the blood stream into cells.

Patients who are considered pre-diabetic are at high risk for developing type 2 diabetes, as well as the other serious medical conditions normally associated with the disease, such as heart attack and stroke. Someone who is pre-diabetic is at a 50 percent higher risk of suffering from heart disease and stroke than someone who isn’t.

Pre-diabetes is diagnosed through the fasting plasma glucose test (FPG) or the oral glucose tolerance test (OGTT). Both tests are supported by the American Diabetes Association in diagnosing pre-diabetes and diabetes.

People with pre-diabetes will have blood glucose levels of 100-125 mg/dl after an overnight or eight-hour fast after the FPG, or blood glucose levels of 140-199 mg/dl after the OGTT.

According to the CDC, there are as many as 57 million Americans aged 20 and above who have pre-diabetes. While it is not yet diabetes, pre-diabetes should not be ignored as it can lead to a more serious health condition later on.

The Centers for Disease Control and Prevention (CDC) revealed on Wednesday that the number of Americans who are suffering from type 2 diabetes has reached 26 million, according to a report on The Washington Post.

The number of adults in the United States who have pre-diabetes, on the other hand, is around 79 million; these adults have blood sugar levels that are higher than normal, but are not yet high enough to be diagnosed as diabetes. Those who have this condition have an increased risk of developing type 2 diabetes, as well as heart disease and stroke.

These numbers are higher than those from 2008, where CDC estimates placed the number of diabetes patients in the United States at 23.6 million, and the number of Americans with pre-diabetes at 57 million.

Ann Albright, Chief of the Diabetes Prevention and Control Program of the California Department of Health Services, gave the following statement: “These distressing numbers show how important it is to prevent type 2 diabetes and to help those who have diabetes manage the disease to prevent serious complications such as kidney failure and blindness… We know that a structured lifestyle program that includes losing weight and increasing physical activity can prevent or delay type 2 diabetes.”

The increase in the number of people who have been diagnosed with diabetes has been attributed to several factors. In addition to the fact that more people are developing diabetes as more people also develop obesity, a leading cause of diabetes, developments in medicine are allowing people to live longer diabetes.

Glucose test strips that are used for monitoring the blood sugar of those suffering from diabetes were recalled by Abbott Laboratories, according to a report on the Los Angeles Times.

The recall involves as many as 359 million test strips. The recall is due to the fact that the strips may not absorb enough blood as quick as it should in order to give a proper reading. It is possible that the strips may give out false low readings, which may lead diabetes sufferers to try to raise their sugar levels, according to Abbott. In its statement, the company also said that its users may not be able to treat elevated glucose levels as appropriate.

Abbot company spokesman Scott Davies shared that the test strips included in the recall were manufactured between January and May, 2010, at an Abbott facility in the United Kingdom. The recall was spurred by the discovery of the defect via routine in-house testing, according to Davies.

Erica Jefferson, spokeswoman for the Food and Drug Administration, revealed that north Chicago-based Abbott reported 22 cases of “false low” readings to the FDA. It also volunteered to do the recall.

Diabetes researcher and George Washington University associate professor of medicine Michael Thompson explained, however, that while diabetes sufferers should be rightly concerned about inaccurate blood sugar readings, “this is an error in a safer direction, falsely low rather than falsely high.”A false high reading is considered more dangerous as it can lead patients to overdose on insulin, which can trigger an episode of hypoglycemia.

Los Angeles Health Screening

The good news, according to a feature on Bloomberg BusinessWeek, is that death rates for Type 1 diabetes are falling; it is not, however, falling fast enough.

A study led by Dr. Trevor J. Orchard, a professor of epidemiology, medicine and pediatrics in the Graduate School of Public Health at the University of Pittsburgh, Pennsylvania, noted a significant drop in the mortality rates of people suffering from Type 1 diabetes. The researchers also determined that patients who were diagnosed with the condition in the 70s had a lower mortality rate when compared against those who were diagnosed in the 60s.

Dr. Orchard gave the following comment: “The encouraging thing is that, given good [diabetes] control, you can have a near-normal life expectancy.”

Despite these encouraging statistics, however, the study also found out that the mortality rates for patients suffering from Type 1 are still significantly higher than the general population – a staggering 7 times higher. For certain demographic groups, such as women, for example, the disparity in mortality rates is even more significant: mortality rates for women who have type 1 diabetes are 13 times higher than those of women who are not suffering from the disease.

Patients suffering from Type 1 diabetes produce little or no insulin, so they are forced to rely on insulin replacement therapy all their life. Insulin replacement therapy, however, is not as effective as naturally-produced insulin.

Barbara Araneo director of complications therapies at the Juvenile Diabetes Research Foundation, said: “The outcome of this study shows that diabetes care has improved in many ways over the last couple of decades, and as a result people with diabetes are living longer now… Managing and taking good care of your diabetes is the surest way to reduce the risk of developing complications later in life.”

Sunday, November 14, is World Diabetes Day. Starting in 2009 until 2013, the observance of World Diabetes Day will carry the same theme: Education and Prevention.

World Diabetes Day was jointly created by the World Health Organization and the International Diabetes Federation to address concerns over the rising threat of diabetes. The United Nations passed Resolution 61/225 in 2007, making World Diabetes Day an official United Nations day.

According to the Centers for Disease Control and Prevention, one in every 10 Americans suffers from diabetes. A feature on The New York Times cited CDC estimates, which projected that if current trends continue, that ratio will become one in every three Americans in the year 2050.

The theme of World Diabetes Day focuses on the importance of understanding diabetes as a way to manage the disease, as well as a means to avoid the disease altogether – or at least delay its onset. The campaign has three key messages: know about the warning signs and risks associated with diabetes; know how to respond to diabetes, and who to turn to; and know how to manage and take control of the disease.

The International Diabetes Federation and the World Health Organization would like to encourage governments to set up, boost, and implement policies towards the prevention and control of diabetes. It is also hoped that the observance of World Diabetes Day will raise awareness regarding, among other things, the warning signs of diabetes, in order to encourage early diagnosis of the disease.

All over the world there are various events that have been organized to mark World Diabetes Day. These include sports events such as charity Run/Walks, workshops, exhibitions, and free diabetes screening.

New York Health Screening