I was diagnosed with thyroid cancer in Nov., 1999. Surgery and radioactive iodine followed. In Dec., 2006, I found a lump in my neck that turned cancerous. Shortly thereafter, it was found to have metastasized throughout my body and to be untreatable and inoperable. I started a clinical trial with Sutent (sunitinib) since Apr., 2007.
In Nov., 2013, the tumors began growing again and I was removed from the Sutent Clinical Trial. I started a clinical trial taking of CEDIRANIB on 04/09/14.
A study
led by John Innes Centre researchers in the United Kingdom (UK)
resulted in the mass production of natural compounds in a single,
genetically modified fruit - a tomato. These compounds include
life-extending Resveratrol found in wine and Genistein found in tofu
which has cancer-preventing benefits.
By introducing a protein called AtMYB12, which is normally
found in a garden weed called thale cress (Arabidopsis thaliana),
scientists found that the protein activates a wide set of genes
responsible for natural compound production in the tomato plant. The
AtMYB12 acts like a plug or tap that scientists can control to reduce or
increase the amount of natural compounds that can benefit the plant and
in turn, humans. The researchers noted that
the introduction of the AtMYB12 protein did not only increase the
plant's ability to create the Resveratrol and Genistein, it also
influenced the plant's ability to devote more carbon and energy in the
compound creation.
"Medicinal plants with high value are often difficult to grow and
manage, and need very long cultivation times to produce the desired
compounds. Our research provides a fantastic platform to quickly produce
these valuable medicinal compounds in tomatoes. Target compounds could
be purified directly from tomato juice," said co-author Dr. Yang Zhang The research team is optimistic that the same genetic switching
technique can be used to mass manufacture other natural compounds
involved in the production of several medicines. Tomatoes are relatively
cheap to produce and can be turned into juice form where the compounds
can be extracted. Eventually, the fruit itself could soon become a
medicinal plant with increased levels of illness-fighting compounds.
The study provides a basis for a more cost-efficient industrial
production of valuable natural compounds from plants compared to
extracting small amounts from tons of soybeans and grapes. The
researchers believe their design can be applied to other compounds such
as alkaloids and terpenoids.
Co-author Cathie Martin stressed that
their study delivers a design to mass produce not just phenylpropanoid
compounds but potentially more natural compounds that can extracted from
aromatic amino acids.
The researchers published their study in the Nature Communicationsjournal on Oct. 26.
An Iranian study finds that drinking three cups of camomile tea a day could improve control of blood glucose levels in people with type 2 diabetes.
Researchers from Tabriz University of Medical Sciences aimed to investigate how the effects of camomile tea would affect glycemic control and antioxidant levels in type 2 subjects. Antioxidants are chemicals that protect or delay against cell damage.
64 participants with type 2 diabetes
were recruited, all of whom were aged between 30 and 60. They consumed
camomile tea three times per day immediately after meals for eight
weeks. A control group also followed this routine, but they drank water
instead.
The camomile tea group had significantly reduced HbA1c and serum insulin levels, as well as significantly increased total antioxidant capacity compared to those in the control group.
The researchers concluded that camomile tea could be useful in reducing diabetes risk factors. They added: "Short-term intake of chamomile tea has beneficial effects on glycemic control and antioxidant status in patients with type 2 diabetes."
However, the researchers noted that a larger sample population and a
longer intervention period would be necessary in order to demonstrate
significant clinical improvements.
This study was published in the journal Nutrition.
‘The results
were staggering,’ said Professor Kevin Moore, who was involved in both
experiments. ‘If you had a drug that did this it would be a
multi-billion pound market.
‘There
was a 40 per cent reduction in liver fat, they lost about three
kilograms in weight and their cholesterol levels improved.’
In the
second, larger study the London researchers looked at 102 relatively
healthy men and women in their forties taking part in a ‘dry January’
campaign.
The
women had been drinking an average of 29 units of alcohol a week,
almost double the Government guidelines. The men were typically on 31
units, ten too many.
All
had blood tests and liver scans and answered detailed questionnaires.
