TUESDAY, June 18 (HealthDay News) -- A diagnosis of type 1 diabetes often seems to come out of the blue. But German researchers say they can predict who will likely develop the chronic disease.

Blood samples taken from children at increased genetic risk of type 1 diabetes reveal significant "preclinical" clues, the researchers found. The strongest predictor is the presence of two diabetes-related autoantibodies, they reported in the June 18 issue of the Journal of the American Medical Association.

"If you have two or more autoantibodies, it's nearly inevitable that you will develop the disease. Most people -- even physicians -- don't appreciate this risk," said Dr. Jay Skyler, deputy director for clinical research at the Diabetes Research Institute and a professor at the University of Miami Miller School of Medicine. Skyler was not involved in the research.

Nearly 70 percent of youngsters with two diabetes-related autoantibodies developed type 1 diabetes over a 10-year period compared to less than 15 percent of kids with just one autoantibody, the researchers found.

Skyler, co-author of an accompanying journal editorial, said this study highlights the need for effective prevention strategies for type 1 diabetes.

Type 1 diabetes is believed to be an autoimmune disease in which the body's immune system mistakenly destroys the insulin-producing beta cells in the pancreas. Insulin is a hormone needed to turn the carbohydrates from food into fuel for the body.

To survive, people with type 1 diabetes must monitor their food intake and replace the lost insulin through injections or an insulin pump.

Type 1 diabetes can occur at any age, and there's currently no known way to prevent or cure it, according to the JDRF (formerly the Juvenile Diabetes Research Association). And unlike its more common counterpart, type 2 diabetes, the development of type 1 diabetes isn't linked to lifestyle choices.

The current study included children from Colorado, Finland and Germany who were followed from birth for as long as 15 years. Children in the Colorado and Finland study groups were included in the study if they had a specific genotype that indicated a genetic predisposition to developing type 1 diabetes. Children in the German study had to have a parent with type 1 diabetes to be included in the study.

More than 13,000 youngsters were recruited in all. During the study follow-up, the researchers found that nearly 1,100 children -- or about 8 percent of the total group -- developed one or more autoantibodies, which are markers for the destruction of the insulin-producing beta cells in the pancreas.

The vast majority of the children, despite their higher risk, remained free of type 1 diabetes and free of signs that the disease might develop.

"Autoantibodies are a marker for the risk of diabetes. [But] they are just markers; they are not causing the disease," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

Of the children who developed autoantibodies, 585 developed two or more. The remaining 474 children had just one autoantibody, according to the study.

In children with multiple autoantibodies, 43.5 percent developed type 1 diabetes within five years, about 70 percent had diabetes after 10 years and about 84 percent had the condition after 15 years. At the 10-year mark, just 14.5 percent of children with a single autoantibody had developed type 1 diabetes.

The researchers also found that children who had multiple autoantibodies before age 3 were more likely to quickly develop type 1 diabetes. Children with certain genotypes -- the HLA genotype DR3/DR4-DQ8 -- were more likely to develop type 1 diabetes faster. And girls were more likely to progress to type 1 diabetes faster than boys if they had multiple autoantibodies, according to the study.

"Findings from this study suggest there should be a greater emphasis for [people with multiple autoantibodies] to be enrolled in studies that could delay or prevent type 1 diabetes," Skyler said.

Zonszein said these findings can help better predict who is at high risk for type 1 diabetes. "[However], we're still a long way from stopping the development of type 1 diabetes," he added.

He also noted that the children in the studies were almost all white, so these findings might not translate to other populations, such as blacks or Hispanics.

More information

Learn more about type 1 diabetes from the Diabetes Research Institute.

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TUESDAY, June 18 (HealthDay News) -- Catching up on your sleep on weekends may help protect you from developing diabetes, a small, early study suggests.

The study found significant improvements in insulin sensitivity -- the body's ability to clear sugar from the blood -- among sleep-deprived men after they had three nights of extra sleep.

"We all know we need to get adequate sleep, but that is often impossible because of work demands and busy lifestyles," Dr. Peter Liu, a researcher at the Los Angeles Biomedical Research Institute, said in an institute news release.

"Our study found extending the hours of sleep can improve the body's use of insulin, thereby reducing the risk of type 2 diabetes in adult men," Liu said. "Reducing the incidence of this chronic illness is critical for a nation where diabetes affects nearly 26 million people and costs an estimated $174 billion annually."

The study included 19 men without diabetes, whose average age was about 29. They slept only 6.2 hours per night during the week but regularly caught up on their sleep on the weekends by sleeping an extra 2.3 hours per night.

Participants spent three nights in a sleep lab on each of two separate weekends and were randomly assigned to varying sleep schedules. These included 10 hours of sleep; six hours of sleep; or 10 hours spent in bed, during which noises during deep sleep aroused them into shallow sleep without waking them.

The men's blood sugar and insulin levels were checked on the fourth morning to calculate their insulin sensitivity.

When the men had 10 hours of sleep for three consecutive nights, their insulin sensitivity was much better than when they got less sleep, according to the study, which is scheduled for presentation Tuesday at the annual meeting of the Endocrine Society in San Francisco.

The findings are important for people who don't get enough sleep during the week due to work and busy lifestyles, but catch up on their sleep on weekends, the news release suggested.

"The good news is that by extending the hours they sleep, adult men who over a long period of time do not get enough sleep during the working week can still improve their insulin sensitivity," Liu said.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. Department of Health and Human Services outlines ways to prevent diabetes.

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MONDAY, June 17 (HealthDay News) -- People who eat a lot of red meat increase their risk of developing type 2 diabetes, while those who cut down on red meat cut their risk.

Those are the findings of a large new study out of Singapore involving 149,000 U.S. men and women.

The researchers found that increasing the consumption of red meat can increase the risk of developing type 2 diabetes by 48 percent.

"There is no need to have more red meat on your plate; it increases the risk of diabetes," said lead researcher An Pan, an assistant professor at the Saw Swee Hock School of Public Health at the National University of Singapore.

"It is better to reduce your red meat consumption by replacing it with other healthy food choices, like beans, legumes, soy products, nuts, fish, poultry and whole grains," he added.

The report was published in the June 17 online edition of the journal JAMA Internal Medicine.

For the study, Pan's team collected data on three Harvard group studies: the Health Professionals Follow-up Study, the Nurses' Health Study and the Nurses' Health Study II. All the participants answered questions about their diet every four years, resulting in more than 1.9 million person-years of follow-up.

There were more than 7,500 cases of type 2 diabetes, the researches found.

Comparing diet with the cases of diabetes, Pan's group found that people who increased their consumption of red meat by 0.5 servings per day during a four-year period were 48 percent more likely to develop type 2 diabetes, compared with people who ate less red meat.

Moreover, people who cut their red meat consumption were 14 percent less likely to develop type 2 diabetes, they found.

Outside experts, however, argued about the findings.

