Diabetic Live

Study on Liraglutide (Victoza) Could Help Type 1 Diabetics: The University of Buffalo conducted an observation study in regards to the use of liraglutide, an injectable medication that is now used to treat only Type 2 diabetes, and how it might help Type 1 diabetics in achieving the very best blood sugar levels possible. This was a small study, and only a larger study that is now planned by the University of Buffalo might show that this could lead to better treatment for Type 1 diabetics. If this proves to be true, then this could be the newest treatment for Type 1 diabetics since the discovery of insulin back in the 1920s. The results of this study will eventually be in print and available in the European Journal of Endocrinology. This study received accolades at the annual meeting of the Endocrine Society in Boston. This study at University of Buffalo was headed by Paresh Dandona, a Professor of Medicine in the School of Medicine and Biomedical Sciences and was the senior author of the study.

Approximately 23.6 million Americans have some form of diabetes, either Type 1 (the more serious and more difficult to control) or Type 2. The number of people with Type 2 diabetes is higher than those with Type 1, and a many number of people with Type 2 diabetes can manage their disease through diet, exercise and oral medication, or with the injectable liraglutide.

With Type 1 diabetes the only form of treatment is through insulin that must be injected. The insulin pump is now available, but this too involves the injection of insulin into the body.

The study showed that liraglutide (Victoza) along with insulin helped control blood sugar much better for tighter Type 1 diabetes management. Liraglutide, or also known as Victoza, is an acylated human glucagon-like peptide-1 (GLP-1) receptor agonist.

An A1C test is a blood test that is taken by diabetics approximately every three months by their physician. This A1C test result tells the physician and the patient how well they have controlled their blood sugar levels over those past months. If the A1C test is below 7, this is considered the best. If their A1C is higher than 7, then they know they need to take steps to better control their blood sugar levels, because the more out of control the blood sugar levels are, the more likely it is for severe complications to arise down the road. These complications include, but are not limited to, vision loss, kidney failure, and heart disease.

This was an unfunded study and was an analysis of data and was conducted at Kaleida Health’s Diabetes-Endocrinology Center of Western New York.

The study involved 14 Type 1 diabetic patients whose hemoglobin A1C levels were under the preferred “7.” In the study, these patients were deemed well controlled diabetics. Even though they were considered well controlled, even these patients had fairly wide swings in their blood sugar levels, some from 150 mg/dl to 250 mg/dl, and sometimes even higher than 250 mg/dl. So though deemed well controlled, they still had periods when their blood sugar level was too high for comfort.

With the addition of liraglutide to their insulin, these patients showed that they had fewer occasions when their blood sugar levels were too high, as well as a lessening in the amount of insulin they were injecting. A decrease in appetite was also noted.

Within a matter of days of the addition of liraglutide to their insulin, a positive result was seen. When the liraglutide was discontinued, their blood sugar levels again rose at times to higher levels than desired. This indicated that it was the addition of liraglutide that created the better controlled blood sugar levels.

More research is needed to understand the mechanics of the improvements in blood sugar levels with the addition of liraglutide to insulin, but it is thought that with the addition of liraglutide to insulin there is a decrease in the post-meal glucagon, which is the hormone that causes the increase in blood sugar levels in Type 1 diabetics.

With this further research, the researchers plan a multicenter study of patients with Type 1 diabetes and hopefully find more information on how the liraglutide suppresses the glucagon that raises the blood sugar levels to an unsafe level.

These patients took liraglutide for periods of one week to 24 weeks. There were 14 adult patients with Type 1 diabetes.

Hopefully, this new research that is planned will be expanded quickly and help even more in the care of Type 1 diabetes in the control of their blood sugar levels, an everyday battle for many people.

Can eating 37 strawberries a day lessen diabetes complications: That old advice, an apple a day keeps the doctor away, might be switched around a bit to “a strawberry a day keeps the doctor away.” Keeping the doctor away, yes, but, more importantly, not only the doctor and/or endocrinologist, but also neurologist and possibly the oncologist.

