The Five Insulin Types

December 5th, 2010

Insulin is divided into 5 types: rapid-acting, short-acting (or fast acting), intermediate-acting, long-acting and pre-mixed insulin. The different types of insulin vary in the amount of time until they begin to work (onset), how long they take to achieve the greatest blood concentration and effectiveness (peak) and how long they continue to control blood sugar (duration). The effects of insulin, including onset, peak and duration times, vary from individual to individual and from day to day.

Depending on the brand, rapid-acting insulin has an average onset of from 5 to 15 minutes, peak of 30 minutes to 3 hours, and duration of 3 to 5 hours. It's normally injected with meals, and used in combination with a longer acting insulin.

Short-acting insulin (also called regular insulin) has an average onset of 30 minutes to an hour, peak of 2 to 4 hours, and duration of 4 to 8 hours, depending on if it's injected or used in an insulin pump. It's taken 30 minutes to an hour before a meal, and may be combined with long-acting insulin.

Intermediate-acting insulin (also called NPH insulin or lente insulin) has an average onset of 2 to 4 hours, a peak of 4 to 10 hours, and duration of 10 to 18 hours. It's often used in combination with rapid or short-acting insulin.

The effects of long-acting insulin (sometimes called background insulin or basal insulin) typically cover a full day. There are two types of long-acting insulin: insulin glargine (Lantus) and insulin detemir (Levemir). Typical onset for Lantus is within 4 to 6 hours. Lantus is delivered steadily and so does not peak, and has an average duration of 24 hours.

Typical onset for Levemir insulin is between 2 to 3 hours. Levemir peaks slightly between 8 to 10 hours, and the duration is dose-dependent, between 6 to 23 hours. Long-acting insulin is often used in combination with rapid or short-acting insulin, or an oral diabetes medication in the case of type 2 diabetics.

Premixed insulin is a combination of short and intermediate-acting insulin in the same vial or insulin pen. It's normally taken twice a day before meals.

The Five Insulin Types

December 5th, 2010

Insulin is divided into 5 types: rapid-acting, short-acting (or fast acting), intermediate-acting, long-acting and pre-mixed insulin. The different types of insulin vary in the amount of time until they begin to work (onset), how long they take to achieve the greatest blood concentration and effectiveness (peak) and how long they continue to control blood sugar (duration). The effects of insulin, including onset, peak and duration times, vary from individual to individual and from day to day.

Depending on the brand, rapid-acting insulin has an average onset of from 5 to 15 minutes, peak of 30 minutes to 3 hours, and duration of 3 to 5 hours. It's normally injected with meals, and used in combination with a longer acting insulin.

Short-acting insulin (also called regular insulin) has an average onset of 30 minutes to an hour, peak of 2 to 4 hours, and duration of 4 to 8 hours, depending on if it's injected or used in an insulin pump. It's taken 30 minutes to an hour before a meal, and may be combined with long-acting insulin.

Intermediate-acting insulin (also called NPH insulin or lente insulin) has an average onset of 2 to 4 hours, a peak of 4 to 10 hours, and duration of 10 to 18 hours. It's often used in combination with rapid or short-acting insulin.

The effects of long-acting insulin (sometimes called background insulin or basal insulin) typically cover a full day. There are two types of long-acting insulin: insulin glargine (Lantus) and insulin detemir (Levemir). Typical onset for Lantus is within 4 to 6 hours. Lantus is delivered steadily and so does not peak, and has an average duration of 24 hours.

Typical onset for Levemir insulin is between 2 to 3 hours. Levemir peaks slightly between 8 to 10 hours, and the duration is dose-dependent, between 6 to 23 hours. Long-acting insulin is often used in combination with rapid or short-acting insulin, or an oral diabetes medication in the case of type 2 diabetics.

Premixed insulin is a combination of short and intermediate-acting insulin in the same vial or insulin pen. It's normally taken twice a day before meals.

Warning Signs for Insulin Dependent Diabetics

December 10th, 2010

Most type 1 diabetics get very good at managing their disease. They can identify when their blood glucose is too high or too low, and skillfully balance a mixture of short, intermediate and long-lasting insulin. They stay up to date on the latest innovations in diabetes control - from the insulin pen through the insulin pump to the implantable glucose monitor. They know the importance of the glycemic index and staying physically active. They deftly adjust their diabetes medication to counteract changes in diet, activity level, stress, illness, and even their menstrual cycle.

Another often overlooked aspect of successful diabetes control is educating family, friends and co-workers about diabetes danger signs that may require medical attention. An unexpected insulin spike or rise or drop in blood sugar can cause a medical emergency for an insulin dependent diabetic, and those close to them should know what to watch for and how to respond. According to WebMD, the following are diabetes symptoms that should never be ignored:

1) Extreme thirst or hunger, blurry vision or frequent urination. These are all warning signs of uncontrolled blood sugar which, if left unchecked, could lead to serious, even life-threatening, conditions.

2) Appearing "drunk". Appearing intoxicated can be a sign of low blood sugar. Low blood sugar can result from a medication such as long-acting insulin working too well. A diabetic in this condition may not realize the seriousness of the situation, and lose consciousness.

3) Infections, gum problems and foot wounds. Diabetics are prone to infection, including fungal infections and foot ulcers, and even a small cut or sore can be risky. It's important for diabetics to watch for skin rashes, practice proper foot care, and to see a doctor if a wound gets infected or is slow to heal.

4) Eye problems and changes in vision. Diabetics are also prone to retinopathy (damage to the retina of the eye), which can cause vision loss. Talk to your doctor about any changes in vision, eye pain, or visual disturbances like seeing spots or lights, and see an ophthalmologist yearly.

5) Symptoms of heart disease. Diabetics are at increased risk of heart disease, heart attack and stroke, and they and those close to them should be aware of and alert for symptoms such as chest pain, shortness of breath, nausea, anxiety, dizziness, sweating, and a rapid or irregular pulse. It's also possible to have heart disease and not have obvious symptoms, so your doctor should evaluate your risk factors regularly.

Advances in diabetes treatment and diabetes medication continue to increase both the quality of life and the life expectancy of both insulin dependent and non insulin dependent diabetics. And promising treatments such as an artificial pancreas, islet cell transplants, glucose monitoring "tattoos", novel ways of delivering insulin without insulin injections and even a diabetes vaccine are in the early stages or on the horizon. While it will never be a good thing to be diabetic, it's no longer the tribulation it used to be.

Injection-Free Insulin Inhaler Awaiting FDA Approval

January 24th, 2011

A new injection-free insulin inhaler is awaiting FDA approval for the treatment of both type 1 and type 2 diabetes. Insulin can't be taken orally, as digestive juices break it down before it can be used by the body. Currently, the only means of delivering insulin are subcutaneous insulin injections or intravenously.

AFREZZA is an ultra-rapid acting inhaled insulin developed by MannKind Corporation. It uses patented Technospere technology to deliver powdered insulin from a thumb-sized device into the lungs. The lungs are an effective option for delivering diabetes medication, largely because of their huge surface area (about the size of a single tennis court).

AFREEZA is a short-acting mealtime insulin, meaning type 1 diabetics will need to combine it with long-acting insulin for complete diabetes control. Clinical trial participants using the new insulin inhaler experienced less hypoglycemia and weight gain than did controls using a standard combination of long-acting glargine insulin and twice a day 70 30 insulin injections.

Generex Biotechnology Corporation also has a rapid-acting insulin spray in clinical trials. Oral-lyn is a buccal spray insulin which is absorbed through the buccal mucosa (mucous membranes on the inside of the cheeks), bypassing the lungs and quickly entering the blood stream. The inhaled insulin is sprayed in the mouth just before meals, delivering about one unit of human insulin per spray. If approved, it may be the only medication needed by many type 2 diabetics.

Oral-lyn's patented inhalation device resembles an asthma inhaler. Steven Elkman was an Oral-Lyn study participant who successfully managed his type 2 diabetes with the experimental spray insulin. Elkman loved how discreet the inhaler is. "Nobody really notices because so many people use inhalators for asthmatic medication," he says, "It doesn't really attract any attention."

The FDA actually approved the first inhaled insulin, called Exubera, to treat type 1 and type 2 diabetes in 2006. It was a short-acting powdered form of recombinant human insulin, delivered into the lungs through an insulin inhaler. But the new system of insulin delivery never really caught on, and Pfizer dropped the novel diabetes medication from the market a year later. AFREZZA is easier to use, faster acting and boasts better bioavailability than Exubera, enabling diabetics to achieve better insulin levels using smaller amounts.

Patients in clinical trials of the new inhaled insulins have reported enhanced quality of life, overall satisfaction, and greater acceptance of being insulin dependent. Dr. Larry Deeb, a pediatric endrocrinologist from the University of Florida College of Medicine, says that finding an alternative to insulin injections is crucial, especially for children and the needle-phobic. "Insulin administration is a huge issue for people with diabetes," he stresses, "You have to appreciate the fear [of injections]. Insulin omission is one of the major issues in diabetes."

Kudzu Used as Diabetes Medication in Chinese Medicine

January 24th, 2011

Kudzu is a herb used in Chinese medicine to treat diabetes mellitus, alcoholism, colds, fever, menopausal symptoms and neck or eye pain. It's also referred to as kudsu, pueraria, or Japanese arrowroot. Both the flowers and the root have medicinal properties.

There is evidence that one of several isoflavones in kudzu, puerarin, improves insulin resistance. Kudzu appears to have additive effects when used with diabetes medication, assisting in lowering blood sugar levels. Puerarin's ability to thin the blood and improve blood flow is also believed beneficial in diabetic retinopathy.