"Epidemiological studies made by questionnaires are not accurate, and they never prove causation, no matter how big and how good the statistics are," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

The interaction of the many genetic and lifestyle factors that cause obesity and type 2 diabetes is remarkably complex and is still being studied, Zonszein added. "Doing cross-sectional analysis or epidemiological analysis produces questions but not answers," he said.

Blaming red meat for diabetes is misleading, said William Evans, head of the Muscle Metabolism Discovery Performance Unit at GlaxoSmithKline and the author of an accompanying editorial in the journal.

The amount of saturated fat that is also found in many types of meat is the most likely cause for the association of red meat and risk of diabetes, he said.

"Red meat is not the bad food that it is touted to be," Evans said. "There are many cuts of beef that are red and have as much fat as a chicken breast, and the redness in meat provides the most available form of iron from any food that we eat."

But Samantha Heller, a senior clinical nutritionist at NYU Langone Medical Center in New York City, countered that Americans are eating too much red meat.

"In 2012, Americans ate an estimated 166 pounds of meat per person," she said. "That is a titanic amount of unhealthy saturated fat and other compounds found in meat, such as iron, zinc or N-nitroso -- compounds that research suggests are linked with increased risks for diseases such as diabetes, cardiovascular disease and cancers."

"A plate loaded with meat also leaves less room for vegetables, whole grains and other healthy foods," Heller said.

Zonszein also doesn't put the blame for type 2 diabetes on red meat alone.

"The public health message should be to eat a heart healthy and balanced diet with balanced macronutrients, and low in saturated fat," he said.

He added, however, that "excessive caloric intake is not good, but I will eat a good steak and potatoes from time to time and enjoy it."

"If the cause of the associated risk is saturated and total fat content," Evans said, "the public health message should be to reduce intake from all sources, such as cheese, whole milk and meat that is rich in saturated fat, not to single out specific types of meat because of redness."

More information

For more information on diabetes, visit the American Diabetes Association.

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SUNDAY, June 16 (HealthDay News) -- Eating breakfast every day may help overweight women reduce their risk of diabetes, a small new study suggests.

When women skipped the morning meal, they experienced insulin resistance, a condition in which a person requires more insulin to bring their blood sugar into a normal range, explained lead researcher Dr. Elizabeth Thomas, an instructor of medicine at the University of Colorado.

This insulin resistance was short-term in the study, but when the condition is chronic, it is a risk factor for diabetes, Thomas said. She is due to present her findings this weekend at the Endocrine Society's annual meeting in San Francisco.

"Eating a healthy breakfast is probably beneficial," Thomas said. "It may not only help you control your weight but avoid diabetes."

Diabetes has been diagnosed in more than 18 million Americans, according to the American Diabetes Association. Most have type 2 diabetes, in which the body does not make enough insulin or does not use it effectively.

Excess weight is a risk factor for diabetes.

The new study included only nine women. Their average age was 29, and all were overweight or obese.

Thomas measured their levels of insulin and blood sugar on two different days after the women ate lunch. On one day, they had eaten breakfast; on the other day, they had skipped it.

Glucose levels normally rise after eating a meal, and that in turn triggers insulin production, which helps the cells take in the glucose and convert it to energy.

However, the women's insulin and glucose levels after lunch were much higher on the day they skipped breakfast than on the day they ate it.

On the day they did not eat breakfast, Thomas explained, "they required a higher level of insulin to handle the same meal."

"There was a 28 percent increase in the insulin response and a 12 percent increase in the glucose response after skipping breakfast," she said. That's a mild rise in glucose and a moderate rise in insulin, she noted.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"Their study doesn't prove causation," said Dr. Joel Zonszein, a professor of clinical medicine at the Albert Einstein College of Medicine and director of the Clinical Diabetes Center at Montefiore Medical Center, in New York City.

The study found only a link or association between breakfast skipping and higher insulin levels. More research is needed for confirmation, another expert said.

"This is a small, but very interesting, study," said Dr. Ping Wang, director of the University of California, Irvine, Health Diabetes Center. "The findings will have to be verified with larger studies."

Whether the effect is short-term or long-term is not known, Wang said.

Zonszein recommends against either skipping meals or eating very frequent meals, the so-called nibbling diet. "Studies done in Europe have shown that a large meal in the middle of the day is better than a large meal at dinner," he said.

However, he acknowledged that pattern is more of a habit in Europe than in the United States. Even so, he advises his patients to eat a good breakfast, a good lunch and a lighter dinner.

Other ways to reduce diabetes risk, according to the American Diabetes Association, are to control weight, blood pressure and cholesterol and to be physically active.

More information

To learn more about reducing diabetes risk, visit the American Diabetes Association.

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WEDNESDAY, June 12 (HealthDay News) -- Older adults at risk for getting diabetes who took a 15-minute walk after every meal improved their blood sugar levels, a new study shows.

Three short walks after eating worked better to control blood sugar levels than one 45-minute walk in the morning or evening, said lead researcher Loretta DiPietro, chairwoman of the George Washington University School of Public Health and Health Services in Washington, D.C.

"More importantly, the post-meal walking was significantly better than the other two exercise prescriptions at lowering the post-dinner glucose level," DiPietro added.

The after-dinner period is an especially vulnerable time for older people at risk of diabetes, DiPietro said. Insulin production decreases, and they may go to bed with extremely high blood glucose levels, increasing their chances of diabetes.

About 79 million Americans are at risk for type 2 diabetes, in which the body doesn't make enough insulin or doesn't use it effectively. Being overweight and sedentary increases the risk. DiPietro's new research, although tested in only 10 people, suggests that brief walks can lower that risk if they are taken at the right times.

The study did not, however, prove that it was the walks causing the improved blood sugar levels.

"This is among the first studies to really address the timing of the exercise with regard to its benefit for blood sugar control," she said. In the study, the walks began a half hour after finishing each meal.

The research is published June 12 in the journal Diabetes Care.

For the study, DiPietro and her colleagues asked the 10 older adults, who were 70 years old on average, to complete three different exercise routines spaced four weeks apart. At the study's start, the men and women had fasting blood sugar levels of between 105 and 125 milligrams per deciliter. A fasting blood glucose level of 70 to 100 is considered normal, according to the U.S. National Institutes of Health.

The men and women stayed at the research facility and were supervised closely. Their blood sugar levels were monitored the entire 48 hours.

On the first day, the men and women did not exercise. On the second day, they did, and those blood sugar levels were compared to those on the first day.

The men and women were classified as obese, on average, with a body-mass index (BMI) of 30. The men and women walked on a treadmill at a speed of about three miles an hour (a 20-minute mile, which DiPietro described as the lower end of moderate).

The walks after meals reduced the 24-hour glucose levels the most when comparing the sedentary day with the exercise day.

A 45-minute morning walk was next best.

Walking after dinner was much better in reducing blood glucose levels than the morning or afternoon walking, DiPietro found.

