Pharmacy Times

Diabetes Watch

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Trouble for Obese and Type 2 Diabetic Teens

In a study published in Circulation: Journal of the American Heart As sociation (June 9, 2009), researchers have found more evidence that obese teens and young adults—and those with type 2 diabetes, which can result from obesity—are at higher risk for stroke or heart attack later in life.

The researchers measured stiffness and fat buildup in the carotid arteries in the head and neck in 182 lean and 136 obese patients and 128 subjects with type 2 diabetes (aged 10-24 years). They found that young people who were obese and those with type 2 diabetes had greater danger signs, including abnormalities in carotid thickness and stiffness, which are only partially explained by traditional cardiovascular risk factors. The results of the study showed that health care professionals should address cardiovascular risk factors early to prevent future stroke or myocardial infarction.

Type 1 Diabetes May Be Linked to Wheat

Researchers at the Ottawa Hospital Research Institute and the University of Ottawa have discovered what may be an important clue to what causes type 1 diabetes. The results of their study, published in the August issue of Diabetes, found that an atypical immune response to wheat proteins may contribute to type 1 diabetes.

Canadian researchers tested 42 patients with type 1 diabetes and found that almost half had immune system T-cells that overreacted to wheat. In addition, the researchers identified genes associated with this abnormal immune response.

Fraser Scott, BSc, MSc, PhD, a senior scientist at the Ottawa Hospital Research Institute and professor of medicine at the University of Ottawa, said, “The immune system has to find the perfect balance to defend the body against foreign invaders without hurting itself or overreacting to the environment, and this can be particularly challenging in the gut, where there is an abundance of food and bacteria. Our research suggests that people with certain genes may be more likely to develop an overreaction to wheat and possibly other foods in the gut, and this may tip the balance with the immune system and make the body more likely to develop other immune problems, such as type 1 diabetes.” Dr. Scott notes that additional research will be needed to confirm the link and determine possible effects of dietary changes.

Insulin Myths Debunked

Patients who have recently been diagnosed with type 2 diabetes sometimes have certain fears surrounding their insulin treatment regimen—including fear of weight gain, developing low blood sugar, and seeing their quality of life decline. A new study recently appearing in Diabetes Care suggests, however, that those fears are largely unfounded.

According to Ildiko Lingvay, MD, MPH, MSc, and colleagues from the University of Texas Southwestern Medical Center at Dallas, insulin “should not be viewed as a treatment of last resort.” The researchers said that insulin can be safely and effectively used as a first-line treatment in individuals who have been newly diagnosed with type 2 diabetes, with high rates of patient satisfaction and adherence. Dr. Lingvay and colleagues found, after 3 years, that the patients in the study who were taking insulin plus metformin had fewer hypoglycemic events, gained less weight, and reported high satisfaction with the insulin.

Lack of Sleep May Increase Diabetes Risk

Abbreviated sleep times may be a factor in the development of insulin resistance and reduced glucose tolerance, which, in turn, may increase the long-term risk of diabetes. A new study, which was accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism, looked at whether reduced sleep duration itself may increase the risk of developing diabetes when combined with physical inactivity and overeating. Short sleep times (<6 hours each night) are becoming more frequent and often are accompanied by physical inactivity and overeating.

In the study, researchers analyzed a group of healthy middle-aged men and women in 2 controlled 14-day periods of sedentary living with free access to food and either 5.5- or 8.5-hour bedtimes. During the study, after the subjects were required to reduce their sleep times from 8.5 to 5.5 hours, they showed changes in response to 2 common sugar tests, which were similar to those seen in individuals with a higher risk of developing diabetes. Researchers stated that additional studies will be needed.

FAST FACT: Although an estimated 17.9 million have been diagnosed with diabetes in the United States, 5.7 million individuals remain undiagnosed.