But 37 strawberries work better than one, according to a recent study that was undertaken at the Salk Institute for Biological Studies, Cellular Neurobiology Laboratory (CNL), with the results to be published in a June 2011 issue of PLoS ONE. David Schubert, Ph.D., Professor and Head of the CNL, is a co-author of the paper and Pam Maher, Ph.D. a Senior Staff Scientist, is the corresponding author of the paper.

Strawberries contain fisetin. Fisetin is a flavonol. Flavonol is a structurally distinct chemical substance that belongs to the flavonoid group of polyphenols. It is the color in the plants and the fruits of those plants. Grapes, spinach, oranges, blueberries, kale, apples, and so on. News reports have shown us for years that any flavonoid helps fight cancer and has positive effects on other illnesses, such as Alzheimer’s Disease. In other words, like mama told you, eat your fruits and veggies.

In this study conducted by CNL, the study involved the use of Akita mice, a very “robust” mice model of type 1 diabetes, formerly known as juvenile diabetes mellitus, which can be treated only with insulin. Mostly affecting young children, this form of diabetes over the passage of years most often leads to severe complications such as blindness, kidney failure, neuropathy, strokes and heart attacks; whereas type 2 diabetes, until recently, was more often diagnosed in the older population and can be treated with oral medication, along with a good diet and having an exercise program in place. Those with type 2 diabetes do develop complications, but they tend to take longer to arise than those complications arising from type 1 diabetes.

These Akita mice showed all the usual effects of Type 1 diabetes, namely increased blood sugar levels, but also “display pathologies seen in serious human complications of both Type 1 and Type 2 diabetes.” In this study, the Akita mice were given supplementation of fisetin. The Akita mice that were fed an enriched diet of fisetin remained diabetic, but kidney enlargement was reversed and high urine protein levels fell. With high urine protein levels, it’s an indication that the kidneys are becoming diseased. As well, fisetin ingestion affected anxiety-related behaviors of the diabetic mice. “A mouse not suffering with anxiety tends to move around when put in a large area, but a mouse suffering from anxiety does not move around. The diabetic mice showed anxiety behavior, but when fed fisetin their movement returned to normal.”

The study also defined a possible molecular mechanism that resulted in these results. Those conducting the study saw that blood and brain levels of “sugars affixed to proteins known as advanced glycation end-products (AGEs)” were reduced in fisetin treated Akita mice as compared to untreated Akita mice. There is evidence that increased AGE levels is implicated in many, if not all, diabetic complications. This study was the first study that indicated that any compound can enhance glyoxalase 1 activity, which fisetin seemed to do on these Akita mice.

It is thought that really high AGE levels might increase cancer risks.

These tests were conducted on mice, and only time will tell if the same results can be manifested in humans, and the possibility that there would be a supplement available to get your fisetin rather than eating those 37 strawberries a day.

In the meantime, think about eating the colors of the rainbow as often as possible, the darker in color the better.

Tom Martinez, Facebook And A Donor: Back in June of 2011, famous quarterback coach Tom Martinez announced on his Facebook page that his complications stemming from diabetes and other ailments gave him only one month remaining to live because he needed a simultaneous heart and kidney transplant. Martinez, a very well-respected coach who has worked with many, many quarterbacks over the years, is probably most well known for working so closely with Tom Brady, the winner of three Super Bowl titles while he’s been with the New England Patriots.

In June when Martinez gave his dire prognosis for his imminent death on Facebook, it was a blow for the football world that was difficult to absorb. The football world mourned. Martinez at that time stated, “My medical test numbers say I’m basically gone. My blood pressure is too low for me to continue with dialysis, and without dialysis poisons build up in my body. Doctors say without dialysis I have a week to go. We’re looking into transplants. I would need both heart and kidney transplants done simultaneously.”

Coach Martinez retired in 2005 from coaching at the College of San Mateo, California, because of his health issues, but he still worked with quarterbacks at camps and on an individual basis. Martinez will always be one of the best coaches from the junior college ranks and is a member of the College of San Mateo’s Hall of Fame.

Facebook can do wonders. Since those announcements by Martinez back in June, he was contacted by eight people who offered Martinez a kidney. Through testing, a suitable donor was found that matched Martinez’s blood type. The heart situation seems to have been corrected through a pacemaker that was adjusted just last week. Now, it seems that Martinez just needs that kidney to keep on going.