Four weeks later the damage caused to their livers by years of heavy
drinking had started to repair itself.
Their
‘liver stiffness’ - an indication of disease - had been reduced by 12.5
per cent. Their insulin resistance - a measurement of diabetes risk -
had come down by 28 per cent.
+2
Current recommendations state men should not drink more than four units of alcohol a day or 21 a week
They
had also lost weight, their blood pressure had dropped, and many said
their concentration and sleeping levels had improved. The researchers
are due to publish further details, which are expected to show their
risk of developing certain cancers was also reduced.
Gautam
Mehta, a liver specialist who oversaw the study, said: ‘I am excited.
There are some findings that will be pretty novel. It’s an important
study which shows the benefit from a month’s abstinence. What we can’t
say is how long those benefits are, how durable those benefits are.’
The
initial results are already being examined by Department of Health
officials, who are preparing new guidelines on safe drinking.
Current
recommendations state women should have no more than three units a day
or 14 units over a week while men should not exceed four units a day or
21 a week.
One unit is equivalent to less than half a glass of wine or half a pint of beer depending on their strength and size.
But
health professionals say these limits should be reduced. They also want
adults to be told to have at least two or three days off a week to
allow their bodies to recover.
The Royal Free’s first experiment was on ten men and women undertaking a dry January last year.
Tom
Smith of Alcohol Concern said: ‘This evidence confirms what a growing
number of other studies have shown, that having even just one month off
from alcohol has incredible health benefits.’
Andrew
Langford of the British Liver Trust said: ‘It provides good evidence
that simple behavioural change can make a real difference to the health
of your liver.’
A
two-year study published in the Annals of Internal Medicine is the
first long-term study aimed at assessing the effects and safety of
drinking moderate amounts of alcohol in people with type 2 diabetes, who
are more at risk for developing cardiovascular disease than the general
population. Those with type 2 diabetes also tend to have lower levels
of HDL, the "good" cholesterol.
The researchers from Ben-Gurion
University of the Negev reported that over two years, red wine helped
improve signs of cardiac health by modestly increasing levels of HDL
cholesterol and lowering overall cholesterol.
The randomized controlled intervention trial involved 224 controlled diabetes patients
aged 45 to 75, who generally abstained from alcohol. The patients were
randomly assigned to drink 5 ounces of red wine, white wine, or mineral
water (the control group) with their dinner for two years. They were all
given instructions to follow a well-balanced Mediterranean diet plan that did not have a calorie restriction.
The
researchers performed genetic tests that showed how quickly the
patients metabolized alcohol, as well as various lipid (cholesterol)
tests. They also measured glucose control, blood pressure, liver
function tests, medication use, and other symptoms at several time
points during the two-year follow-up.
Compared with the group that
drank water, patients in the red wine group had improvements in their
lipid tests, the study showed. "Red wine
was found to be superior in improving overall metabolic profiles,
mainly by modestly improving the lipid profile, by increasing good HDL
cholesterol and apolipoprotein A1, one of the major constituents of HDL
cholesterol, while decreasing the ratio between total cholesterol and
HDL cholesterol," the researchers explained.
Also, in both wine
groups, patients who were "slow alcohol metabolizers" (according to the
genetic tests) showed more improvements in glucose control tests than
"fast alcohol metabolizers." Compared with water, wine did not increase
or decrease blood pressure or liver function tests.
The study
authors noted that in both red and white wine drinkers, sleep quality
was significantly improved, too, compared with the water control group.
Iris
Shai, principal investigator of the trial, and a member of the
Department of Public Health in the Faculty of Health Sciences, said in a
press statement, "The differences found between red and white wine were
opposed to our original hypothesis that the beneficial effects of wine
are mediated predominantly by the alcohol."
So, how much can
people with type 2 diabetes sip at dinner without going over the top?
"One to two glasses of red wine for men and up to one glass of red wine
for women, daily, at dinner," was the amount indicated by the study, Dr.
Minisha Sood, an endocrinologist at Lenox Hill Hospital, told CBS News.