According to research published the Journal of Agriculture and Food Chemistry in 2009, researchers from the University of Alabama who addied kudzu root extract to the diets of laboratory rats think the herb could be valuable in treating metabolic syndrome. Metabolic syndrome is a group of risk factors that contribute to heart disease, stroke and diabetes mellitus.

The researchers say that the puerarin in kudzu regulates blood sugar levels by directing it away from fat cells and blood vessels to places in the body where it is beneficial, like muscles. "Our findings show that puerarin helps to lower blood pressure and blood cholesterol," reports the study's lead author, Dr. J. Michael Weiss, "But perhaps the greatest effect we found was its ability to regulate [blood sugar]."

"Kudzu root may prove to be a strong complement to existing medications for insulin regulation or blood pressure," adds the study's co-author Dr. Jeevan Prasain, "Physicians may be able to lower dosages of such drugs, making them more tolerable and cheaper."

Kudzu was first brought to the US from Japan in the late 1800s. It can now be found in many parts of the country, most commonly in the south eastern regions, where it has become an unwelcome weed. It's a climbing, trailing vine whose out of control growth makes it quite invasive, earning it the names "the mile a minute plant", and "the vine that ate the South". Southerners claim that they must keep their windows closed at night to keep the kudzu out.

During World War II, American forces seeking a fast-growing plant to camouflage their equipment introduced kudzu to Fiji and nearby Vanuata, where it is now also a major weed. Kudzu remains respected and enjoyed in China and Japan, where it is a common ingredient in medicines and foods.

Because of its impact on blood sugar, it's important that diabetics taking either oral diabetes medication or insulin injections monitor their blood glucose levels carefully if taking the herb. Because kudzu has estrogenic effects, it should not be taken along with tamoxifen or by anyone with hormone sensitive cancer.

Kudzu Used as Diabetes Medication in Chinese Medicine

January 24th, 2011

Kudzu is a herb used in Chinese medicine to treat diabetes mellitus, alcoholism, colds, fever, menopausal symptoms and neck or eye pain. It's also referred to as kudsu, pueraria, or Japanese arrowroot. Both the flowers and the root have medicinal properties.

There is evidence that one of several isoflavones in kudzu, puerarin, improves insulin resistance. Kudzu appears to have additive effects when used with diabetes medication, assisting in lowering blood sugar levels. Puerarin's ability to thin the blood and improve blood flow is also believed beneficial in diabetic retinopathy.

According to research published the Journal of Agriculture and Food Chemistry in 2009, researchers from the University of Alabama who addied kudzu root extract to the diets of laboratory rats think the herb could be valuable in treating metabolic syndrome. Metabolic syndrome is a group of risk factors that contribute to heart disease, stroke and diabetes mellitus.

The researchers say that the puerarin in kudzu regulates blood sugar levels by directing it away from fat cells and blood vessels to places in the body where it is beneficial, like muscles. "Our findings show that puerarin helps to lower blood pressure and blood cholesterol," reports the study's lead author, Dr. J. Michael Weiss, "But perhaps the greatest effect we found was its ability to regulate [blood sugar]."

"Kudzu root may prove to be a strong complement to existing medications for insulin regulation or blood pressure," adds the study's co-author Dr. Jeevan Prasain, "Physicians may be able to lower dosages of such drugs, making them more tolerable and cheaper."

Kudzu was first brought to the US from Japan in the late 1800s. It can now be found in many parts of the country, most commonly in the south eastern regions, where it has become an unwelcome weed. It's a climbing, trailing vine whose out of control growth makes it quite invasive, earning it the names "the mile a minute plant", and "the vine that ate the South". Southerners claim that they must keep their windows closed at night to keep the kudzu out.

During World War II, American forces seeking a fast-growing plant to camouflage their equipment introduced kudzu to Fiji and nearby Vanuata, where it is now also a major weed. Kudzu remains respected and enjoyed in China and Japan, where it is a common ingredient in medicines and foods.

Because of its impact on blood sugar, it's important that diabetics taking either oral diabetes medication or insulin injections monitor their blood glucose levels carefully if taking the herb. Because kudzu has estrogenic effects, it should not be taken along with tamoxifen or by anyone with hormone sensitive cancer.

"Diabesity" Epidemic Leads to Double Digit Growth in Sales of Diabetes Drugs

January 24th, 2011

Two converging epidemics are striking Americans across the socioeconomic spectrum. Diabetes and obesity are so closely connected that health care professionals have coined the term "diabesity" to describe the connection between the two. "I really believe that it is the obesity epidemic that has driven diabetes", says Dr. Christopher Still, obesity expert from the Geisinger Center for Nutrition and Weight Management, "simply because of the increase in insulin resistance."

Excess weight is linked to insulin resistance. Insulin resistance is a condition in which the hormone insulin becomes less effective at lowering blood sugar levels. The resulting high blood sugar increases the risk of developing type 2 diabetes. In type 1 diabetes, the body produces little or no insulin. In type 2 diabetes, the body still produces insulin, but can't use it effectively. Ninety to ninety-five percent of diabetics have type 2 diabetes, and about 95% of type 2 diabetics are overweight.

The skyrocketing rate of obesity across the socioeconomic spectrum has been referred to as a "public health time bomb". About one-third of Americans are now considered obese (20% or more above normal weight), including nearly 17% of children and teens. Type 2 diabetes typically strikes in middle age, but as the obesity epidemic spreads to our children, doctors are seeing more diabetes in children and teens. A lot more cases - there has been a ten-fold increase in diabetes in children over the last five years.

As more and more diabetic Americans become insulin dependent, sales of diabetes medication and related products like insulin pumps and insulin pens are soaring. The diabetes products market has been "enjoying" double digit growth for years. Novo Nordisk reported an increase of 24% in sales of insulin products in 2009, and is forecasting continuing increases.

Diabetes is the seventh leading cause of death in the US. What health care providers find most frustrating is that both obesity and type 2 diabetes are largely preventable with proper diet and regular exercise. The World Health Organization refers to obesity, diabetes and heart disease as "diseases of affluence," and recommends a low glycemic index diet of foods rich in complex carbohydrates and protein. A US study of 90 years of national data found that the rising consumption of high glycemic index corn syrup (widely used to sweeten soft drinks and processed foods) and decreasing intake of dietary fiber parallels the explosion of type 2 diabetes in America. Dr. Still recommends those with insulin resistance cut sugary beverages like soda and juice out of their diet as a first step. "I tell people who are trying to lose weight to eat their calories, not drink them."

Super Long Acting Insulin Developed in India

January 25th, 2011

man with syringe
Scientists from India's National Immunology Institute (NII) have developed a new long-acting insulin that can control blood sugar in animals for up to 120 days with a single insulin injection. In contrast, the most effective long-acting insulin on the market today is only effective for a maximum of 18 hours.

The new diabetes medication, dubbed supramolecular insulin assembly-II, or SIA-II, is a "prodrug - a drug administered in an inactive form that becomes active after being administered. Prodrugs are generally better absorbed, distributed, and metabolized than active drugs.

Both bovine and human insulin versions of SIA-II are faring well in animal testing, and the researchers have every expectation that they will perform equally well in clinical trials in humans. "Personally speaking, SIA-II can straight away go to human trials," says NII Director Professor Avadhesha Surolia, "It is pretty safe, as we have not modified the insulin, nor is any addictive used."

The insulin's long lasting effects are due to a unique process called protein folding, in which bovine or human insulin is altered or "misfolded" to form a supramolecule which is protected from the body's enzymatic action. This protection allows the molecules to be stored in the body and be slowly released over long periods of time.

The NII team has been working on the patented SIA-II technology for two years, and recently entered into what Surolia calls "one of the biggest licensing deals from any academic institution in India", licensing the technology to Life Science Pharmaceuticals from Connecticut. A subsidiary of Life Science, Extended Delivery Pharmaceuticals, will be continuing trials of the new diabetic medication.

Experts speculate that the superlative long-term blood glucose control achieved with the use of the novel diabetes medication may indicate some level of recovery of the insulin producing cells in the pancreas that normally stop functioning in insulin dependent or type 1 diabetes.

There is some debate as to whether the super long-acting insulin will be of more benefit to type 1 or type 2 diabetics. India, dubbed "the diabetes capital of the world", has over 50 million diabetics, most of them type 2. Some Indians are paying an average one-quarter of their family income for their current diabetic medication. "Our motivation was to reduce the burden of diabetes," says Surolia, "It doesn't matter whether it's type 1 or 2."

Researchers Study Vinegar as a Preventative Diabetes Medication

January 25th, 2011

apple cider vinegarVinegar, especially apple cider vinegar, has long been prescribed as a natural treatment for various ailments, including acne, allergies, asthma, arthritis, indigestion, insect stings, night time leg cramps, hypertension, warts, sore throat, cold sores, burns, sunburns, and even hiccups. Hippocrates, the father of medicine, used vinegar as an antiseptic and antibiotic 1000's of years ago. Diabetics drank vinegar teas for blood glucose control before the invention of modern day diabetes medications.

Professor Carol Johnston, a nutritionist at the Arizona State University, has been studying the benefits of vinegar as a diabetes medication, researching its effect on blood glucose levels. Johnston and her fellow researchers performed three separate studies over a number of years.

In the first study, they gave people with type 2 diabetes, prediabetes (a pre-diabetic state associated with insulin resistance), and healthy controls four teaspoons of apple cider vinegar just before a high carbohydrate breakfast. The vinegar slowed the rise of blood sugar levels in the type 2 diabetics almost 20%. Those with prediabetes experienced an even greater benefit, with their rise in blood sugar slowed almost 35%. Even the healthy study participants experienced lower blood sugar and insulin spikes than the control group that was not given vinegar.