After Martinez finishes up with the camp that he’s now visiting, he will return to UCLA for more internal tests to see if he is well enough to undergo the kidney transplant and stated that, “They might try to do a double transplant if everything works.”

This is great news for the football world, his family and those who love him. Most importantly, it’s great news for Coach Martinez. There might be a new young kid out there somewhere with a great throwing arm that needs Martinez’s guidance, and catches Martinez’s eye. Coach Martinez has never walked away from a good challenge, particularly when it comes to quarterbacking, but especially when it comes to his diabetes.

New Discoveries Made in Conquering Kidney Disease in Diabetic Patients: Diabetes and kidney failure go hand in hand. The kidneys do not fail simply because one has either Type 1 or Type 2 diabetes, but the kidneys fail because increased blood sugar levels over time damage blood vessels and the internal organs. Researchers worldwide are seeking to find the answers to why a person develops diabetes, how to stop the complications that arise from having these elevated blood sugar levels caused by diabetes and how to protect the organs. The kidneys, along with the eyes, are at times the main targets of these complications. With the eyes, there is vision loss. With the kidneys, there is kidney failure, which could lead to kidney dialysis. Many people live with the help of kidney dialysis, waiting for a transplant to become available.

According to the latest issue of the Journal of Clinical Investigation, Professor Dr. Tobias Huber, a kidney expert at the Nephrology Division of the University Medical Center Freiburg, Germany (a teaching hospital and medical research unit of the University of Freiburg and well known for its advanced research), along with the help of the Cluster of Excellence BIOSS (Center for Biological Signaling Studies), and his team have been able to make new discoveries as to why the kidneys fail as a result of diabetes.

This new research data was able to identify a signaling path that affects the progression of kidney disease in diabetic patients. mTOR (which belongs to the phosphatidylinositol 3-kinase-related kinase protein family) is a metabolic enzyme that controls the growth and reproduction of cells. Through research, it has been shown that diabetes, either Type 1 or Type 2, causes the mTOR signaling path to become overactive. When the signaling path becomes overactive, it causes damage to the kidney cells which in turn leads to kidney failure.

Basal activation of mTOR may be proven to be vital for the regular function of renal corpuscles during human development, but the overactive mTOR can result in breakdown of kidney filtering in diabetic patients, which eventually leads to the total shutdown of the kidneys.

Using animals for testing, the researchers were able to stop the signaling path and able to stop the kidney disease in its tracks. If applied to diabetic patients with kidney failure in the future, this is a chance for the end of kidney failure in those suffering from any form of diabetes.

Kidney failure affects approximately 288,000 American citizens who are currently undergoing kidney dialysis. Kidney dialysis involves removing waste and excess water from the blood. Like artificial insulin being placed into the body to replace insulin no longer produced by the body, dialysis takes away the excess waste products for people with lost kidney function. Kidney failure can develop over months or years. Acute kidney failure is not reversible and kidney dialysis is required in order for the patient to live. Many consider kidney dialysis as the waiting period until a kidney transplant can be performed.

Through the new research results from Dr. Huber and his team there might be hope on the horizon for those new patients in the future who suffer from kidney failure. This new research information might lead the way for the discoveries necessary to eliminate the need for kidney dialysis. There may be hope that those with diabetes may never have to face the possibility of kidney failure and dialysis.

High-Fat Diet Pregnancy Could Lead to Diabetes in Children: A study created by the University of Illinois suggests that a high-fat diet throughout one’s pregnancy could lead to diabetes in the child even if the mother herself is not a diabetic or even obese.

A University of Illinois professor of nutrition, Yuan-Xiang said, “We found that exposure to a high-fat diet before birth modifies gene expression in the livers of offspring so they are more likely to overproduce glucose, which can cause early insulin resistance and diabetes. He also noted, “The high-fat diet that caused these changes was a typical Western diet that contained 45 percent fat, which is not at all unusual. In recent years, the American diet has shifted to include many high-energy, high-fat, cafeteria-type, and fast foods.”

Based off of the study, researchers hope that doctors will be able to screen newborns through a diagnostic tool in which cam help keep children’s blood sugar in the normal range, which in the end will give them a better chance at lessening the risk of diabetes.