Sood
said researchers have known for some time that moderate amounts of
alcohol are acceptable for diabetics, but the jury was out on which kind
of alcohol might offer the most benefit.
Sood said of red wine's health-enhancing ingredients: "It's the non-ethanol components of the wine, which are present more so in red wine. It's the phenols, it's the resveratrol, it's the tannins. They all work together with the ethanol possibly to result in these positive changes."
While
the study shows benefits, Dr. Susan Spratt, an endocrinologist and
assistant professor of medicine at Duke University School of Medicine,
said, "I worry about the subset of my type 2 diabetes patients who drink
too much, and that this may give them more ammunition to say alcohol is
good for diabetes. Over-drinking can poison the pancreas. In these
patients, when they stop drinking, their diabetes gets tremendously
better."
Spratt also told CBS News that in the South, where she
lives, many people abstain from drinking for religious reasons. She
said, "Here in the South, it would not be something I would generally
recommend. I would not say, 'Now you should start drinking wine.' I
wouldn't tell someone to start drinking, but if I knew a type 2 diabetes
patient was a moderate drinker, I would tell them it looks like red
wine is the best choice out of all alcohols to drink, rather than white
wine, beer, or hard liquor."
Spratt also noted that the study did not look at cardiovascular outcomes such as heart attack and stroke.
For
51-year-old Garret Rubin, who said he has to watch out for everything
-- fats, salt, sugar -- in his diet since being diagnosed with type 2
diabetes, the study is a positive note.
Rubin said diet,
exercise and medication will remain his first line of defense, but he
told CBS News, "Now, since I have a choice, I think red wine might be
the thing."
Editor's note: In an earlier version of this
article, Dr. Sood said red wine decreased development of heart disease,
but that was not found in the study. The research only looked at risk
factors like cholesterol levels, not whether patients actually developed
heart disease.
Sept. 28, 2015 -- People who are trying to lose weight or manage
diabetes should try to change their lifestyle not only to exercise or
cut calories, but also to avoid chemicals that may be contributing to
their condition, experts say.
“You may have a healthy meal, but if it’s in a plastic container,
it’s leaching chemicals,” said Andrea Gore, PhD, a pharmacologist at the
University of Texas at Austin in a webinar for reporters on Monday.
Gore is the chair of a task force that issued on Monday a new
statement on the harm from hormone-disrupting chemicals. The statement,
which is based on a review of more than 1,300 studies, says there’s
convincing evidence to support a link between hundreds of hormone
disruptors and several chronic health problems, including:
Diabetes
Obesity
Heart disease
Infertility
Hormone-sensitive cancers in women (breast, endometrial, ovarian)
Prostate cancer
Thyroid problems
Poor brain development and brain function in young children
Researchers say the statement is significant because it comes from a
group of doctors that treat people for hormone problems instead of
scientists who study the effects of chemicals in animals or on cells.
Gore said the evidence for these effects is now strong enough that
everyone should take steps to avoid chemicals that block or mimic the
action of hormones in the body.
She also called on doctors who are treating patients for infertility
to tell their patients to avoid hormone disruptors, which are known to
decrease semen quality and interfere with how ovaries work. She said
doctors who are counseling pregnant women and the parents of young
children should also warn about chemical exposures.
“In particular, we’re worried about fetuses, infants, children,
etc.,” she said, because exposure to the chemicals during development
could set the stage for disease down the road.
Avoiding these kinds of chemicals is easier said than done, however,
since no one knows how many of them exist or exactly how they’re being
used. That’s because chemicals aren’t tested for safety before they used
in products that are sold to consumers.
There are about 85,000 chemicals known to be used in the U.S. No one knows how many might disrupt hormones.
“Not all of them are EDCs [endocrine-disrupting chemicals], but if
even 1% of them were EDCs, that would be 850 chemicals,” Gore said.