Walking a half hour after eating gives time for digestion first, DiPietro said. Within that half hour, she said, "the glucose starts flooding the blood. You are using the working muscles to help clear the glucose from the blood stream." The exercise "is helping a sluggish pancreas do its job, to secrete insulin to clear the glucose," she said.

The briefer, more frequent exercise may also sound more doable to sedentary older adults, she said. "Committing to do this with someone would work best," DiPietro said. "It can be coupled with things like walking the dog or running errands."

The findings make physiological sense, said Dr. Stephen Ross, attending physician at UCLA Medical Center in Santa Monica, Calif.

"If you are exercising right after you eat, that would cause blood sugar to decrease because more of the glucose would go to the muscles to help the muscles with their metabolism," he said.

The brief walks, Ross said, may also fit a person's schedule better.

DiPietro cautioned, however, that "you have to do it every day" to get the benefit. It's not a prescription for fitness, she said, but simply to reduce diabetes risk.

The study was funded by the U.S. National Institutes of Health, the U.S. National Institute on Aging and the Beltsville Human Nutrition Research Center of the U.S. Department of Agriculture.

More information

To learn more about diabetes risk, visit the American Diabetes Association.

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WEDNESDAY, June 12 (HealthDay News) -- Restricting the sale of large sodas and other sugar-sweetened beverages in restaurants and other food-service outlets would affect 7.5 percent of Americans each day and have the greatest impact on overweight people, according to a new study.

In an effort to fight obesity, New York City's Board of Health approved a ban on the sale of sugary beverages larger than 16 ounces at eateries, but the law was struck down by the New York state Supreme Court in March. An appeal began this week.

In order to assess the effect that such a ban would have nationwide, researchers at Columbia University's Mailman School of Public Health analyzed the records of more than 19,000 people who took part in the U.S. National Health and Nutrition Examination Survey from 2007 to 2010.

The study found that about 60 percent of Americans consumed sugary drinks daily, but only 7.5 percent of them purchased "super-size" sugary drinks from an eatery on a given day. The rates, however, were somewhat higher for certain groups: 13.6 percent of overweight teens, 12.6 percent of overweight young adults aged 20 to 44 and 8.6 percent of overweight people in general.

The investigators also found that low-income and high-income people were equally likely to buy large sugary drinks from restaurants, which challenges the criticism that a ban on the sale of these drinks at eateries discriminates against the poor.

The researchers said this finding was a surprise because poorer people are more likely to drink sugary beverages than those with higher incomes. But although poor people tend to consume more sugary beverages, it's cheaper for them to buy these drinks at a store and consume them at home, the authors said.

The study, published online in the American Journal of Clinical Nutrition, used national data but shows that this type of ban would help fight obesity no matter where in the country it was implemented.

"Our findings are clear: A law like this would address one of the fundamental causes of obesity -- the growing portion size of sweetened drinks," lead author Dr. Y. Claire Wang, an assistant professor of health policy and management, said in a university news release.

For example, the study authors said, in 1955, a regular-size soda at McDonald's was 7 ounces. The sizes offered today range from a 12-ounce child-size drink to a 32-ounce drink. "Changing social norms is difficult, but as portion sizes have grown, it's useful to establish a new standard," Wang said.

Another expert, Dr. Sandro Galea, chairman of the department of epidemiology at the Mailman School, pointed out the importance of the study findings.

"[The study] provides critical foundational evidence that the proposed efforts to restrict marketing of large sodas in New York City and elsewhere can have a substantial impact on population health," said Galea, who is also a member of the New York City Board of Health.

Commenting on the study findings, Christopher Gindlesperger, senior director of public affairs at the American Beverage Association, stated that "it's time for a comprehensive approach to addressing obesity."

Gindlesperger pointed out that "obesity is a complex issue with many contributing factors beyond one type of food or beverage. A recent report found that in 2010, U.S. youth consumed 68 fewer calories and adults 45 fewer calories per day from added sugar in soft drinks than in 2000, yet obesity rates continue to rise."

More information

The U.S. National Heart, Lung, and Blood Institute has more about overweight and obesity.

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TUESDAY, June 11 (HealthDay News) -- Clever food labeling can fool well-intentioned consumers into believing that foods labeled sugar-free, fat-free or whole-wheat are healthy choices, a dietitian says.

"Consumer food marketing can be extremely persuasive, and the right buzzword on a package can lure a shopper into making an unwise purchase," Kari Kooi, a registered dietitian at the Methodist Hospital in Houston, said in a hospital news release. "We need to educate consumers on how to read nutrition labels so they can avoid falling prey to the 'health halo' effect."

Studies have shown that this "health halo" effect leads some people to eat twice as much or more of these foods because they are marketed as healthy, she says.

Five foods Kooi recommends avoiding are:

• Vegetable chips. These are marketed as healthy substitutes for vegetables but the nutrition labels on most brands read the same as potato chips. Many of the vegetables' nutrients are lost in the processing of these chips. Choose real vegetables instead.
• Nutrient-enhanced waters. Most are nothing more than colored sugar water that contain empty calories that contribute to weight gain. Claims that some of these products are a healthy choice because of added vitamins are just marketing hype, Kooi said. Taking a daily multivitamin with a glass of water is a better option, she said.
• Muffins. If they're sprinkled with a few oats or packed with blueberries, consumers think they're a healthier choice than donuts. But muffins are really nothing more than cupcakes without icing, said Kooi. She also noted that mega-size muffins sold in coffee shops can contain 500 to 600 calories.
• Premade smoothies. Most commercial ready-made smoothies are loaded with sugar and calories. You're better off making your own smoothies with high-quality, nourishing ingredients such as low-fat Greek yogurt, skim milk and fresh or frozen fruits, Kooi says.
• Frozen yogurt. Although made with low-fat or fat-free dairy ingredients, frozen yogurt typically contains high amounts of added sugar. Many of the live and active cultures added to frozen yogurt cannot survive freezing, so you won't get any probiotic benefits, Kooi said. Probiotics help maintain the balance between good and bacteria in the digestive tract.

More information

The U.S. Centers for Disease Control and Prevention has more about nutrition.

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MONDAY, June 10 (HealthDay News) -- Elementary schools are less likely to sell unhealthy snack foods and drinks if school districts or states have rules that limit the sale of such products, a new study finds.

However, more than three-quarters of public elementary schools in the United States are located in a state or school district that does not limit the sale of items such as sugary drinks, salty snacks, candy or high-fat milk, according to the research published June 10 in the journal JAMA Pediatrics.

For the study, researchers examined the types of foods and drinks offered by schools nationwide between 2008-2009 and 2010-2011. Candy, ice cream, cookies and other sweets were sold by about 32 percent of schools in areas where both school district or state policies limited the sugar content of snack foods, compared with 43 percent of schools where there were no such policies.

Ice cream was sold by just over 10 percent of schools in areas where the state and school district limited the fat content of snack foods, compared with about 21 percent of schools where there was no such policy. Cookies, cakes and other high-fat baked goods were sold by nearly 12 percent of schools in areas with such a policy and by about 25 percent of schools in areas with no such policy, the investigators found.