"Both the blood glucose and insulin were better managed after the meal when they consumed vinegar," says Johnston, "It appears that the vinegar mimics the action of both acarbose [generic Precose] and metformin [generic Glucophage], which are two of the commonly prescribed medications for diabetics." Johnston suspects it's the acetic acid in the vinegar that helps with diabetes control. "The acetic acid in vinegar may inhibit enzymes that digest starch, so that carbohydrate molecules aren't available for absorption", she theorizes.

In a follow up study, participants with type 2 diabetes who did not require insulin injections but were taking oral diabetes medications were given either two tablespoons of vinegar or water with an ounce of cheese before going to bed. Those given the vinegar at saw their fasting blood sugar levels reduced an average 4% the next morning. Those with the highest fasting blood sugar levels achieved the most benefit, experiencing a drop of 6%.

In the most recent study, researchers concentrated on the effects of vinegar on healthy participants. They fed both healthy participants and diabetics a standard evening meal, and then a breakfast high in complex carbohydrates with or without vinegar following an overnight fast. The non-diabetics given vinegar with their meals had a 20% reduction in post-meal blood sugar levels compared to those who weren't given vinegar. Two teaspoons of vinegar was determined to be the most effective amount, taken with the meal instead of before eating.

In a welcome but unexpected twist, participants given the vinegar in the longer-term study also lost weight. "The group that got the vinegar lost several pounds on average," said Johnston. Obesity and insulin resistance are closely related to each other, and to diabetes. Unrelated studies have shown that improving insulin sensitivity in pre-diabetics can delay or prevent the development of type 2 diabetes. If something as simple as a couple of teaspoons of vinegar before meals could help address both obesity and high blood sugar, vinegar could gain recognition as a cost-effective oral diabetes medication. "Further investigations to determine the efficacy of vinegar as an antidiabetic therapy are warranted, says Johnston." As many who could benefit from vinegar are put off by its strong taste and the quality of existing vinegar supplements such as capsules is inconsistent, Johnston's team is now working on a more palatable medicinal vinegar tablet.

Blueberries Improve Insulin Sensitivity

January 25th, 2011

blueberries
Sixty-seven percent of overweight and pre-diabetic adults who drank two blueberry smoothies a day experienced a ten percent or greater improvement in their insulin sensitivity in just six weeks. The pre-diabetic adults, who were taking part in a study conducted by the Pennington Biomedical Research Center at the Louisiana State University System, had high insulin levels, but not type 2 diabetes.

Type 2 diabetes, formerly called non-insulin dependent or adult-onset diabetes, is the most common form of the disease, affecting more than 26 million Americans. Diabetes two occurs when the body either does not produce enough insulin, or can not properly use the insulin it does produce. Insulin is necessary for the body to be able to use glucose, the basic fuel for the body's cells, for energy. A lack of or resistance to insulin can result in high blood sugar levels.

The 15 of the 32 members of the study group who drank smoothies containing 22.5 grams of freeze-dried blueberry powder grew more responsive to insulin than the members of the group who were given smoothies without the blueberry powder.

A 2006 Canadian study of the effect of wild blueberry juice on middle-aged overweight men also showed improvements in insulin sensitivity. The participants were given just over a cup (250 ml) of blueberry juice a day for just three weeks. The Canadian study, conducted at the University of Prince Edward Island, also suggested blueberries played a role in reducing inflammation. Researchers can't yet say how blueberries are able to improve insulin sensitivity. One theory is that compounds in blueberries called anthocyanins, which have antioxidant properties, may play a role.

People produce less insulin as they age, increasing their risk of diabetes two. An increased sensitivity to insulin can allow older people and pre-diabetics to use the insulin their body does produce to its best effect, warding off diabetes and the accompanying increased risk of heart attack, stroke and other diseases.

Classic diabetes 2 symptoms are increased urination, thirst, hunger, fatigue and weight loss. Type 2 diabetes is an incurable condition that will progress if left untreated. Diabetes type 2 treatment usually involves changes in diet and regular exercise, but type 2 diabetes patients may require the use of diabetes medication as the disease progresses. The day may come when type 2 diabetics are prescribed the humble diabetes preventing blueberry. The less common type 1 diabetes (once referred to as insulin-dependent diabetes) is characterized by the body's inability to produce enough insulin. Although they can still enjoy blueberries, type 1 diabetes patients will have to rely on insulin injection to manage their disease for the foreseeable future.

Lantus versus Levemir

February 2nd, 2011

insulin syringe

Choosing a long-acting insulin can be daunting, especially since both Lantus (insulin glargine) and Levemir (insulin detemir) are similar in many respects. There are a few key differences that will help you and your doctor make the decision about which insulin to use.

Both Lantus and Levemir are injected subcutaneously, either with a syringe or insulin pen, and both can be used with fast-acting insulin at meal times to aid with diabetes control. Neither forms of long-acting insulin should be diluted, or mixed with other insulin products. Lantus and Levemir have a 1:1 ratio, but will be accepted by the body differently from patient to patient; any changes to diabetes medication and dosage should always be discussed with a doctor.



Lantus

Lantus (insulin glargine) is marketed as a "peakless" insulin option, with an 18-26 hour action period. It is injected once a day, at the same time every day to maintain regularity. One of the biggest advantages of Lantus is that, due to its lack of peak, it decreases the risk of nocturnal hypoglycemia.

Some doctors suggest that Lantus be taken twice daily, even though it is approved to be taken once daily. Lantus may not be the best option for people with irregular schedules, as its long action time gives less control (it can take up to three days to complete its action). As with other long-acting insulin, Lantus can be used with fast-acting insulin at meal times.

Levemir

Levemir (insulin detemir) is a long-acting insulin with a 9-12 hour action period. It is injected twice a day, morning and night. Because one of its peak periods can occur at night, when glucose levels are often lower, it poses an increased risk of nocturnal hypoglycemia, and should not be used by patients with hypoglycemia.

Levemir has the advantage or greater diabetes control, because it is taken more frequently. And while patients using Levemir often use a higher insulin dosage, they often experience less weight gain than patients using Lantus.

Choosing a long-acting insulin comes down to what works best for the individual in question, taking into account the body's interaction with the insulin, as well as factors such as lifestyle and eating habits.Any decision involving diabetes medication should be made with the help of a doctor or other health-care provider.

Lantus versus Levemir

February 2nd, 2011

insulin syringe

Choosing a long-acting insulin can be daunting, especially since both Lantus (insulin glargine) and Levemir (insulin detemir) are similar in many respects. There are a few key differences that will help you and your doctor make the decision about which insulin to use.

Both Lantus and Levemir are injected subcutaneously, either with a syringe or insulin pen, and both can be used with fast-acting insulin at meal times to aid with diabetes control. Neither forms of long-acting insulin should be diluted, or mixed with other insulin products. Lantus and Levemir have a 1:1 ratio, but will be accepted by the body differently from patient to patient; any changes to diabetes medication and dosage should always be discussed with a doctor.



Lantus

Lantus (insulin glargine) is marketed as a "peakless" insulin option, with an 18-26 hour action period. It is injected once a day, at the same time every day to maintain regularity. One of the biggest advantages of Lantus is that, due to its lack of peak, it decreases the risk of nocturnal hypoglycemia.

Some doctors suggest that Lantus be taken twice daily, even though it is approved to be taken once daily. Lantus may not be the best option for people with irregular schedules, as its long action time gives less control (it can take up to three days to complete its action). As with other long-acting insulin, Lantus can be used with fast-acting insulin at meal times.

Levemir

Levemir (insulin detemir) is a long-acting insulin with a 9-12 hour action period. It is injected twice a day, morning and night. Because one of its peak periods can occur at night, when glucose levels are often lower, it poses an increased risk of nocturnal hypoglycemia, and should not be used by patients with hypoglycemia.

Levemir has the advantage or greater diabetes control, because it is taken more frequently. And while patients using Levemir often use a higher insulin dosage, they often experience less weight gain than patients using Lantus.

Choosing a long-acting insulin comes down to what works best for the individual in question, taking into account the body's interaction with the insulin, as well as factors such as lifestyle and eating habits.Any decision involving diabetes medication should be made with the help of a doctor or other health-care provider.

Long-Acting Insulin Best at Controlling Blood Sugar

February 3rd, 2011

blood glucose testing

As type 2 diabetes progresses, oral diabetes medication doses typically need to be adjusted upwards over time, and a good many type 2 diabetics can expect to end up insulin dependent. There does not appear to be any clear consensus on how best to introduce insulin injections in addition to oral diabetes medications - three times a day with meals, twice daily injections, or a single daily long-acting insulin injection.

Professor Rury Holman, director of the Diabetes Trial Unit at Oxford University, was the principal investigator of a large scale study conducted to determine how best to introduce insulin to control blood sugar levels as type 2 diabetes progresses. "Type 2 diabetes is a progressive condition with the majority of patients eventually requiring insulin therapy," Holman explains.

Holman and his fellow researchers recruited over 700 type 2 diabetes patients whose current medications were not effectively controlling their blood sugar levels. The patients were divided randomly into three groups to compare the effectiveness of the different insulin dosing regimens, and monitored for three years. After the first year, those patients who were still not achieving the necessary blood glucose control were moved to a more complex insulin therapy.

At the end of the three years, the researchers concluded that once-a-day basal insulin and three-times-a-day mealtimes injections were both more effective at controlling blood sugar levels than twice-daily insulin injections. In addition, those who took the once-daily basal insulin had fewer incidents of low blood sugar than those taking three-times-a-day mealtime insulin.