Some of the best-known hormone-disrupting chemicals include:
Bisphenol A (BPA) and bisphenol S, which are used in some plastics, metal food cans, and cash register receipts
Phthalates, a class of chemicals that are used to soften plastic and also used in some perfumes, soaps, shampoos, and cosmetics
Some pesticides, like DDT
Triclosan, an antibacterial chemical
“They act at very low doses,” she said.
The statement calls for better safety testing to determine which
chemicals could pose problems, tighter regulation, and more research on
the health effects.
Environmental health experts cheered the new statement.
“I’m thrilled,” said Richard Stahlhut, MD, a visiting research scientist at the University of Missouri-Columbia.
“The endocrinologists had to be the first ones on board, and
fortunately, they are,” he said. “If they’re not on board, then maybe
people like me are crazy,” said Stahlhut, who studies the
hormone-disrupting effects of chemicals like BPA.
Chemical manufacturers said the statement went too far.
“The statement incorrectly characterizes as settled the
still-unproven hypothesis regarding risks of low levels of exposure to
particular chemicals. In doing so, the [Endocrine] Society discounts the
extensive reviews by experts at the U.S. Environmental Protection
Agency and the European Food Safety Authority that were unable to
substantiate the health significance of the so called low-dose effects,”
said the American Chemistry Council in a statement.
“Furthermore, the Endocrine Society’s report fails to differentiate
between chemicals that are 'endocrine-active,' meaning they interact
with the endocrine system, and those that are 'endocrine disruptors,'
meaning that the levels of exposure associated with that interaction
cause scientifically-proven adverse health effects,” the statement said.
Some retailers and manufacturers aren’t waiting for the dust to settle on the chemical debate.
On Monday, Bloomberg News reported that Target is expanding the list
of chemicals it would ask suppliers to take out of their products. The
expanded list will included nearly 600 chemicals on Health Canada’s
roster of prohibited cosmetic ingredients. It will include triclosan,
which is found in antibacterial soaps and some toothpastes.
Walmart also has a list of substances it asks retailers to avoid, though it doesn’t post the list publicly, Bloomberg reported.
Until more is known, Gore said consumers could reduce their exposure
to known endocrine disruptors by avoiding bottled water in plastic
bottles and being careful not to heat or microwave food in plastic
containers.
Stahlhut said people who are concerned about chemical exposure should
try to do the best they can, but because it’s impossible to avoid all
potential exposures, to “Try to be Zen about it. Don’t drive yourself
crazy.”
He said he tries to eat and drink out of stainless steel or glass
containers instead of plastic. He especially tries to avoid heating food
in plastic. He said he tries to avoid chemicals in the nonstick
coatings by cooking in cast-iron pans. And he steers clear of soaps and
toothpaste with triclosan.
“Make the easy choices when you can. Make the harder choices when you can afford it,” he said.
Tight Control of Type 2 Diabetes May Help Prevent Dementia
Conversely, poor blood sugar control appears to increase risk of brain troubles, study finds
TUESDAY, Sept. 15, 2015 (HealthDay News)
-- Keeping blood sugar levels in check may have a protective effect
against dementia in people who have type 2 diabetes, new Swedish
research suggests.
"The positiv
e association between [average blood sugar levels] and
risk of dementia in fairly young patients with type 2 diabetes indicates
a potential for prevention of dementia with improved blood sugar
control," study author Dr. Aidin Rawshani, from the National Diabetes
Register and Institute of Medicine in Gothenburg, Sweden, and colleagues
wrote.
However, the study wasn't able to definitively prove a
cause-and-effect relationship between blood sugar levels and dementia;
it was only able to show an association between these factors.
The study included almost 350,000 people with type 2 diabetes. They
were all registered in the Swedish National Diabetes Registry between
January 2004 and December 2012. They had no history of dementia when
they were diagnosed with type 2 diabetes. The mean age was 67 years when
the study began.
Study volunteers were tracked until the study ended in 2012 or they
were hospitalized for dementia or died. Using a computer model, the
researchers calculated the link between average blood sugar levels and
dementia. Average blood sugar levels were based on the results of
hemoglobin A1C tests (HbA1C). This test provides doctors with a
several-month average of blood sugar levels, according to the American
Diabetes Association (ADA). The ADA generally recommends an HbA1C level
of 7 percent or less for people with diabetes.