During the study, doctoral student Rita Strakovsky was able to feed obesity-resistant rats with a high-fat or a controlled diet from the first day of their gestation period. The rats were not obese at all, which means they were able to see that the diet alone was very helpful in slowing the risk of diabetes.

Strakovsky said, “At birth, offspring in the high-fat group had blood sugar levels that were twice as high as those in the control group, even though their mothers had normal levels. The high-fat offspring also had epigenetic modifications to genes that regulate glucose metabolism. One of these modifications, the acetylation of histones, acts by loosening the DNA, making it easier for the gene to be transcribed.”

Through the study it was quickly understood that diabetes cannot be stopped but the chances can be lessened with a low-fat diet.

Pan said, “We’d like to see if diet after birth could alleviate this problem that was programmed before birth,” During the study epigenetics was used as the diagnostic tool but Strakovsky states “The importance of making dietary recommendations for pregnant women more available so they are able to prevent this health problem.

She also stated, “Obstetrics patients rarely see a dietitian unless they’re having medical problems like gestational diabetes or pre-eclampsia. Doctors now tend to focus on how much weight a woman should gain in a healthy pregnancy. Although healthy weight gain is extremely important, nutritional guidance could be invaluable for all pregnant women and their babies.”

A pregnant woman’s diet should consist of foods that are low in saturated fats such as fish, walnuts, whole grain bread, poultry, sunflower seeds and eggs. Fast foods, pastries and fattier cuts of meat are all bad, high-fat foods that are leading to more diabetic patients.

Oil Refining Helping Researchers With New Tools For Type 1 Diabetes: In order to control blood sugar, engineering researchers from the Rensselaer Polytechnic Institute are merging automation techniques from oil refining in order to create a closed-loop artificial pancreas.

The reason for this device is so that blood sugar levels can be automatically monitored and insulin can be administered to patients suffering from Type 1 diabetes. After six years of research and studies, Professor B. Wayne Bequette, a member of the Department of Chemical and Biological Engineering at Rensselaer had progressively created more highly advanced control systems for the closed-loop artificial pancreas. Through Professor Bequette work, he hopes to benefit 15,000 children and 15,000 adults who are diagnosed with Type 1 diabetes every single year.

Bequette states: “Every single person with Type 1 diabetes has a different response to insulin and a different response to meals. These responses also vary with the time of day, type of meal, stress level, and exercise. A successful automated system must be safe and reliable in spite of these widely varying responses.”

Like most people, Bequettes fight against type 1 diabetes is very personal to him, given that his little sister developed the disease very early in life. Unfortunately, at that time diabetes wellness was not as advanced as it is today.

A person who had Type 1 diabetes will find themselves with little or no insulin in their pancreas. Due to this, they will have to take insulin injections on a daily basis. Some people who have Type 1 diabetes prefer to use an insulin pump instead. The insulin will help to maintain the blood sugars, for if they do not stay balanced serious life-threatening health problems could occur through hyperglycemic, which means blood sugar is too high and through hypoglycemic, which means blood sugar is too low.

Bequette says, “A key challenge for people living with Type 1 diabetes is the constant monitoring of their blood sugar level. Blood glucose levels are generally measured from a tiny blood sample captured from a finger stick test, prior to eating or sleeping. Another critical challenge is accurately estimating how many carbohydrates they eat. These blood sugar readings, along with the amount of carbs eaten, must be interpreted to decide how much insulin the individual needs to inject. Exercise and fitness also impact the amount of insulin required. Continuous blood glucose monitors are available on the market, but are not yet as accurate as finger sticks tests. There are many judgment calls and best guesses being made on a daily basis by individuals with Type 1 diabetes. And though medical technology for diabetes is very advanced and reliable, he is working on an artificial pancreas that would remove the need for most of this guesswork.”

HbA1C Results Prove Inaccurate For Dialysis Patients: According to a new study at Wake Forest Baptist Medical Center, a test known as the golden standard long-term glucose monitoring test proved to be less valuable in patients who are on dialysis.