As a result, the researchers advise those beginning insulin therapy to start with a basal insulin, and add a mealtime insulin if required for what they term "the best combination of effectiveness, safety, and treatment satisfaction". "This large scale study strengthens guidelines recommending adding a basal insulin to oral agents when glycemic targets are not met," says Holman.

Insulin Shock Therapy Once Used to Treat Schizophrenia

February 7th, 2011

electric shock

It's not widely known that large doses of insulin were commonly used in psychiatric institutions in the 1940s and 1950s to treat schizophrenia and other mental illness. Insulin shock therapy was regarded as the treatment of choice for schizophrenia for about twenty years, enjoying uncritical acceptance in Europe and America.

The "treatment" was considered a type of shock therapy. Patients were given regular insulin injections to produce five or six diabetic comas a week for weeks at a time. Insulin therapy continued until the patient improved, or until 50 to 60 comas had been induced.

The originator of insulin shock therapy, also known as insulin coma therapy, was Dr. Manfred Sakel. The Polish doctor stumbled upon the therapy accidentally while working in Vienna, when a patient in whom he'd provoked an insulin coma showed a remarkable improvement in her mental functioning.

Sakel practiced and popularized insulin therapy in Europe, and introduced it to the US after he emigrated from Austria to New York in 1936. The practice of insulin dosing continued into the 1960s in America, and for much longer in countries like China and the former Soviet Union.

Sakel believed that the seizures and unconsciousness experienced by psychiatric patients undergoing an insulin-induced hypoglycemic episode resulted in dramatic change in their mental state. In his own words: "My supposition was that some noxious agent weakened the resilience and the metabolism of the nerve cells-blocking the cell off with insulin will force it to conserve functional energy and store it to be available for the reinforcement of the cell."

Sakel claimed that close to ninety percent of his patients improved with insulin shock therapy, but his methods were later called into question and discredited as unscientific. In particular, Sakel was accused of "cherry picking" the patients most likely to improve using insulin therapy, and providing them with extra attention and support.

Patients were said to have been terrified of the procedure, which is now considered to be inhumane. Severe hypoglycemia such as that induced by Sakel can result in permanent brain damage and even death. Some of his insulin therapy patients did indeed suffer adverse effects, including fatalities. While today's antipsychotic medications are not without their side effects, thankfully they are much safer and more effective than anything available just a couple of decades ago.

Travelling with Diabetes

February 15th, 2011

Diabetes control can be a trial, even when you are in a familiar location with all of your supplies at hand. Going to a foreign country, or even city, adds extra complications and can be daunting. With the proper planning, however, travel can be enjoyable and relaxing.

Before you go:

  • Get travel insurance
  • Check in with your health care provider to make sure that you are fit to travel, and get any vaccinations required for your destination
  • Fill any prescriptions you require (make sure you have twice what you need, just in case)
  • Bring copies of your prescriptions and a list of medications that you are taking
  • Research your destination for information on medical clinics and food options

En Route:

  • Check airline regulations concerning carry-on luggage
  • Keep prescriptions, diabetes medications and syringes on you at all times
  • Don't let your insulin or insulin pumps go through the x-ray — talk to the security staff beforehand and ask for a manual search of your medical supplies
  • Make sure all insulin and supplies are properly marked with a professionally printed label from the manufacturer or pharmacy
  • Syringes must have needle guards and be kept with your insulin
  • Alert the security staff if you are wearing an insulin pump as they will need to check it in person
  • Take time to stretch or walk around

While There:

  • Remember to keep time differences in mind when you check your blood sugar level. Talk to your doctor, as you may need to adjust the dosage of your long-acting insulin, depending on how many hours you gain or lose in your travels.
  • Always bring extra water and snacks on outings
  • Keep your diabetes medication in two separate places, just in case anything gets lost or stolen
  • Never go on hikes or to remote places on your own, and make sure that your travel buddy is aware of your condition

Whether you are going away for a weekend or a month, to a new city or a new country, the proper preparation can ensure an enjoyable trip. Bring extras of all your supplies, keep snacks and bottled water with you at all times, and when in doubt, ask your health care provider.

Diabetes Medications May Hold the Clue for New Weight Loss Drugs

March 4th, 2011

Barbie doll with tape measure
Researchers at the University of Pennsylvania are "one step closer to developing effective, FDA-approved treatments for obesity", according to Matthew Hayes, PhD, of the University's School of Medicine. The researchers say current type 2 diabetes medications may hold the clue for new anti-obesity drugs.

Hayes and his team are the first to identify the body mechanisms that produce the feeling of being full, or satiety. This mechanism helps explain why type 2 diabetes medications which target a hormone for insulin production called GLP-1 often promote weight loss, presumably by causing diabetes patients to feel fuller and eat less.

Read the whole story here>Science Daily<.

Diabetes Medications May Hold the Clue for New Weight Loss Drugs

March 4th, 2011

Barbie doll with tape measure
Researchers at the University of Pennsylvania are "one step closer to developing effective, FDA-approved treatments for obesity", according to Matthew Hayes, PhD, of the University's School of Medicine. The researchers say current type 2 diabetes medications may hold the clue for new anti-obesity drugs.

Hayes and his team are the first to identify the body mechanisms that produce the feeling of being full, or satiety. This mechanism helps explain why type 2 diabetes medications which target a hormone for insulin production called GLP-1 often promote weight loss, presumably by causing diabetes patients to feel fuller and eat less.

Read the whole story here>Science Daily<.

New Hormone Pathway May Replace Insulin Therapy for Diabetes

March 28th, 2011

Researchers have discovered a hormone pathway that they are hopeful may eventually lead to new type 1 diabetes treatments to replace insulin therapy. Currently, America's approximately one million type 1 diabetics rely on multiple insulin injections per day to control their blood sugar.

The pathway involves a hormone with insulin-like characteristics called fibroblast growth factor 19 (FGF 19). Unlike insulin, FGF 19 does not cause excess glucose to be stored as fat, also raising the prospect of a new anti-obesity treatment.

To read the whole story, click here >Science Daily<.

Actos Lowers Risk of Developing Diabetes in Those with Prediabetes

April 5th, 2011

prescription actosA commonly prescribed diabetes medication dramatically lowered the risk of developing type 2 diabetes in a recent study of over 600 people with prediabetes, or high blood sugar. Study participants taking the oral diabetes medication Actos experienced a 72 percent reduction in diabetes risk.

Actos, or generic pioglitazone, helps control blood sugar by decreasing insulin resistance. Increasing insulin sensitivity can have a dramatic impact on diabetes risk, according to the researchers.

To read the entire story online on WebMD, click >HERE<.

Actos Lowers Risk of Developing Diabetes in Those with Prediabetes

April 5th, 2011

prescription actosA commonly prescribed diabetes medication dramatically lowered the risk of developing type 2 diabetes in a recent study of over 600 people with prediabetes, or high blood sugar. Study participants taking the oral diabetes medication Actos experienced a 72 percent reduction in diabetes risk.

Actos, or generic pioglitazone, helps control blood sugar by decreasing insulin resistance. Increasing insulin sensitivity can have a dramatic impact on diabetes risk, according to the researchers.

To read the entire story online on WebMD, click >HERE<.

Diabetes Medication May Treat Alcohol Addiction

April 6th, 2011

empty alcohol bottle

Actos, an oral diabetes medication used to treat type 2 diabetes, may play a future role in combating alcohol addiction. Actos belongs to a class of medications called thiazolidinediones, or TZDs (also known as glitazones). TZDs reduce insulin resistance by binding to peroxisome proliferator-activated receptors, or PPARs. They also activate PPAR-g, a sub-class receptor which may play a role in the brain's reward circuits involved in addiction.

"As we learn more about the brain, we are seeing a growing number of examples where medications developed initially for purposes unrelated to psychiatry may have new and otherwise unexpected applications," writes Dr. John Krystal, the Editor of Biological Psychiatry, "New data in animal models suggest that TZDs might be promising agents in the fight against addiction."

Research is also ongoing in the use of commonly prescribed cholesterol medications in fighting nicotine addiction. To read the whole article in Science Daily, click >HERE<.

Diabetes Medication May Treat Alcohol Addiction

April 6th, 2011

empty alcohol bottle

Actos, an oral diabetes medication used to treat type 2 diabetes, may play a future role in combating alcohol addiction. Actos belongs to a class of medications called thiazolidinediones, or TZDs (also known as glitazones). TZDs reduce insulin resistance by binding to peroxisome proliferator-activated receptors, or PPARs. They also activate PPAR-g, a sub-class receptor which may play a role in the brain's reward circuits involved in addiction.

"As we learn more about the brain, we are seeing a growing number of examples where medications developed initially for purposes unrelated to psychiatry may have new and otherwise unexpected applications," writes Dr. John Krystal, the Editor of Biological Psychiatry, "New data in animal models suggest that TZDs might be promising agents in the fight against addiction."

Research is also ongoing in the use of commonly prescribed cholesterol medications in fighting nicotine addiction. To read the whole article in Science Daily, click >HERE<.

Ten Percent of European Type 2 Diabetics have Gene Mutation

April 12th, 2011

dna

An international study found that nearly ten percent of Europeans with Type 2 diabetes have a mutation in a gene called HMGA1. HMGA1 regulates how the body responds to insulin. The gene mutation causes insulin resistance, a condition where the body can no longer use insulin effectively.

This finding, which was published in the March 2011 Journal of the American Medical Association, has important significance in screening for and treating type 2 diabetes in the future, and may lead to better diabetes medications. To read the whole story online at WebMD,click >HERE<.

Experimental Weight Loss and Diabetes Drug in Clinical Trials

April 19th, 2011

overweight male
Diabetes and obesity are closely linked, and many diabetics struggle to follow their doctor's orders to lose weight. The biopharmaceutical company Vivus hopes to market an investigational new drug, Qnexa, as both a weight loss drug and a diabetes medication.