Slightly more than 3 percent of those in the study -- 11,035 people
-- were admitted to the hospital with dementia during the nearly
five-year follow-up period.
After taking other variables into account, the study found that those
with HbA1c levels of 10.5 percent or higher were 50 percent more likely
to be diagnosed with dementia compared to people with HbA1c levels of
6.5 percent or less.
Study volunteers who'd had a previous stroke were 40 percent more
likely to have declines in memory and thinking abilities, the
researchers said.
The study's findings were to be presented Sept. 14 at the annual
meeting of the European Association for the Study of Diabetes, in
Stockholm, Sweden. Findings presented at meetings are usually considered
preliminary until published in a peer-reviewed medical journal.
More information
The American Diabetes Association has more on blood sugar management for people with type 2 diabetes.
SOURCE: European Association for the Study of Diabetes, news release, Sept. 14, 2015
Research says that walking
offers many health along with healthy eating. United States authorities
are now encouraging everyone to live an active life. Vivek Murthy, a
surgeon general of the US has recently initiated a campaign that
encourages citizens to walk frequently.
Murthy is aware that "an average of 22 minutes a day of physical
activity-such as brisk walking-can significantly reduce the risk of
heart disease and diabetes."
"The key is to get started because even a small first effort can make
a big difference in improving the personal health of an individual and
the public health of the nation," Murthy added.
Health authorities say that making walking part of the daily life can
reduce the chance of acquiring diseases thus saving more money.
However, there are many obstacles that are hindering authorities to
achieve their goal of motivating people to exercise regularly. Lack of
facilities disable them to meet their goals.
In line with the "Step It Up"
campaign of Murthy, he also promotes the development of walkable
communities. The American physician believes that program and policy
efforts should be implemented including funding to ensure public health.
Facilities and designs like curb cuts, sidewalks, safe crossings for
the visually impaired and crosswalks should be made to provide
opportunities to the people to live a more active life.
Physical activity can help prevent osteoporosis and can help
individuals manage their weight. It can also lower stress, enhance mood
and even reduce risks of cancer, cardiovascular diseases and type 2
diabetes.
Walking is the simplest, easiest and most cost-effective form of
physical activity one can add to his lifestyle but it can offer many
health benefits like improving blood sugar levels and blood pressure.
Inactive lifestyle on the other hand, can cause lung and heart
disease including cancer and diabetes which receive 86% budget from the
health care cost of the US.
About half of all Americans have either diabetes or pre-diabetes,
according to a new report. And experts in the field say that's good news.
That's
because the study finds that after two decades of linear growth, the
prevalence of diabetes in the United States has finally started to
plateau.
In a paper published Tuesday in JAMA, the authors write
that their findings are consistent with other studies that show
the percentage of people with diagnosed diabetes remained steady from
2008 to 2012.
"Although
obesity and Type 2 diabetes remain major clinical and public health
problems in the United States, the current data provide a glimmer of
hope," wrote William Herman and Amy Rothberg of the University of
Michigan in an article accompanying the paper.
Herman and
Rothberg, who were not involved in the research, said the study suggests
the implementation of food, nutrition and physical activity policies
and regulations by federal, state and local governments as well as other
efforts to curb obesity and diabetes have finally started to pay off.
"Progress has been made, but expanded and sustained efforts will be required," they wrote.
The
study is based on data collected by the National Health and Nutrition
Examination Survey. The researchers report that from 2011 to 2012
between 12% and 14% of Americans had diabetes, depending on what
criteria were used to diagnose them. This percentage has remained
stable since 2008.
The research team also found that the
proportion of people who had diabetes without knowing it decreased from
40.3% in 1988-1994 to 31% in 2011-2012. ------------
A previous version of this post incorrectly stated the beginning year in the period 1988-1994 as 1998. ------------
This decrease, however, was not seen across all racial and ethnic groups.