In the case of sugary drinks, school district policies had more impact than state laws: Sugar-sweetened beverages were sold by close to 4 percent of schools when school districts banned them, compared with 13 percent of schools when there was no school district ban.

However, the sale of sugary beverages by schools was not affected by state bans -- especially in the South -- where sugary drinks were sold by one-quarter of schools in states that banned the sale of the drinks in schools.

The study was funded by the Robert Wood Johnson Foundation through its national research program, Bridging the Gap.

"We found that states and districts can influence the types of snacks and drinks sold at school," study lead author Jamie Chriqui, an investigator at Bridging the Gap, said in a foundation news release. "These policies can go a long way in helping kids have healthy choices during the school day, but more states and districts need to get strong policies on the books to have a meaningful impact nationally."

However, Chriqui and colleagues found that many states and school districts do not have specific nutritional rules for school snacks and drinks. Among U.S. elementary schools:

• 78 percent were in a district and state that did not limit the sodium (salt) content of snacks or ban high-fat milk.
• 77 percent were in a district and state that allowed the sale of candy.
• 75 percent were in a district and state that did not prohibit the sale of sports drinks, sodas and sugar-sweetened fruit drinks.
• 58 percent were in a district and state that did not limit the sugar content of snacks.

"Too many of our nation's schools are still selling junk foods and sugary drinks to young children," Chriqui said.

"But the good news is that this is the first generation of children to be enrolled in school at a time when educators and policymakers are focused on preventing childhood obesity -- that's why it's so critical to enact or change policies that make schools healthier places for students," she added in the news release.

More information

The American Academy of Pediatrics has more about childhood nutrition.

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MONDAY, June 10 (HealthDay News) -- Low blood sugar in older adults with type 2 diabetes may increase their risk of dementia, a new study suggests.

While it's important for diabetics to control blood sugar levels, that control "shouldn't be so aggressive that you get hypoglycemia," said study author Dr. Kristine Yaffe, a professor of psychiatry, neurology and epidemiology at the University of California, San Francisco.

The study of nearly 800 people, published online June 10 in JAMA Internal Medicine, found that people with episodes of significant hypoglycemia -- low blood sugar -- had twice the chance of developing dementia, Yaffe said. Conversely, "if you had dementia you were also at a greater risk of getting hypoglycemic, compared with people with diabetes who didn't have dementia," she said.

People with type 2 diabetes, by far the most common form of the disease, either don't make or don't properly use the hormone insulin. Without insulin, which the body needs to convert food into fuel, blood sugar rises to dangerously high levels. Over time, this leads to serious health problems, which is why diabetes treatment focuses on lowering blood sugar. But sometimes blood sugar drops to abnormally low levels, which is known as hypoglycemia.

Exactly why hypoglycemia may increase the risk for dementia isn't known, Yaffe said. Hypoglycemia may reduce the brain's supply of sugar to a point that causes some brain damage, Yaffe said. "That's the most likely explanation," she added.

Moreover, someone with diabetes who has thinking and memory problems is at particularly high risk of developing hypoglycemia, she said, possibly because they can't manage their medications well or perhaps because the brain isn't able to monitor sugar levels.

Whether preventing diabetes in the first place reduces the risk for dementia isn't clear, although it's a "very hot area" of research, Yaffe said.

But the findings do suggest that patients' mental status needs to be considered in the management of diabetes, Yaffe said.

Other experts agreed.

"This does raise concern about low blood sugar causing future problems with dementia and dementia causing problems with low blood sugar," said Dr. Stuart Weinerman, an endocrinologist at North Shore-LIJ in Great Neck, N.Y.

Weinerman isn't convinced that the association between hypoglycemia and dementia is cause-and-effect, however. "This is not a definitive study. It raises questions, but it doesn't answer them," he added.

But hypoglycemia is a serious problem for diabetics, Weinerman said. "Sooner or later, everyone is going to have some hypoglycemia," he said.

Episodes of hypoglycemia increase with age, perhaps because of changes in kidney function and drug metabolism, according to an accompanying journal commentary.

Anyone taking drugs that lower blood sugar should be aware of the signs of hypoglycemia, and be prepared to deal with it, Weinerman said. Symptoms can include confusion, jitteriness, fainting, heart palpitations and blurred vision.

For the study, Yaffe's team collected data on 783 diabetic patients who were aged 70 to 79 and free of dementia at the start of the study in 1997.

Over 12 years of follow-up on average, participants were periodically given tests of mental ability.

The researchers found people who were hospitalized for severe hypoglycemia had twice the risk of developing dementia compared with those who didn't have bouts of hypoglycemia.

And patients with dementia were also more than twice as likely to have severe hypoglycemia, they found.

Based on the findings, Dr. Marc Gordon, chief of neurology at Zucker Hillside Hospital in Glen Oaks, N.Y., said he thinks trying to control blood sugar too aggressively might be ill-advised.

"There has been a concern about the association between diabetes and dementia, Gordon said. "Patients need to be careful that they are not either undertreated or over treated and that they monitor their blood sugar," he said.

More information

For more on hypoglycemia, visit the American Diabetes Association.

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FRIDAY, June 7 (HealthDay News) -- Obese teens don't need to lose large amounts of weight to lower their risk of developing diabetes, according to a new study.

Researchers found that obese teens who reduced their body-mass index (BMI) by 8 percent or more had improvements in insulin sensitivity, a measure of how well the body processes insulin and an important risk factor for developing type 2 diabetes. BMI is a measurement of body fat based on height and weight.

"This threshold effect that occurs at 8 percent suggests that obese adolescents don't need to lose enormous amounts of weight to achieve improvements," study co-author Dr. Lorraine Levitt Katz, a pediatric endocrinologist at the Diabetes Center for Children at the Children's Hospital of Philadelphia, said in a hospital news release.

"The improvements in insulin sensitivity occurred after four months of participating in a lifestyle-modification program," Katz said.

The study included 113 teens, aged 13 to 17, whose average BMI at the start of the study was 37.1. People with a BMI of 35 to 40 are classified as severely obese. None of the teens had type 2 diabetes at the start of the study, but their obesity placed them at high risk to develop the disease in the future.

The teens were put on a weight-loss program that used family-based lifestyle changes. They and their parents were taught about healthy eating habits and encouraged to increase their levels of physical activity. The teens and their parents attended weekly group counseling sessions and the parents were encouraged to support their children's lifestyle changes and to be healthy-lifestyle role models.

The study, published online May 24 in the Journal of Pediatrics, reinforces the importance of lifestyle changes in helping teens lose weight, the researchers said.

They also noted that the 8 percent reduction in BMI needed to improve insulin sensitivity is "achievable" and easy for doctors to track.

More information

The Nemours Foundation outlines how obesity and overweight affect teens' health.