Qnexa is in phase 3 clinical trials to treat obesity, and in phase 2 clinical development for the treatment of type 2 diabetes and sleep apnea. The most recent clinical trial of Qnexa as a weight loss drug resulted in an average 10 percent weight loss in study participants.

Qnexa is a combination of the appetite suppressant phentermine, (best known as the "phen" in fen-phen, a controversial weight loss drug that was pulled off the market in 1997), and the anticonvulsant topiramate, prescribed to treat epilepsy and prevent migraine headaches.

Qnexa was denied approval in late 2010, when the FDA expressed concerns about a slightly increased risk of adverse psychiatric and cardiovascular events, and questioned the possibility of birth defects in pregnant women taking the drug.

More than 2400 patients took part in the latest study. Study participants were all clinically obese, and also suffered from two or more secondary medical conditions such as diabetes or heart disease. Patients also saw improvements in high blood pressure, cholesterol and A1C levels (glycated hemoglobin). High A1C levels indicate high levels of blood glucose in diabetics.

Shares of Vivus have increased up to sixteen percent in value since the latest study results were released. If approved, Qnexa would be the first new weight loss drug on the market in more than ten years. Currently, the only FDA approved prescription weight loss drug is orlistat (Zenical). Orlistat prevents the body from absorbing the fat in food, and is known for unpleasant side effects such as loose, oily stools, fecal incontinence and flatulence.

A second weight-loss drug manufacturer, Orexigen, is also struggling to get FDA approval for their new diet drug, Contrave. Contrave is a combination of bupropion (the antidepressant Wellbutrin, also marketed as the smoking cessation aid Zyban) and naltrexone, an opiate antagonist prescribed to treat narcotic and alcohol addiction. Contrave is designed to curb food cravings, and proved effective than Qnexa in terms of weight loss.

Contrave passed a major hurdle in late 2010 when an FDA advisory committee voted 13-7 for its approval, but the FDA disagreed in early 2011, asking for a new clinical trial evaluating the drug's cardiovascular risks.

Arena Pharmaceutical's Lorcaserin was the third diet drug to fail to win FDA approval in 2010, when the FDA deemed that safety concerns outweighed the drug's "marginal effectiveness".

Experimental Weight Loss and Diabetes Drug in Clinical Trials

April 19th, 2011

overweight male
Diabetes and obesity are closely linked, and many diabetics struggle to follow their doctor's orders to lose weight. The biopharmaceutical company Vivus hopes to market an investigational new drug, Qnexa, as both a weight loss drug and a diabetes medication.

Qnexa is in phase 3 clinical trials to treat obesity, and in phase 2 clinical development for the treatment of type 2 diabetes and sleep apnea. The most recent clinical trial of Qnexa as a weight loss drug resulted in an average 10 percent weight loss in study participants.

Qnexa is a combination of the appetite suppressant phentermine, (best known as the "phen" in fen-phen, a controversial weight loss drug that was pulled off the market in 1997), and the anticonvulsant topiramate, prescribed to treat epilepsy and prevent migraine headaches.

Qnexa was denied approval in late 2010, when the FDA expressed concerns about a slightly increased risk of adverse psychiatric and cardiovascular events, and questioned the possibility of birth defects in pregnant women taking the drug.

More than 2400 patients took part in the latest study. Study participants were all clinically obese, and also suffered from two or more secondary medical conditions such as diabetes or heart disease. Patients also saw improvements in high blood pressure, cholesterol and A1C levels (glycated hemoglobin). High A1C levels indicate high levels of blood glucose in diabetics.

Shares of Vivus have increased up to sixteen percent in value since the latest study results were released. If approved, Qnexa would be the first new weight loss drug on the market in more than ten years. Currently, the only FDA approved prescription weight loss drug is orlistat (Zenical). Orlistat prevents the body from absorbing the fat in food, and is known for unpleasant side effects such as loose, oily stools, fecal incontinence and flatulence.

A second weight-loss drug manufacturer, Orexigen, is also struggling to get FDA approval for their new diet drug, Contrave. Contrave is a combination of bupropion (the antidepressant Wellbutrin, also marketed as the smoking cessation aid Zyban) and naltrexone, an opiate antagonist prescribed to treat narcotic and alcohol addiction. Contrave is designed to curb food cravings, and proved effective than Qnexa in terms of weight loss.

Contrave passed a major hurdle in late 2010 when an FDA advisory committee voted 13-7 for its approval, but the FDA disagreed in early 2011, asking for a new clinical trial evaluating the drug's cardiovascular risks.

Arena Pharmaceutical's Lorcaserin was the third diet drug to fail to win FDA approval in 2010, when the FDA deemed that safety concerns outweighed the drug's "marginal effectiveness".

Foot Care Fundamental for Diabetics

April 20th, 2011

bare foot

Uncontrolled or poorly controlled diabetes can allow too much glucose to build up in your blood. Over time, high glucose levels can damage nerves and blood vessels. People who have diabetes often have trouble with their feet because of nerve and blood vessel damage, and about one in ten will develop foot ulcers. Two main concerns for diabetics are:

Sensory diabetic neuropathy: If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain. You may not feel a cut or sore on your foot, which could lead to its being ignored and getting infected. Check your feet regularly for cuts, cracks and blisters.

Peripheral vascular disease: Damaged blood vessels can lead to poor circulation, especially in the extremities. Poor blood flow impedes healing and puts diabetics at risk of developing foot ulcers, or even gangrene.

If you're diabetic, you should avoid going barefoot, wear well-padded socks and comfortable shoes, wash your feet and apply lotion daily, and keep your feet warm and dry. Follow your doctor's advice on diet and exercise, and take your diabetes medication exactly as prescribed to help control your blood glucose.

WebMD has created an informative Diabetes and Foot Problems Slideshow which includeshelpful advice on foot care. To view it, >CLICK HERE<.

Foot Care Fundamental for Diabetics

April 20th, 2011

bare foot

Uncontrolled or poorly controlled diabetes can allow too much glucose to build up in your blood. Over time, high glucose levels can damage nerves and blood vessels. People who have diabetes often have trouble with their feet because of nerve and blood vessel damage, and about one in ten will develop foot ulcers. Two main concerns for diabetics are:

Sensory diabetic neuropathy: If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain. You may not feel a cut or sore on your foot, which could lead to its being ignored and getting infected. Check your feet regularly for cuts, cracks and blisters.

Peripheral vascular disease: Damaged blood vessels can lead to poor circulation, especially in the extremities. Poor blood flow impedes healing and puts diabetics at risk of developing foot ulcers, or even gangrene.

If you're diabetic, you should avoid going barefoot, wear well-padded socks and comfortable shoes, wash your feet and apply lotion daily, and keep your feet warm and dry. Follow your doctor's advice on diet and exercise, and take your diabetes medication exactly as prescribed to help control your blood glucose.

WebMD has created an informative Diabetes and Foot Problems Slideshow which includeshelpful advice on foot care. To view it, >CLICK HERE<.

Antibodies Associated with Insulin Resistance Raise Hope of a Diabetes Vaccine

April 28th, 2011

Doctors and researchers have known for a while that excess weight, diet and lack of exercise can all be contributing factors in the development of type 2 diabetes and insulin resistance. Unlike type 1 diabetes, which is known as an immune disease, type 2 diabetes is generally considered a metabolic disorder, and is attributed to poor lifestyle choices. A new study shifts some of the responsibility for the development of their condition away from the patients by shedding light on other possible influences.

For this study, the results of which were published in Nature Medicine, researchers tested blood samples of 32 obese people, and found that the half who had insulin resistance had antibodies that were not present in the half who were obese but not insulin resistant. This suggests that type 2 diabetes may be an immune disorder, and that there is a possibility of developing a vaccine for the condition.

When fat developing in the abdomen runs out of space and becomes constricted the fat cells eventually die, and the immune system sends in cells to clean up the dead fat cells. Among the immune system response cells are T-cells and B-cells, which are responsible for remembering threats to the body and creating antibodies. The antibodies then attack the fat cells, which makes them insulin resistant. This immune response against fat cells is also connected to fatty liver disease, high cholesterol and high blood pressure.

The study also tested the effects on mice of an immune-modifying drug called anti-CD20. Mice were fed a diet that was 60% fat, and after six and seven weeks some of the mice received the drug. The mice who were given the drug had normal blood sugar levels, and did not develop insulin resistance, whereas the control mice did become insulin resistant. However, anti-CD20 can have serious side effects and can negatively affect the immune system, so it is likely that it will not be used any time soon as a diabetes medication.

While the findings of this study are promising, more research needs to be done. The mice and human subjects were all male, so it is not known whether the results apply to females. Currently, type 2 diabetes is treated first with lifestyle changes such as diet and exercise, sometimes combined with oral diabetes medication. Over time, many type 2 diabetics require insulin injections to control their blood sugar.

Antibodies Associated with Insulin Resistance Raise Hope of a Diabetes Vaccine

April 28th, 2011

Doctors and researchers have known for a while that excess weight, diet and lack of exercise can all be contributing factors in the development of type 2 diabetes and insulin resistance. Unlike type 1 diabetes, which is known as an immune disease, type 2 diabetes is generally considered a metabolic disorder, and is attributed to poor lifestyle choices. A new study shifts some of the responsibility for the development of their condition away from the patients by shedding light on other possible influences.

For this study, the results of which were published in Nature Medicine, researchers tested blood samples of 32 obese people, and found that the half who had insulin resistance had antibodies that were not present in the half who were obese but not insulin resistant. This suggests that type 2 diabetes may be an immune disorder, and that there is a possibility of developing a vaccine for the condition.