The
proportion of Mexican Americans who were undiagnosed was higher than
their white and black counterparts, and this percentage had not
decreased over time. The authors suggest this result may be due to a
lower percentage of Mexican Americans with health insurance, leading to
lower access to healthcare.
The authors also found that Asian people were more likely than any other racial group to have undiagnosed diabetes.
The
prevalence of people with pre-diabetes has grown over time. Previous
studies show that between 1990 and 2002, 29% of people had pre-diabetes.
Between 2007 and 2010, that number grew to 36%. In 2011 and 2012, the
authors report the number grew slightly to 37% to 38%.
Altogether,
that means that in 2011-2012, 49% to 52% of the entire U.S. population
is estimated to have diabetes or pre-diabetes.
UpdatedRon LeutyReporter San Francisco Business Times
Google Inc. and drug developer Sanofi are joining forces to develop and streamline tools for managing diabetes.
The end game: reducing the risk of complications and ultimately lowering the cost of managing type 1 and type 2 diabetes for nearly 30 million patients in the United States and nearly 400 million worldwide.
The move comes as questions swirl about Google's future in health care, following the Mountain View-based company's (NASDAQ: GOOG) decision to move its life sciences unit from the Google X R&D division into a standalone company under the control of its new overarching Alphabet company.
Sanofi (NYSE: SNY), based in Paris, is one of the leading diabetes drug and device sellers.
There is a huge opportunity in diabetes, Google said in a statement. Patients use devices, apps and pieces of paper all try to keep track of food intake, but those methods are largely unintegrated and only a third of patients with type 1 diabetes meet their target blood sugar levels. That can lead to long-term complications, such as heart disease, stroke and nerve damage.
"With new technologies emerging to provide a more continuous and real-time view of a patient's health, we can see the promise for more proactive and effective ways to control diabetes," Andy Conrad, CEO of Google's life sciences team, said in a press release.
Google's highest-profile moonshot to date has come in the aging-related company Calico Life Sciences LLC, led by former Genentech Inc. CEO Art Levinson. But it also is working with Novartis AG on a "smart" contact lens with a miniaturized glucose sensor, a Star Trek-like Tricorder for early detection of disease and Liftware for Parkinson's disease patients who have trouble lifting and controlling utensils.
People With Type 2 Diabetes Do Benefit From Blood Sugar Checks
Study suggests monitoring at least twice a day helps people manage better
WEDNESDAY, Aug. 5, 2015 (HealthDay News)
-- Personalized blood sugar self-monitoring benefits people with type 2
diabetes even if they're not taking insulin, a new small study shows.
Some experts have questioned the value of self-monitoring in this
group, and many insurers -- including Medicare -- limit the
reimbursement of blood sugar (glucose) testing strips to one a day for
people with type 2 diabetes.
This study included 11 people with type 2 diabetes who worked with
the researchers to create personalized, structured self-monitoring blood
glucose schedules. In most cases, self-monitoring twice a day was the
most helpful in providing meaningful information about blood sugar
levels.
However, there was room for individualization based on a patient's
type of lifestyle and needs. For example, a patient might check their
blood sugar twice a day three days a week instead of once a day seven
days a week, according to the study authors.
People were taught to react to their blood sugar levels readings in a number of ways, such as eating less or going for a walk.
The 11 patients in the study lowered their A1C levels -- a test that
measures average blood sugar levels for the past few months -- from an
average of 7.3 percent to 6.2 percent. The usual goal for people with
diabetes is to keep those levels below 7 percent, the researchers
explained.
"Most of the participants in the study were self-described 'country
folk' who found that they were able to control their diabetes. This
study helps doctors and nurses to understand how people with type 2
diabetes can benefit from [self-monitoring]," study author Dana
Brackney, a diabetes educator and an assistant professor of nursing at
Appalachian State University in Boone, N.C., said in an American
Association of Diabetes Educators (AADE) news release.
The findings were to be presented Wednesday at the AADE annual
meeting in New Orleans. Research presented at meetings is generally
viewed as preliminary until it has been published in a peer-reviewed
journal.