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THURSDAY, June 6 (HealthDay News) -- Low breast-feeding rates in the United States are a serious threat to women's health and a drain on the nation's health dollars, according to a new study.

Researchers concluded that low breast-feeding rates may be linked to as many as 5,000 cases of breast cancer, nearly 54,000 cases of high blood pressure and almost 14,000 heart attacks among American women each year.

But some experts question the study's methodology and maintain that more research is needed before drawing conclusions about lags in breast-feeding and women's health.

The researchers, who used a simulated model to arrive at their conclusions, said the costs of premature death caused by illnesses related to low breast-feeding rates are $17.4 billion a year. The study, published online June 6 in the journal Obstetrics & Gynecology, defines premature death as death before age 70, or more than 10 years before the average U.S. woman is expected to die.

Only about 25 percent of U.S. women follow medical recommendations to breast-feed each child for at least one year, the researchers said. This low rate also is associated with $734 million more in direct medical costs for women and $126 million more in indirect costs each year, they said.

"Thousands of women are suffering needless disease and premature death because they are not able to breast-feed their infants as long as they may want to," said study lead author Dr. Melissa Bartick, an assistant professor of internal medicine at Harvard Medical School and an internist at Cambridge Health Alliance, in Massachusetts. "Support from all sectors of society is important to help women breast-feed much longer than they do now."

Other experts said the findings should be viewed with caution.

"Although there is general agreement that breast-feeding provides benefits to both the mother and child, assuming that it will decrease cost by using a simulated model is risky," said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City.

"For example, although breast-feeding may reduce the risk of heart disease, perhaps it is not the actual breast-feeding, but rather the mother's demeanor that reduces her risks," Bernik said. If a woman has the time and patience to breast-feed for one year, this may reflect a less stressful life, which could be the actual reason she is less likely to suffer a heart attack later in life, she said.

"The findings of this study are provocative, but more research needs to be done to clearly delineate why breast-feeding may be good for overall health," Bernik said.

Dr. Frank Monteleone, director of the breast health program at Winthrop-University Hospital in Mineola, N.Y., also pointed out shortcomings in the study. The link between breast cancer and breast-feeding is still fuzzy, he said.

"More clinical and scientific studies need to be performed before we can establish a clear link between breast cancer and breast-feeding," Monteleone said. "This study is based on estimated and expected results rather than actual results of a study looking at the effects of breast-feeding on breast cancer rates."

According to the U.S. Centers for Disease Control and Prevention, 60 percent of American women do not breast-feed as long as they intend to.

Policies are needed to enable women to meet their own breast-feeding goals and also meet medical breast-feeding recommendations, Bartick said in a Cambridge Health Alliance news release. For example, she said, mothers who deliver in "baby-friendly hospitals" are more likely to get the early breast-feeding support they need.

"They want to breast-feed longer," she said. "We need to support their goals."

More information

The U.S. Office on Women's Health has more about breast-feeding.

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THURSDAY, June 6 (HealthDay News) -- Certain lifestyle changes could greatly reduce your stroke risk, according to a new study.

Researchers calculated stroke risk among nearly 23,000 black and white Americans aged 45 and older. Their risk was assessed using the American Heart Association's Life's Simple 7 health factors: be active, control cholesterol, eat a healthy diet, manage blood pressure, maintain a healthy weight, control blood sugar and don't smoke.

During five years of follow-up, 432 strokes occurred among the participants. All seven factors played an important role in predicting stroke risk, but blood pressure was the most important, according to the study, which was published June 6 in the journal Stroke.

"Compared to those with poor blood pressure status, those who were ideal had a 60 percent lower risk of future stroke," study senior author Dr. Mary Cushman, a professor of medicine at the University of Vermont in Burlington, said in a journal news release.

Cushman and her colleagues also found that people who didn't smoke or quit smoking more than a year before the start of the study had a 40 percent lower stroke risk.

For the study, the researchers categorized the participants' Life's Simple 7 scores as inadequate (zero to four points), average (five to nine points) or optimum (10 to 14 points). Every one-point increase was associated with an 8 percent lower stroke risk. People with optimum scores had a 48 percent lower risk than those with inadequate scores, and those with average scores had a 27 percent lower risk.

Overall, blacks had lower scores than whites, but the association between scores and stroke risk was similar for blacks and whites.

"This highlights the critical importance of improving these health factors since blacks have nearly twice the stroke mortality rates as whites," Cushman said.

Each year, about 795,000 people in the United States have a stroke, which is the No. 4 killer and a leading cause of long-term disability in the country, according to the American Heart Association.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about stroke and stroke prevention.

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THURSDAY, June 6 (HealthDay News) -- An expert advisory panel to the U.S. Food and Drug Administration voted narrowly Thursday to recommend changing tough safety restrictions on the diabetes drug Avandia, which was all but banned nearly two years ago because of reported links to heart problems.

The panel's decision came after a review of data that suggested the medication might not be as harmful as once thought.

However, because of initial concerns over cardiovascular safety, Avandia had been taken off drugstore shelves and its use restricted to patients who first signed a waiver saying they understood the possible risks. The drug was also dispensed only through specially registered pharmacies.

But the new recommendation might change all that. Thirteen members of the 26-person panel voted to alter the safety restrictions, the Associated Press reported, while seven voted to remove the restrictions altogether. Five panelists voted to keep the restrictions in place, while one panelist voted to withdraw Avandia from the marketplace.

The exact nature of any changes to current restrictions are yet to be decided. The FDA is not obligated to follow its advisory panels' decisions, but it usually does.

The panelists spent the past two days reconsidering evidence from an independent review by Duke University researchers of Avandia's original clinical trial, called RECORD. That review did uncover some previously unreported cases of heart complications and deaths, but the Duke team concluded that those cases did not significantly raise the overall risk of heart disease.

"I'm considerably reassured, in light of the reanalysis, that the magnitude of risk we're talking about here is not very great," Dr. Dale Hammerschmidt, of the University of Minnesota, who voted on Thursday to modify the safety limits, told the AP.

The drug's maker, GlaxoSmithKline, which had funded the Duke review, said it was satisfied with the panel's decision.

"We appreciate the committee's thorough examination of the RECORD results and will continue to work with the FDA as it considers the recommendation of the committee," the company's chief medical officer, Dr. James Shannon, said in a statement. "We continue to believe that Avandia is a safe and effective treatment option for type 2 diabetes when used for the appropriate patient and in accordance with labeling."

Not everyone is likely to be so pleased. The FDA's reconsideration of Avandia's safety has prompted stinging criticism from the drug's detractors, who say the agency is trying to save face following a very public embarrassment over the drug.

"This is a drug that has essentially been off the market in almost the entire world for the last three years. It has been banned in most countries, and is available in the United States under such strict requirements that only 3,000 patients now take it," said Dr. Steven Nissen, the Cleveland Clinic cardiologist who first led the charge against Avandia. "It's really about the FDA wanting to clean up its image, not about whether the drug is actually safe or unsafe."