When fat developing in the abdomen runs out of space and becomes constricted the fat cells eventually die, and the immune system sends in cells to clean up the dead fat cells. Among the immune system response cells are T-cells and B-cells, which are responsible for remembering threats to the body and creating antibodies. The antibodies then attack the fat cells, which makes them insulin resistant. This immune response against fat cells is also connected to fatty liver disease, high cholesterol and high blood pressure.

The study also tested the effects on mice of an immune-modifying drug called anti-CD20. Mice were fed a diet that was 60% fat, and after six and seven weeks some of the mice received the drug. The mice who were given the drug had normal blood sugar levels, and did not develop insulin resistance, whereas the control mice did become insulin resistant. However, anti-CD20 can have serious side effects and can negatively affect the immune system, so it is likely that it will not be used any time soon as a diabetes medication.

While the findings of this study are promising, more research needs to be done. The mice and human subjects were all male, so it is not known whether the results apply to females. Currently, type 2 diabetes is treated first with lifestyle changes such as diet and exercise, sometimes combined with oral diabetes medication. Over time, many type 2 diabetics require insulin injections to control their blood sugar.

Scientists Discover Why Oral Diabetes Medication Causes Weight Gain

May 3rd, 2011

Thiazolidinediones, also known as glitazones, are a widely prescribed class of oral diabetes medications. The most commonly used thiazolidinedione is prescription Actos, also known as generic pioglitazone. Thiazolidinediones act by binding to a group of receptor molecules called PPAR-y which regulate the production of fat cells, improving their receptivity to insulin and therefore reducing insulin resistance.

Although effective, pioglitazone has a down side - one of Actos side effects is considerable weight gain. This is of particular concern to diabetics, many of whom have been instructed to lose weight to help control their condition.

Before this study, it was believed that weight gain in patients taking oral diabetes medication was due to PPAR-y's effect on fat cells. Researchers at the University of Cincinnati (UC) have now discovered that the diabetes medication delivers a double-whammy. It not only stimulates the production of fat cells, it also causes changes in the part of the brain which effects appetite, increasing hunger.

The researchers also conducted experiments to see if the PPAR-y molecular system is activated by a high fat diet. Experiments with animals showed that to be the case. This suggests that Americans' fondness for high-fat foods that activate PPAR-y might be contributing to our rising rates of obesity, and the associated increase in diabetes.

According to lead researcher Randy Seeley, PhD, PPAR-y is a system designed to promote eating more and gaining weight. "It tells your brain to eat more, and it tells your fat tissue to add new fat cells to serve as repositories to store those extra calories," explains Seeley, a UC professor.

It's hoped that these discoveries may lead to modified diabetes medications that still lower blood sugar, but without impacting the part of the brain effecting appetite. "If you artificially turn on PPAR-y, you can increase food intake in rats," explained Seeley, "[But] if you block these receptors in animals on high fat diets that make animals obese, they gain less weight."

Seeley stresses the importance of understanding how what we eat affects our bodies. "We know that one way to activate PPAR-y is by exposing cells to fatty acids," he points out, "If we know which ones activate PPAR-y, we could find ways to alter diets so as to limit their ability to turn on this system that drives increased food intake, making it easier for people to avoid weight gain."

Scientists Discover Why Oral Diabetes Medication Causes Weight Gain

May 3rd, 2011

Thiazolidinediones, also known as glitazones, are a widely prescribed class of oral diabetes medications. The most commonly used thiazolidinedione is prescription Actos, also known as generic pioglitazone. Thiazolidinediones act by binding to a group of receptor molecules called PPAR-y which regulate the production of fat cells, improving their receptivity to insulin and therefore reducing insulin resistance.

Although effective, pioglitazone has a down side - one of Actos side effects is considerable weight gain. This is of particular concern to diabetics, many of whom have been instructed to lose weight to help control their condition.

Before this study, it was believed that weight gain in patients taking oral diabetes medication was due to PPAR-y's effect on fat cells. Researchers at the University of Cincinnati (UC) have now discovered that the diabetes medication delivers a double-whammy. It not only stimulates the production of fat cells, it also causes changes in the part of the brain which effects appetite, increasing hunger.

The researchers also conducted experiments to see if the PPAR-y molecular system is activated by a high fat diet. Experiments with animals showed that to be the case. This suggests that Americans' fondness for high-fat foods that activate PPAR-y might be contributing to our rising rates of obesity, and the associated increase in diabetes.

According to lead researcher Randy Seeley, PhD, PPAR-y is a system designed to promote eating more and gaining weight. "It tells your brain to eat more, and it tells your fat tissue to add new fat cells to serve as repositories to store those extra calories," explains Seeley, a UC professor.

It's hoped that these discoveries may lead to modified diabetes medications that still lower blood sugar, but without impacting the part of the brain effecting appetite. "If you artificially turn on PPAR-y, you can increase food intake in rats," explained Seeley, "[But] if you block these receptors in animals on high fat diets that make animals obese, they gain less weight."

Seeley stresses the importance of understanding how what we eat affects our bodies. "We know that one way to activate PPAR-y is by exposing cells to fatty acids," he points out, "If we know which ones activate PPAR-y, we could find ways to alter diets so as to limit their ability to turn on this system that drives increased food intake, making it easier for people to avoid weight gain."

FDA Approves New Type 2 Diabetes Medication

May 4th, 2011

diabetes medicationThe FDA has approved a new oral diabetes medication, Tradjenta (linagliptin) to help control blood glucose in type 2 diabetics. Tradjenta works by blocking the enzyme dipeptidyl peptidase-4 (DPP-4), resulting in increased levels of hormones which stimulate the release of insulin after eating.

Tradjenta was tested in almost 4000 diabetics in eight separate double-blind clinical studies. It was studied both by as a stand-alone therapy, and in combination with other current diabetes medications such as glimepiride, pioglitazone, and metformin. It has not been tested along with insulin injections, and is not recommended for use by insulin dependent type 1 diabetics.

Tradjenta is meant to be used along with diet and exercise. People with diabetic ketoacidosis (high levels of ketones in the blood or urine) are cautioned not to use linagliptin. People taking the antibiotic rifampin, used to treat tuberculosis, should also avoid Tradjenta. The most common side effects of linagliptin were nasal congestion or a runny nose, sore throat, upper respiratory infection headache, and muscle pain.

An estimated 24 million Americans have diabetes, and up to 95 percent of them have the most common form, type 2. People with Type 2 diabetes either can't produce or are resistant to the effects of insulin, a hormone produced by the pancreas which regulates blood sugar. A lack of insulin or insulin resistance lead to high blood sugar levels, which can cause serious, and even life threatening, complications.

Some type 2 diabetics can control their blood sugar with diet and exercise, but many require oral diabetes medication or even insulin injections. The existing diabetes medications Januvia and Onglyza are also DPP-4 inhibitors. While all in the same class, the three diabetes drugs appear to have significant differences in effect, making it important that non insulin dependent diabetics have yet another option to successfully control their blood sugar.

The new diabetes medication is the first of its class to be approved at one dosage strength (5 mg) for all patients, including those with kidney or liver impairment. In another first, the diabetes drug is marketed by an alliance of Boehringer Ingelheim Pharmaceuticals Inc in Connecticut, and Eli Lilly in Indianapolis.

FDA Approves New Type 2 Diabetes Medication

May 4th, 2011

diabetes medicationThe FDA has approved a new oral diabetes medication, Tradjenta (linagliptin) to help control blood glucose in type 2 diabetics. Tradjenta works by blocking the enzyme dipeptidyl peptidase-4 (DPP-4), resulting in increased levels of hormones which stimulate the release of insulin after eating.

Tradjenta was tested in almost 4000 diabetics in eight separate double-blind clinical studies. It was studied both by as a stand-alone therapy, and in combination with other current diabetes medications such as glimepiride, pioglitazone, and metformin. It has not been tested along with insulin injections, and is not recommended for use by insulin dependent type 1 diabetics.

Tradjenta is meant to be used along with diet and exercise. People with diabetic ketoacidosis (high levels of ketones in the blood or urine) are cautioned not to use linagliptin. People taking the antibiotic rifampin, used to treat tuberculosis, should also avoid Tradjenta. The most common side effects of linagliptin were nasal congestion or a runny nose, sore throat, upper respiratory infection headache, and muscle pain.

An estimated 24 million Americans have diabetes, and up to 95 percent of them have the most common form, type 2. People with Type 2 diabetes either can't produce or are resistant to the effects of insulin, a hormone produced by the pancreas which regulates blood sugar. A lack of insulin or insulin resistance lead to high blood sugar levels, which can cause serious, and even life threatening, complications.

Some type 2 diabetics can control their blood sugar with diet and exercise, but many require oral diabetes medication or even insulin injections. The existing diabetes medications Januvia and Onglyza are also DPP-4 inhibitors. While all in the same class, the three diabetes drugs appear to have significant differences in effect, making it important that non insulin dependent diabetics have yet another option to successfully control their blood sugar.

The new diabetes medication is the first of its class to be approved at one dosage strength (5 mg) for all patients, including those with kidney or liver impairment. In another first, the diabetes drug is marketed by an alliance of Boehringer Ingelheim Pharmaceuticals Inc in Connecticut, and Eli Lilly in Indianapolis.

Pancreatic Cell Breakthrough May End Need for Insulin Therapy

May 6th, 2011

In a potential breakthrough that could lead to a cure for type 1 diabetes, scientists at the University of California, Los Angeles (UCLA) have found a way to alter the DNA of pancreas cells to turn them into insulin producing beta cells.