The results confirm that people with type 2 diabetes do respond to
the results of blood sugar self-monitoring tests, Dana Brackney noted.
"Participants in this study said that sticking to a regular
[self-monitoring] schedule really helped them to know where their blood
levels were and take appropriate action, such as adding physical
activity or choosing a healthy snack," Brackney said.
"They said it helped them accept that they had diabetes, but also
feel confident that they could control it rather than letting it control
them," she added.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about diabetes.
SOURCE: American Association of Diabetes Educators, news release, Aug. 5, 2015
A new study published in the journal Neurology
shows that Type 2 diabetes triggers a significant reduction in
cognitive ability within just a two-year period. The main culprits
appear to be increased tissue inflammation and decreased blood flow to
the brain.
Researchers conducted several tests on 65 participants (average age
66) at the beginning of a two-year study, roughly half of whom had
already been diagnosed with Type 2 diabetes. All of the participants
took tests to assess cognitive function and memory performance, and
underwent MRI scans and blood tests to measure blood flow and pressure,
rate of tissue inflammation, and brain volume.
The tests were repeated after two years, with the following results:
Thinking and memory test scores for participants with Type 2 diabetes
dropped 12% over the two-year period. Test scores for participants
without diabetes remained steady.
Participants with Type 2 diabetes experienced a 65% decrease in blow flow regulation.
The diabetic participants also experienced a 50% decline in
“vasoreactivity” – the ability of blood vessels to contract in response
to stimuli, a key indicator of blood vessel health.
“People with type 2 diabetes have impaired blood flow regulation,” according to study co-author Vera Novak, MD, PhD, of Beth Israel Deaconess Medical Center
in Boston. “Our results suggest that diabetes and high blood sugar
impose a chronic negative effect on cognitive and decision-making
skills.”
Negative
effects of diabetes on blood flow and blood vessel function are
well-evidenced in prior research, but this study added the dimension of
linking these effects to changes in brain function over a brief window
of time.
“These correlations provided the link between altered cerebral
vasoregulation and cognitive deterioration in participants with type 2
diabetes that can be tracked prospectively even over a relatively short
time period of 2 years,” according to the research team.
Although this was a small study that should be validated with larger
groups of participants, the results further substantiate a link between
diabetes and cognitive impairment. Previous studies have found a similar
link, including a potential link between diabetes and Alzheimer’s disease.
“Early detection and
monitoring of blood flow regulation may be an important predictor of
accelerated changes in cognitive and decision-making skills,” Novak said
in a statement.
Medically complex patients with Type 2 diabetes could benefit from seeing a specialist soon
Healthier patients do well with family doctors
St. Michael's Hospital
TORONTO, June 25, 2015 - People recently diagnosed with Type 2
diabetes and who have other serious chronic health issues have less
heart disease and lower death rates if they see an endocrinologist
within one year of diagnosis, new research suggests. Patients with Type 2 diabetes who are not as medically complex did
well when managed solely by primary care providers - a finding the
researchers called optimistic.
"This study showed that Ontario's primary care system is functioning
as it should by providing good care for the majority of newly diagnosed
patients with Type 2 diabetes," said Dr. Gillian Booth, an
endocrinologist at St. Michael's Hospital and researcher at the
Institute for Clinical Evaluative Sciences.
"With more than a million people living with diabetes in Ontario,
endocrinologists don't expect, or necessarily need, to see every
patient. We really wanted to look at who would stand to benefit from
early specialist care and should be referred as soon as possible."
The study, published online today in Diabetic Medicine,
found medically complex patients with newly diagnosed diabetes receiving
early endocrinologist care had 10 to 20 per cent lower risk of
cardiovascular events (heart attack, stroke and death from coronary
heart disease); those with at least three or more visits had 30 per cent
lower rates.
The study used Ontario health data examining almost 80,000 adults 30
and older diagnosed with Type 2 diabetes between April 1, 1998, and
March 3, 2006.