But the FDA defended its decision to review the Duke re-analysis of the original trial.

"Given the public interest in Avandia, the extensive history of the product and the continued uncertainty of risk, the FDA is holding the advisory committee meeting to have a transparent, public discussion of the results of the RECORD readjudication," FDA spokesperson Morgan Liscinsky said.

Avandia quickly became a blockbuster diabetes drug following its release in 1999, with sales topping $3 billion in 2006.

But in 2007, Nissen published a study showing that Avandia raised the risk of heart attack by more than 40 percent. The outcry that followed led to Senate hearings in which the FDA's drug approval process came under intense scrutiny.

An FDA analysis of more than 50 studies of Avandia found that the drug was linked to an increased risk of heart problems. One study tied Avandia use to more than 47,000 cases of heart attack, stroke or heart failure during a 10-year period, even though the company-funded RECORD trial had not found an increased risk of cardiovascular trouble.

The FDA ended up pulling Avandia from pharmacy shelves in November of 2011, placing severe restrictions on the drug that limited its use to extremely ill diabetics. Patients wanting to take the medication now must enroll in a special program to qualify for its use.

Critics called this week's meetings a waste of taxpayer dollars, arguing that so many concerns have been raised about Avandia's safety that a green light now from the FDA would be meaningless.

"It's not an issue of any importance to the medical community," Nissen said. "It's all about the FDA. If the FDA is allowed to whitewash the Avandia affair, it makes it less likely the right thing will be done when issues like this come up in the future," he added.

"Unfortunately, the public is caught in the crossfire," he continued. "The last thing we want to do is promote the use of an agent that is not helpful and is almost certainly harmful in the majority of the people who take it."

Nissen and other critics noted that the Duke review was funded by GlaxoSmithKline and have questioned the independence of the follow-up research.

A panel of FDA officials had vouched for the Duke report, however, and argue that its findings deserve scrutiny in a public forum.

"The FDA strongly believes that regulatory decisions should be based on strong scientific evidence. If such evidence becomes available to revisit previous regulatory decisions, it is important for the FDA to consider this evidence in a transparent process," Liscinsky said. "The FDA is critically evaluating the RECORD readjudication. Once the advisory committee meeting has been held and review is complete, the FDA will determine if the results of the readjudication in the context of all the pertinent available data affect the agency's assessment of the risk-benefit information for rosiglitazone [Avandia]."

Dr. George King, director of research for the Joslin Diabetes Center and a professor of medicine at Harvard Medical School, said Avandia use needs to be restricted but has no problem with the FDA taking a look at the new evidence.

"A reanalysis is always good," King said. "Why spend all that money to do the study if you're not going to consider the data, right?"

King noted that Avandia and other drugs in its class, called thiazolidinediones, occupy a unique place in diabetes treatment. They decrease insulin resistance in the body by binding to receptors in fat cells and making those cells more responsive to insulin.

"We don't have any other diabetic medications that can actually improve insulin resistance," he said. "The others either promote more insulin production from the pancreas, make you urinate out more glucose or help your liver handle glucose better."

On the other hand, thiazolidinediones also cause problems with fluid retention. "In diabetic patients who are older, almost all of them have some kind of cardiovascular problem," King noted. "If you retain fluid, you are going to have increased risk for cardiovascular problems and mortality."

Both sides in the debate have a point, King concluded.

"From my view of it, it does have a niche for use, but the restrictions have to be there," he said. "The people who think it is absolutely safe are absolutely not right, but others who are focused on finding fault with it are overlooking some benefits."

More information

For more on the latest look at Avandia, go to the U.S. Food and Drug Administration.

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WEDNESDAY, June 5 (HealthDay News) -- Using an immune-suppressing medication and adult stem cells from healthy donors, researchers say they were able to cure type 1 diabetes in mice.

"This is a whole new concept," said the study's senior author, Habib Zaghouani, a professor of microbiology and immunology, child health and neurology at the University of Missouri School of Medicine in Columbia, Mo.

In the midst of their laboratory research, something unanticipated occurred. The researchers expected that the adult stem cells would turn into functioning beta cells (cells that produce insulin). Instead, the stem cells turned into endothelial cells that generated the development of new blood vessels to supply existing beta cells with the nourishment they needed to regenerate and thrive.

"I believe that beta cells are important, but for curing this disease, we have to restore the [blood vessels]," Zaghouani said.

It's much too early to know if this novel combination would work in humans. But the findings could stimulate new avenues of research, another expert says.

"This is a theme we've seen a few times recently. Beta cells are plastic and can respond and expand when the environment is right," said Andrew Rakeman, a senior scientist in beta cell regeneration at the Juvenile Diabetes Research Foundation (JDRF). "But, there's some work still to be done. How do we get from this biological mechanism to a more conventional therapy?"

Results of the study were published online May 28 in Diabetes.

The exact cause of type 1 diabetes, a chronic disease sometimes called juvenile diabetes, remains unclear. It's thought to be an autoimmune disease in which the body's immune system mistakenly attacks and damages insulin-producing beta cells (found in islet cells in the pancreas) to the point where they no longer produce insulin, or they produce very little insulin. Insulin is a hormone necessary to convert the carbohydrates from food into fuel for the body and brain.

Zaghouani said he thinks the beta cell's blood vessels may just be collateral damage during the initial autoimmune attack.

To avoid dire health consequences, people with type 1 diabetes must take insulin injections multiple times a day or obtain continuous infusions through an insulin pump. It's estimated that 3 million U.S. children and adults have the disease, which increased by almost one-quarter in Americans under age 20 between 2001 and 2009.

Zaghouani and his colleagues previously tested a drug called Ig-GAD2 that would destroy the immune system cells responsible for destroying the beta cells. The drug worked well to prevent type 1 diabetes, but it didn't work as a therapy when type 1 diabetes was more advanced.

"This made us question whether there were enough beta cells left when the disease is advanced," said Zaghouani. After conducting bone marrow transplants, the researchers came to a surprising conclusion. "The bone marrow cells did go to the pancreas, but they didn't become beta cells; they became endothelial cells," he said. "So, the problem wasn't a lack of beta cells or their precursor, the problem was that the blood vessels that irrigate the islet cells are damaged. That was a very novel and intriguing finding."

The immune-suppressing drug was given for 10 weeks, and bone marrow transplants were given intravenously on weeks 2, 3 and 4 after the diabetes diagnosis.

The mice were cured throughout the study follow-up of 120 days, which is about the lifespan of a mouse, Zaghouani said.

Zaghouani said he believes the immune attack may not be ongoing, and he hopes to give the mice bone marrow transplants without the immune-suppressing drug to see if that is sufficient to cure their disease.

Rakeman explained that while current thinking is that "a cure would need to address the immune system attack and the regrowth of beta cells," some scientists suspect that the immune system might not have initially gone after healthy beta cells. It's possible that the immune system actually targeted beta cells that had already been damaged. "This is a different way of thinking how the disease develops," said Rakeman.