Beta cells are a type of cell in areas of the pancreas called islets of Langerhans. These beta cells produce insulin, a hormone that regulates blood sugar. Beta cells react quickly to spikes in blood glucose by releasing insulin into the bloodstream, and producing more. They also produce C-peptide and amylin, which contribute to blood sugar control and prevent nerve disorders associated with diabetes.

In type 1 diabetes, the body's immune system attacks and destroys the pancreas' beta cells, leading to a lack of insulin. Type I diabetes is fatal unless treated with insulin injections (insulin is destroyed in the stomach, and can't be taken orally).

The UCLA scientists report they may have discovered an underlying mechanism that could convert other types of cells into insulin producing pancreatic beta cells. It's been assumed that cells were immutable and could not be altered, but recent studies indicate that some cells can be "coaxed" into changing into other cells.

But it's now known that chemical tags called methyl groups that bind to DNA can activate or deactivate the actions and identities of certain genes. "Our work shows that beta cells and related endocrine cells can easily be converted into each other," reports study co-author Dr. Anil Bhushan form the UCLA Department of Molecular, Cell and Developmental Biology.

The UCLA findings suggest that a defect in beta cells' DNA methylation keeps a gene that triggers the ability to produce insulin "silent". The researchers are hopeful that knowledge can lead to discovery of a mechanism to produce functioning beta cells.

Converting other pancreatic cells to insulin producing beta cells would also benefit those with the much more common type 2 diabetes. In type 2 diabetes, beta cells decline over time. Type 2 diabetics either can't produce enough insulin, or develop insulin resistance, a condition where insulin becomes less effective at lowering blood sugar.

Almost 26 million American adults and children have diabetes, and that number is rising so rapidly that the International Diabetes Association has called the disease "the epidemic of the 21st century". Although the techniques to manipulate non-beta pancreatic cells into insulin producing beta cells are still emerging, the prospect of an eventual end to the need for diabetes medication brings new hope to all those impacted by the disease.

Pancreatic Cell Breakthrough May End Need for Insulin Therapy

May 6th, 2011

In a potential breakthrough that could lead to a cure for type 1 diabetes, scientists at the University of California, Los Angeles (UCLA) have found a way to alter the DNA of pancreas cells to turn them into insulin producing beta cells.

Beta cells are a type of cell in areas of the pancreas called islets of Langerhans. These beta cells produce insulin, a hormone that regulates blood sugar. Beta cells react quickly to spikes in blood glucose by releasing insulin into the bloodstream, and producing more. They also produce C-peptide and amylin, which contribute to blood sugar control and prevent nerve disorders associated with diabetes.

In type 1 diabetes, the body's immune system attacks and destroys the pancreas' beta cells, leading to a lack of insulin. Type I diabetes is fatal unless treated with insulin injections (insulin is destroyed in the stomach, and can't be taken orally).

The UCLA scientists report they may have discovered an underlying mechanism that could convert other types of cells into insulin producing pancreatic beta cells. It's been assumed that cells were immutable and could not be altered, but recent studies indicate that some cells can be "coaxed" into changing into other cells.

But it's now known that chemical tags called methyl groups that bind to DNA can activate or deactivate the actions and identities of certain genes. "Our work shows that beta cells and related endocrine cells can easily be converted into each other," reports study co-author Dr. Anil Bhushan form the UCLA Department of Molecular, Cell and Developmental Biology.

The UCLA findings suggest that a defect in beta cells' DNA methylation keeps a gene that triggers the ability to produce insulin "silent". The researchers are hopeful that knowledge can lead to discovery of a mechanism to produce functioning beta cells.

Converting other pancreatic cells to insulin producing beta cells would also benefit those with the much more common type 2 diabetes. In type 2 diabetes, beta cells decline over time. Type 2 diabetics either can't produce enough insulin, or develop insulin resistance, a condition where insulin becomes less effective at lowering blood sugar.

Almost 26 million American adults and children have diabetes, and that number is rising so rapidly that the International Diabetes Association has called the disease "the epidemic of the 21st century". Although the techniques to manipulate non-beta pancreatic cells into insulin producing beta cells are still emerging, the prospect of an eventual end to the need for diabetes medication brings new hope to all those impacted by the disease.

Enzyme Discovery May Lead to New Diabetes Medication

May 13th, 2011

Researchers at the Salk Institute for Biological Studies have discovered a mechanism that stimulates glucose production in the liver in response to a drop in blood sugar. Histone deacetylasses (HDACs) are a group of enzymes that respond to what researchers call "fasting signals".

Fasting signals kick in after long periods without food, such as overnight. HDACs are situated in liver cells, usually outside of the nucleus. The Salk researchers discovered that they move rapidly into the cell in response to fasting signals, and turn on the genes that produce glucose.

After a meal, the hormone insulin normally prompts cells to store glucose for future fuel, and turns off the liver's sugar production to avoid blood glucose from getting too high. Many people with type 2 diabetes have insulin resistance, a condition in which the body no longer responds properly to insulin, allowing the liver to continue manufacturing glucose, resulting in high blood sugar.

Currently, most type 2 diabetics are prescribed an oral diabetes medication called metformin (marketed as Glucophage XR) to help control their blood sugar levels. "Metformin is originally derived from a plant found in Western Europe called 'French lilac' or 'Goat's Rue because goats don't like to eat it, explains scientist Reuben Shaw, Ph.D., "They steered clear of the plant because it contains a compound that acts naturally to lower blood glucose in animals that eat it to prevent them from eating it again."

Shaw researched metformin to find out how it helped insulin to control blood sugar. He discovered it binds to AMPK, a metabolic regulating enzyme which blocks glucose production in the liver. A graduate student in his laboratory, Maria Mihhaylova, then delved into targets of AMPKs relevant to diabetes, eventually focusing on a family of HDACs called class II HDACs.

In collaboration with two other labs, Mihhaylova discovered that HDACs only controlled glucose synthesizing enzymes in response to the fasting hormone glucagon. "In response to the glucagon, chemical modifications on class II HDACs are removed, and they can translocate into the [liver cell] nucleus", she explains.

The team went on to perform tests on mice with dramatic results - suppression of HDACs restored blood glucose levels to near normal in four different models of type 2 diabetes. "These exciting results show that drugs that inhibit the activity of class II HDACs may be worthwhile to be pursued as potential diabetes drugs," says Shaw.

The search for a new and improved diabetes medication may get a boost from current cancer research - prescription drug companies have been developing HDAC inhibitors as anti-cancer drugs. Shaw hopes that some of the compounds they have developed could have therapeutic potential for the treatment of insulin resistance and diabetes, whether or not they are effective against cancer.

To view Shaw's explanation of his team's discovery on YouTube, >CLICK HERE<.

Enzyme Discovery May Lead to New Diabetes Medication

May 13th, 2011

Researchers at the Salk Institute for Biological Studies have discovered a mechanism that stimulates glucose production in the liver in response to a drop in blood sugar. Histone deacetylasses (HDACs) are a group of enzymes that respond to what researchers call "fasting signals".

Fasting signals kick in after long periods without food, such as overnight. HDACs are situated in liver cells, usually outside of the nucleus. The Salk researchers discovered that they move rapidly into the cell in response to fasting signals, and turn on the genes that produce glucose.

After a meal, the hormone insulin normally prompts cells to store glucose for future fuel, and turns off the liver's sugar production to avoid blood glucose from getting too high. Many people with type 2 diabetes have insulin resistance, a condition in which the body no longer responds properly to insulin, allowing the liver to continue manufacturing glucose, resulting in high blood sugar.

Currently, most type 2 diabetics are prescribed an oral diabetes medication called metformin (marketed as Glucophage XR) to help control their blood sugar levels. "Metformin is originally derived from a plant found in Western Europe called 'French lilac' or 'Goat's Rue because goats don't like to eat it, explains scientist Reuben Shaw, Ph.D., "They steered clear of the plant because it contains a compound that acts naturally to lower blood glucose in animals that eat it to prevent them from eating it again."

Shaw researched metformin to find out how it helped insulin to control blood sugar. He discovered it binds to AMPK, a metabolic regulating enzyme which blocks glucose production in the liver. A graduate student in his laboratory, Maria Mihhaylova, then delved into targets of AMPKs relevant to diabetes, eventually focusing on a family of HDACs called class II HDACs.

In collaboration with two other labs, Mihhaylova discovered that HDACs only controlled glucose synthesizing enzymes in response to the fasting hormone glucagon. "In response to the glucagon, chemical modifications on class II HDACs are removed, and they can translocate into the [liver cell] nucleus", she explains.

The team went on to perform tests on mice with dramatic results - suppression of HDACs restored blood glucose levels to near normal in four different models of type 2 diabetes. "These exciting results show that drugs that inhibit the activity of class II HDACs may be worthwhile to be pursued as potential diabetes drugs," says Shaw.

The search for a new and improved diabetes medication may get a boost from current cancer research - prescription drug companies have been developing HDAC inhibitors as anti-cancer drugs. Shaw hopes that some of the compounds they have developed could have therapeutic potential for the treatment of insulin resistance and diabetes, whether or not they are effective against cancer.

To view Shaw's explanation of his team's discovery on YouTube, >CLICK HERE<.

What's the Best Exercise to Control Blood Sugar in Diabetics?

May 16th, 2011

jogger

Researchers analyzing the results of 24 separate clinical trials involving over 8400 participants have determined the best type of exercise program to control blood sugar in diabetics. It turns out that engaging in moderate exercise for longer periods of time is more effective at stabilizing blood glucose than shorter bursts of intensive physical activity.

As well, diabetes patients given a structured exercise routine by their health care provider do better than those simply told to get more physical activity. "We always tell patients, even those without diabetes, to get more exercise," says Dr. Joel Zonszein, the Director of the clinical diabetes centre at New York's Montefiore Medical Center, "It would be good if we were able to prescribe an exercise program for them to follow."