There are no specific guidelines in Canada for referring patients
with Type 2 diabetes for specialist care. Often, primary care providers
(doctors, together with nurses and dieticians) will solely manage the
care of patients with Type 2 diabetes. But Type 2 diabetes can be a
complicated condition to manage, involving a combination of diet,
physical activity and medications to control blood sugar, blood pressure
and cholesterol levels. When a patient's care becomes complex,
endocrinologists often step in. Endocrinologists are doctors who
specialize in the diagnosis and treatment of medical conditions caused
by hormone imbalances.
"The earlier we can help provide targeted care to these patients, the better," said Dr. Booth.
"Our research will hopefully contribute to the efficiency of our
health-care system, ensuring people with diabetes are living healthy
lives, as long as possible."
It's estimated 360 million people worldwide live with Type 2
diabetes, in which the pancreas does not produce sufficient insulin, or
doesn't properly use the insulin it produces. This leads to a buildup of
glucose in blood, instead of energy use.
Diabetes rates in Ontario have doubled in the last 12 years, with
one in 10 adults now living with the disease; this number rises to one
in four adults over the age of 65. The Canadian Diabetes Association
forecasts that with the aging population and dramatic rise in obesity,
one in three Canadians will live with diabetes by 2020.
###
Dr. Booth's work was funded by an Applied Health Research Grant from
the Canadian Diabetes Association and by the University of Toronto
Dean's Fund.
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Individuals with Type 2 diabetes have heightened
amounts of sugars and fats in their blood, which increases their risks
for cardiovascular diseases such as strokes and heart attacks. Exercise
is a popular prescription for individuals suffering from the symptoms of
Type 2 diabetes, but little research has explored whether these
individuals receive more benefits from working out before or after
dinner. Now, researchers at the University of Missouri have found that
individuals with Type 2 diabetes can lower their risks of cardiovascular
diseases more effectively by exercising after a meal.
"This study shows that it is not just the
intensity or duration of exercising that is important but also the
timing of when it occurs," said Jill Kanaley, professor in the MU
Department of Nutrition and Exercise Physiology. "Results from this
study show that resistance exercise has its most powerful effect on
reducing glucose and fat levels in one's blood when performed after dinner."Kanaley and her colleagues studied a group of obese individuals with Type 2 diabetes. On one occasion, participants performed resistance exercises
before eating dinner. During another visit, participants exercised 45
minutes after eating dinner. Participants performed resistance exercises
such as leg curls, seated calf raises and abdominal crunches. Compared
to levels on a non-exercise day, Kanaley found that the participants who
exercised before dinner were able to only reduce the sugar levels in
their blood; however, participants who exercised after dinner were able
to reduce both sugar and fat levels. Participants consumed a moderate
carbohydrate dinner on the evenings of the study.
Kanaley said her research is particularly helpful for health care providers who have patients who exercise every day but are not seeing benefits.
"Knowing that the best time to exercise is after a meal could provide health care professionals with a better understanding of how to personalize exercise prescriptions to optimize health benefits," Kanaley said.
Kanaley also found that improvements in participants'
blood sugar and fat levels were short-lived and did not extend to the
next day. She suggests individuals practice daily resistance exercise
after dinner to maintain improvements.
"Individuals who exercise in the morning have usually fasted for 10
hours beforehand," Kanaley said. "Also, it is natural for individuals'
hormone levels to be different at different times of day, which is
another factor to consider when determining the best time to exercise."
In the future, Kanaley said she plans to research how exercising in the morning differs from exercising after dinner and how individuals' hormone levels also affect exercise results.
The study, "Post-dinner resistance exercise improves postprandial
risk factors more effectively than pre-dinner resistance exercise in
patients with type 2 diabetes," was published in the Journal of Applied Physiology.
"This study shows that it is not just the
intensity or duration of exercising that is important but also the
timing of when it occurs," said Jill Kanaley, professor in the MU
Department of Nutrition and Exercise Physiology. "Results from this
study show that resistance exercise has its most powerful effect on
reducing glucose and 