Rakeman said this research might spur the development of new drug targets that could mimic the action of the stem cells. But the current research is many steps away from such a therapy for humans, according to both experts.

More information

Learn more about type 1 diabetes from the U.S. National Library of Medicine.

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TUESDAY, June 4 (HealthDay News) -- For the extremely obese, the benefits of weight-loss surgery generally outweigh the risks of the procedure. Now, new research suggests that the same might be true for less-obese people as well.

For those who are mildly or moderately obese, weight-loss surgery can improve type 2 diabetes, high blood pressure and high cholesterol more effectively than conventional diabetes management and lifestyle changes, new research suggests.

"We're seeing a pattern in these studies. There's a definite impact on the diabetes after surgery. Some people don't respond so well, but most do," said Dr. Bruce Wolfe, a professor of surgery and co-director of bariatric surgery at Oregon Health & Science University, in Portland.

But, he added, "We need longer-term studies to identify who's the right candidate for surgery, and we need a number of years of follow-up and a fairly large study population to see if the diabetes improvements after surgery prevent the heart disease, blindness and kidney disease associated with type 2 diabetes."

Results of the two new studies, as well as an accompanying editorial written by Wolfe and colleagues, are in the June 5 issue of the Journal of the American Medical Association.

Body mass index (BMI) is a measurement calculated with height and weight that's used to estimate the amount of body fat someone has. A BMI of 18 to 24.9 is considered normal weight while 25 to 29.9 is overweight, according to the U.S. Centers for Disease Control and Prevention. Mild to moderate obesity is between 30 and 39.9, and 40 and above is morbidly (or extremely) obese.

Normally, weight-loss surgeries are done on people who have a BMI of 40 or above. The surgery is also done on people who have a BMI of 35 or more if they have heart disease risk factors, such as type 2 diabetes, high blood pressure, high cholesterol or sleep apnea, according to Wolfe.

The first study was a review of previous research on non-morbidly obese people with type 2 diabetes. The authors searched the medical literature and among other related studies, found three randomized controlled clinical trials that compared weight-loss surgery (also known as bariatric surgery) to nonsurgical treatments, such as diabetes medications and lifestyle changes.

Weight-loss surgeries -- including gastric bypass and gastric banding -- were associated with a greater weight loss than nonsurgical treatments. Weight-loss surgeries led to as much as 32 to 53 pounds more weight loss and also to greater improvements in blood sugar levels.

"I think we found some promising results for the lower BMI patients with diabetes. There were better results in terms of controlling glucose [blood sugar] and weight loss over one to two years. That we have a way to provide some sort of successful treatment is exciting. But, we don't yet know how sustainable these changes are. We need longer and larger studies," said Dr. Melinda Maggard-Gibbons, lead review author, and an associate professor with RAND Health in Santa Monica, Calif.

The second study included 120 people from four teaching hospitals in the United States and Taiwan. They all took part in an intensive lifestyle and medical management program before the study, and half of the group was given gastric bypass surgery.

All had a BMI between 30 and 39.9, with an average of 34.3 in the medical management group and 34.9 in the surgery group. They also all had type 2 diabetes.

A year later, 28 people from the surgery group and 11 people from the medical management group met the study's goals. These goals were to have an HbA1C level of below 7 percent (a measure that indicates good blood sugar control); LDL or "bad" cholesterol of less than 100 milligrams per deciliter; and systolic blood pressure (the top number) of less than 130.

Overall, those in the surgical group needed three fewer medications. They also lost significantly more of their initial body weight -- about 26 percent for the surgical group compared with 8 percent for the medical management group, the study found.

However, there were 22 serious adverse events in the surgical group compared with 15 in the medical management group. And, one person in the surgical group had a number of complications that eventually led to brain damage, which will likely be permanent.

"The risk of these surgeries is fundamentally low, but we can't make it zero. Most of the complications can be managed. But, disasters can occur, and if you're that one, any benefit of surgery is lost," Wolfe said.

Cost is another issue. A weight-loss surgery may cost $20,000 and up, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. And, insurance may or may not pay for the procedure, as there isn't yet clear evidence of a long-term benefit for people who are less obese.

"There are a whole host of contributing factors to consider. At some point, the surgery will be identified to work best in some and not so well in others. We understand this in cancer treatment, and we want to be able to do the same thing with weight loss surgery, and this is a part of the process to get there," Wolfe said.

So, what should folks with lower-level obesity and type 2 diabetes do? Wolfe said to start with making a concerted effort to lose weight and exercise regularly, and to make sure you use any diabetes medications prescribed for you exactly as your physician directs you to.

"If this doesn't work, consider surgery. If you have risk factors, like diabetes, you can appeal a negative insurance decision and ask for an exception," he suggested.

Maggard-Gibbons also suggested talking to your doctor or a bariatric surgeon about the possibility of enrolling in a clinical trial.

More information

Learn more about weight-loss surgery from the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

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The American Diabetes Association offers this information about a fungal skin infection:

• It can lead to red, itchy, moist patches surrounded by scales and small blisters.
• Common areas for these infections are at the groin area, armpits, beneath the breasts, in the corners of the mouth, beneath the foreskin of uncircumcised men, between fingers and toes, and under the nails.
• The most common types of fungal infections include athlete's foot, ringworm, "jock itch" and vaginal infections.
• Speak with your doctor if you believe you have a fungal infection.

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The Nemours Foundation offers suggestions for the parents of these children:

• Prepare as much as possible before telling your child it's time, and do it out of your child's sight.
• Strive to make the procedure quick, relaxed and quiet.
• Avoid giving the shot at the same spot on the body each day.
• Rub the site with ice before inserting the needle to help numb the area.
• Offer your child a distraction (sing a song or blow a whistle), and keep a stuffed animal on hand.
• Offer a small reward and lots of praise when it's over.

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WEDNESDAY, May 29 (HealthDay News) -- Pregnant women with thyroid disorders are at greater risk for premature delivery and other pregnancy complications, a new study indicates.

Researchers caution that these complications could have both short-term and long-term health consequences for women and their babies. Thyroid disease occurs when the thyroid gland -- located at the front of the neck -- doesn't supply the proper amount of hormones needed by the body.

"In the United States, at least 80,000 pregnant women each year have thyroid diseases," study lead author, Dr. Tuija Mannisto, of the U.S. National Institute of Child Health and Human Development (NICHD), said in a news release from the Endocrine Society.

"These women are at increased risk of having serious adverse pregnancy outcomes, including hypertension and preterm birth. They also have a higher rate of labor inductions and other birth interventions," Mannisto explained.

In conducting the study, the researchers examined medical records from more than 223,000 pregnancies. The investigators found that women with thyroid conditions were more likely to develop preeclampsia, a complication marked by protein in the urine and a sharp rise in blood pressure during pregnancy. These women were also admitted to the intensive care unit more often, were more likely to develop gestational diabetes and had a higher rate of cesarean deliveries.