The hemoglobin A1C (HbA1c) is administrated to patients over a 3-month period to check blood sugar levels and has become a trusted test in terms of the medical field. It had even been identified as an applicable tool in diagnosing diabetes, according to the American Diabetes Association. However, recently professionals have found that the HbA1c test is not helpful for patients who have been diagnosed with diabetes and are in the advanced stages of kidney failure. Alternatively, the GA assay, aka glycated albumin does appear to be more helpful in that area.

Diabetes is the most common cause of kidney failure worldwide and is associated with high mortality rates — more than 20 percent of dialysis patients die each year. As such, there is an urgent need for accurate blood sugar testing in diabetic dialysis patients.

Barry I. Freedman, M.D., lead investigator of the study and Professor at John H. Felts III said, “Many organs don’t function properly in severe kidney failure. For example, most dialysis patients have anemia with fewer red blood cells than they should, which has a dramatic impact on the accuracy of the HbA1c reading.”

Freedman goes on to say, “Doctors long thought the HbA1c predicted outcomes in diabetes. This test is not predictive of outcomes in diabetes patients with kidney disease on dialysis. Dialysis patients and physicians get a false sense of security because their lower HbA1c actually relates to shorter red cell survival, yet suggests diabetes control is better than it really is.”

This is the way it works. Hemoglobin takes red blood cells through the body, carrying oxygen. Blood sugar will interact with the hemoglobin and come up with HbA1c, which are only accurate when red cells have a regular lifespan. However, dialysis patients have a shorter red cell lifespan, which means the time that sugar is in the blood stream to interact with hemoglobin is reduced and cause less HbA1c values.

During this study, 444 patients suffering from diabetes who also have to undergo dialysis were tested on. While patients continued their normal treatments and were monitored in the amount of HbA1c they also agreed to the GA test every three months for 2.3 years.

Freedman responds the results of the test. “This is the first study showing that a blood sugar test predicts risk of death in diabetic dialysis patients, as well as risk of hospitalization. This test provides the missing link that will allow dialysis patients and physicians to accurately gauge risk. The association is clear: high GA readings predict higher risk.”

More than 24 million Americans suffer from diabetes and being able to monitor blood sugar is one way to manage diabetes. More than 500,000 people are on dialysis in United States alone and diabetes is the cause of almost 50 percent of those with kidney failure. More than 20 percent of patients who suffer from kidney failure die each year.

Master Gene Found To Cause Obesity And Diabetes: According to a study led by a team of King’s College London and the University of Oxford researchers, a “master regulator” gene is being named the culprit of high cholesterol levels and type 2 diabetes in the body.

The regulatory gene has become a lead target in helping to fight off metabolic diseases such as diabetes, obesity and even heart disease. Fat alone is the biggest cause of these diseases.

Through years of continuous study, it had already come to light that the KLF14 gene was linked to type 2 diabetes and cholesterol levels. However, researchers did not know about the role that was being played in which could control other genes positioned further away on the genome.

Over 20,000 genes within subcutaneous fat biopsies in 800 UK female twin volunteers were examined. A connection was found between the KLF14 gene and the expression levels of multiple distant genes that were found in fat tissue. This means that the gene acts as a master switch to control these genes. Six hundred subcutaneous fat biopsies were then confirmed in Icelandic subjects.

These other genes that are controlled by the KLF14 gene are found to be linked to certain metabolic traits like cholesterol, insulin, glucose levels, and BMX (body-mass index).

There are a set of genes that are inherited by the mother and the father, but the KLF14 gene is inherited from the mother. In this instance, the father’s side of the KLF14 for lack of a better world “switched off.” This means that the mother’s gene is the one that is ready and active. This is actually referred to as a process known as imprinting. The KLF14’s ability to control other genes is completely dependent on the mother, as the father’s copy showed nothing.

A professor by the name of Tim Spector who led the MuTHER project to find out what the master gene was capable of had this to say. “This is the first major study that shows how small changes in one master regulator gene can cause a cascade of other metabolic effects in other genes. This has great therapeutic potential particularly as by studying large detailed populations such as the twins we hope to find more of these regulators.”

Another professor, Mark McCarthy also commented. “KLF14 seems to act as a master switch controlling processes that connect changes in the behavior of subcutaneous fat to disturbances in muscle and liver that contribute to diabetes and other conditions. We are working hard right now to understand these processes and how we can use this information to improve treatment of these conditions.”