"Women need appropriate thyroid hormone levels to support a healthy pregnancy, so it is very important to carefully monitor expecting mothers who have thyroid diseases," said one of the study's authors, Pauline Mendola, from the NICHD. "We also need more research to identify ways to reduce the risks these women currently face."

Although the study found an association between having a thyroid condition and higher risk of pregnancy complications, it did not establish a cause-and-effect relationship.

The study appears in the current issue of the Journal of Clinical Endocrinology & Metabolism.

More information

The U.S. National Library of Medicine has more about thyroid disease.

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TUESDAY, May 28 (HealthDay News) -- Researchers have developed a network of so-called "nanoparticles" that theoretically could be injected into the body and release insulin to counteract rising blood sugar levels in people with diabetes.

Tested so far in mice, the nano-network was able to maintain normal glucose levels for more than a week with a single injection. Currently, patients have to inject themselves with insulin several times a day to control their blood sugar levels.

"The main aim was to mimic the activity of the pancreas. In our system, when glucose levels go up, the nanoparticles degrade to release insulin," said study author Zhen Gu, from the joint department of biomedical engineering at the University of North Carolina at Chapel Hill and North Carolina State University. Gu, along with Robert Langer and Daniel Anderson, developed this technology when Gu was working at the Massachusetts Institute of Technology.

Although exciting, the research is very preliminary, one expert said.

"From a patient perspective, this could be incredible. It would reduce the burden of diabetes," said Sanjoy Dutta, senior director of treatment therapies at JDRF (formerly known as the Juvenile Diabetes Research Foundation). "But there are still lots of questions to be answered. This was a first-pass study."

This treatment would likely be most useful for people with type 1 diabetes, an autoimmune condition in which the pancreas no longer creates insulin. Insulin is a hormone that is needed to properly metabolize the carbohydrates in food. Because their bodies no longer produce insulin, people with type 1 diabetes must take multiple daily injections of insulin to replace the missing insulin so blood sugar levels stay steady.

Dutta said this treatment could also be helpful for people with type 2 diabetes who need to take insulin injections. People with type 2 diabetes still produce insulin, but their bodies don't use it efficiently.

There are many problems with existing insulin therapy. One is that you have to give yourself multiple injections every day. Another is that it's hard to figure out the exact dose of insulin you might need. Currently, people on insulin test their blood sugar by drawing a drop of blood from their fingertip numerous times a day, which lets them know whether they need more or less insulin in their next shot.

Someone with diabetes must also figure out how many carbohydrates are in the food they plan to eat. (Carbohydrates are broken down into sugar in the body to provide fuel for the cells in the body and brain.) If any of these calculations are wrong, blood sugar levels can go either too high or too low. Both extremes can be dangerous.

The nano-network is designed to deal with some of these issues. Insulin would be released in response to higher glucose levels, so there wouldn't be a need to check blood sugar levels so often. There also would be no need to count carbohydrates, because the nano-network would release insulin to process the food someone has eaten.

The nano-network is made up of nanoparticles with a solid core of insulin, modified dextran and glucose oxidase enzymes. In the presence of high glucose levels, the glucose oxidase enzymes convert glucose into gluconic acid. Gluconic acid, in turn, then dissolves the modified dextran, releasing the insulin.

The nano-network forms in the body after injection because some nanoparticles are coated with a negative charge, while others are given a positive charge. Once inside the body, these particles are attracted to each other and join together to form the nano-network, Gu said.

All of the components of the nano-network -- and its byproducts -- are completely biocompatible and dissolve over time, so they shouldn't cause any immune system response, Gu added.

The current study, published online this month in the journal ACS Nano, found that when injected into mice, the nano-network was able to control blood glucose levels for up to 10 days.

What remains to be seen is how the researchers will ensure that the nano-networks won't release too much insulin (causing low blood sugar levels) or not enough insulin (causing high blood sugar levels) in humans, and how someone would know when it was time for a new injection. Also, research with animals often can't be replicated in humans.

"This study demonstrates the idea. It's very promising, but we need to perform more studies," Gu said. "We want to further tailor the materials, and we want to increase the response speed of the insulin. It may take some time, but I'm quite confident in this new technology."

Dutta also was enthusiastic about the possibility of using glucose-responsive nano-networks. But, he cautioned, "This is going to take time. Many questions still need to be answered in animal studies, and we don't know what the regulatory pathway would be, although I do anticipate regulatory challenges. This is an uncharted pathway."

More information

Learn more about both types of diabetes from the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

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MONDAY, May 27 (HealthDay News) -- All women should be screened for gestational diabetes after 24 weeks of pregnancy regardless of whether they have symptoms of the condition, according to a new draft recommendation statement issued by the U.S. Preventive Services Task Force (USPSTF).

The independent panel of national experts also said there is not enough evidence to weigh the benefits and risks of screening for diabetes that develops during pregnancy before 24 weeks.

"It's important to remember that each case of gestational diabetes affects two people: the expectant mother and the baby," task force member Dr. Wanda Nicholson said in a USPSTF news release. "We now have good evidence that screening expectant mothers for gestational diabetes after 24 weeks provides a substantial benefit, with few to no harms, leading to healthier moms and babies."

Women with gestational diabetes are unable to process starches or sugars into energy during pregnancy. Any woman can develop gestational diabetes -- even those who did not have diabetes before they became pregnant.

Although gestational diabetes usually resolves once a woman gives birth, those with the condition are at greater risk for labor and birth complications, preeclampsia (a serious condition in pregnancy characterized by high blood pressure and high levels of protein) and developing diabetes later in life.

Infants born to women with gestational diabetes also may be affected. These babies are at greater risk for increased birth weight, birth injuries, glucose intolerance and obesity during childhood, according to background information in the news release.

New data that has emerged since the last time the task force looked at this issue, in 2008, indicates that there is an overall benefit to screening pregnant women for gestational diabetes, including lowering the risks of preeclampsia, giving birth to overly large babies (macrosomia) and delivery complications caused by large infants becoming stuck in the birth canal (shoulder dystocia).

Although there is not enough research to support gestational diabetes screening before 24 weeks of pregnancy, the task force said future research may shed more light on how to better manage diabetes in early pregnancy.

"It's always better to prevent a disease than to be diagnosed with one," Nicholson said. "Women should have a conversation with their doctor before getting pregnant or in the early stages of pregnancy about steps they can take -- such as improving their diet, being physically active or other strategies -- to reduce their risk of developing gestational diabetes."

Of the 4 million women who give birth each year, 7 percent have gestational diabetes. The experts said the number of women developing the condition is on the rise as obesity, older maternal age and other risk factors become increasingly common.

Before developing its final recommendation, the task force posted its draft recommendation on its website for public comment. Comments can be submitted from May 28 to June 24.

More information

The American Diabetes Association provides more information on gestational diabetes.

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