Current guidelines suggest type 2 diabetics get at least 2 ½ hours of moderate to intense exercise every week, including aerobic activity and some sort of resistance training such as working out with weights. "Exercise improves insulin activity," stresses Zonszein, "it makes insulin work better."

Some diabetics discover regular work outs reduce their need for diabetes medication, so be sure to consult with your healthcare provider if you are beginning or revving up an exercise program. To read more about the study and the researchers' recommendations on HealthDay, >CLICK HERE.<

Dietary Supplement Could Replace Diabetes Medication

May 24th, 2011

grapefruit

Could the common grapefruit hold the key to avoiding or treating both type 2 diabetes and high cholesterol? A pre-meal supplement currently in clinical trials in the US could change the way your body reacts to both fats and sugars.

A nano-dietary supplement which substantially reduces the amount of fat and sugar the body absorbs from a meal has been developed in a collaboration between Boston's Harvard University and the Hebrew University of Jerusalem.

The supplement contains naringenin, the flavonoid that gives grapefruit its bitter taste. In studies with rats, a single dose of naringenin taken just before a high fat and high sugar meal increased insulin sensitivity by an impressive 64%, and reduced the generation of bad cholesterol by a substantial 42%.

The researchers had previously established that the bitter molecule had the potential to treat diabetes, arteriosclerosis (hardened fat in the arteries) and hypermetabolism (increased metabolism, accompanied by insulin resistance), but had to contend with the fact that absorption of naringenin in its natural from is very low.

They were able to increase naringenin's absorption rate by 11 times by creating a nano-complex of naringenin within a ring of sugar called cyclodextrin. As an added bonus, the sugar makes the bitter naringenin more palatable.

"The complex is special in that it is taken just before a meal as a preventative measure," explains Yaakov Nahmias from the Hebrew University, "In comparison, existing medications are given only after the chronic development of abnormal lipid [and sugar] levels in the blood."

Naringenin activates a family of small proteins called nuclear receptors, which cause the liver to break down fatty acids. It appears to mimic the action of both lipid lowering drugs such as Tricor (generic fenofibrate), and diabetes medication such as Avandia (generic rosiglitazone), without any undesired side effects. Naringenin not only combats high levels of cholesterol and other fats in the blood; it also improves the body's sensitivity to insulin, reducing insulin resistance.

The researchers have applied for patents, and the supplement is undergoing clinical trials in the US. They are hopeful that the complex may be an effective future preventative and treatment for diabetes, arteriosclerosis and hypermetabolism.

Dietary Supplement Could Replace Diabetes Medication

May 24th, 2011

grapefruit

Could the common grapefruit hold the key to avoiding or treating both type 2 diabetes and high cholesterol? A pre-meal supplement currently in clinical trials in the US could change the way your body reacts to both fats and sugars.

A nano-dietary supplement which substantially reduces the amount of fat and sugar the body absorbs from a meal has been developed in a collaboration between Boston's Harvard University and the Hebrew University of Jerusalem.

The supplement contains naringenin, the flavonoid that gives grapefruit its bitter taste. In studies with rats, a single dose of naringenin taken just before a high fat and high sugar meal increased insulin sensitivity by an impressive 64%, and reduced the generation of bad cholesterol by a substantial 42%.

The researchers had previously established that the bitter molecule had the potential to treat diabetes, arteriosclerosis (hardened fat in the arteries) and hypermetabolism (increased metabolism, accompanied by insulin resistance), but had to contend with the fact that absorption of naringenin in its natural from is very low.

They were able to increase naringenin's absorption rate by 11 times by creating a nano-complex of naringenin within a ring of sugar called cyclodextrin. As an added bonus, the sugar makes the bitter naringenin more palatable.

"The complex is special in that it is taken just before a meal as a preventative measure," explains Yaakov Nahmias from the Hebrew University, "In comparison, existing medications are given only after the chronic development of abnormal lipid [and sugar] levels in the blood."

Naringenin activates a family of small proteins called nuclear receptors, which cause the liver to break down fatty acids. It appears to mimic the action of both lipid lowering drugs such as Tricor (generic fenofibrate), and diabetes medication such as Avandia (generic rosiglitazone), without any undesired side effects. Naringenin not only combats high levels of cholesterol and other fats in the blood; it also improves the body's sensitivity to insulin, reducing insulin resistance.

The researchers have applied for patents, and the supplement is undergoing clinical trials in the US. They are hopeful that the complex may be an effective future preventative and treatment for diabetes, arteriosclerosis and hypermetabolism.

Nutrition and Diabetes Control

May 25th, 2011

woman grocery shopping

Nutrition is vitally important in diabetes management and blood sugar control. About.com's Nutrition and Diabetes page editors have compiled a wealth of information on healthy eating for diabetics including facts on carbs, calories, fiber and the all-important glycemic index; advice on surviving restaurant meals and holiday dinners, and even diabetes-friendly recipes and meal plans.

For those with an interest in alternative approaches, the Nutrition and Diabetes page also provides information on less conventional diets such as vegetarian, raw food and vegan. Other articles give you the lowdown on foods believed to have a positive affect on blood sugar and insulin resistance, such as fenugreek, prickly pear cactus and omega 3 fatty acids.

There are articles on sugar substitutes and hidden sugars, and nutrition facts and carb and calorie counts for individual foods like avocados, pomegranates, eggplant and watermelon (warning - very high carb!). The page also links to articles with recommendations for losing weight, specific diet tips for those with kidney disease, and even advice on healthy eating on a budget.

When making any major changes to your diet and/or activity levels, bear in mind they may impact your blood sugar levels and need for diabetes medication. Consult your healthcare provider about possible changes to your insulin dosage or other diabetes medicine.

To view About.com's Nutrition and Diabetes page, >CLICK HERE.<

Diabetics May Have Super-Sticky Cholesterol

May 30th, 2011

As if having diabetes isn't troubling enough, the British Heart Foundation is now warning that type 2 diabetics are more likely to have a newly discovered super-sticky "ultra bad" form of cholesterol. This extra sticky cholesterol is more likely to adhere to and build up in the arteries, forming dangerous artery-narrowing plaque. These narrowed or blocked arteries are the cause of coronary heart disease and resulting heart attacks and strokes.

The super-sticky cholesterol, called MGmin-LDL, is formed by the bonding of a sugar molecule (such as glucose or fructose) to a lipid molecule (such as low density lipoprotein) in a process called glycation. Glycation changes the shape of LDL molecules, making them smaller and denser and creating more exposed areas that are likely to stick to artery walls.

Low density lipoprotein, or LDL, enables the transfer of lipids (fatty substances) like cholesterol and triglycerides in the bloodstream. High levels of LDL cholesterol are a major risk factor for heart disease, as is diabetes. Narrowed arteries not only reduce blood flow, they can rupture, releasing a blood clot. If the clot causes a blockage in the heart, it can cause a heart attack, and if it lands in the brain, it can cause a stroke.

In fact, America's over 25 million diabetics are twice as likely to develop heart or vascular disease as the general population, and at least sixty percent of diabetics die from a cardiovascular event such as a heart attack or stroke. There is a direct correlation between the amount of plaque in their arteries and the risk of early death for diabetics.

These new findings may help explain the increased risk of coronary heart disease in diabetics. The discovery of the relationship between blood glucose and the formation of "ultra bad" cholesterol also explains why use of the widely prescribed oral diabetes medication Glucophage (generic metformin) has been linked to a reduced risk of heart attack. The diabetes medicine is believed to block the transformation of LDL to the stickier MGmin-LDL.

It's hoped that the discovery of this new type of more harmful cholesterol will lead to advancements in the prevention and treatment of heart disease in both diabetics and the elderly, who are also more likely to develop MGmin-LDL.

"Understanding exactly how 'ultra-bad' LDL damages arteries is crucial," stresses British Heart Foundation Research Advisor Dr. Shannon Amoils, "As this knowledge could help develop new anti-cholesterol treatments for patients."

"We've known for a long time that people with diabetes are at greater risk of heart attack and stroke," says Amoils, "There is still more work to be done to untangle why this is the case, but this study is an important step in the right direction." The next step for the British researchers is to develop treatments to target this more dangerous type of cholesterol, and to help neutralize its harmful effects on diabetics' arteries.

Type 1 Diabetics Respond Well to New Type 2 Diabetes Medication

June 8th, 2011

Type 1 diabetics given a recently approved type 2 diabetes medication in addition to their insulin therapy experienced a "dramatic change" in their health. They had more stable blood sugar levels, needed less insulin, and even lost an average ten pounds over six months.

The FDA approved Victoza as a once-daily injection to treat type 2 non insulin dependent diabetes in adults in early 2010. Although it is injected, Victoza is not a type of insulin. Victoza (generic name liraglutide) belongs to a new class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists.

GLP-1 receptor agonists mimic the action of a natural peptide which helps the pancreas to make more insulin after a meal. They also slow the absorption of sugar in the stomach, act as an appetite suppressant, and lower levels of glucagon, a hormone which counteracts the effect of insulin.

Researchers at the State University of New York conducted a clinical study with 14 type 1 diabetics whose blood sugar was well controlled using an insulin pump. Although their insulin therapy was effective, all the study participants showed unpredictable peaks and dips in their blood sugar levels.

When Victoza was added to their insulin therapy, all 14 saw their blood sugar quickly stabilize. Within a week, their fasting and blood sugar levels fell an average 15 percent. The longer they took Victoza, the less insulin they required. Both their mealtime and all-day insulin dosing lowered about 30 percent. Those that continued in the study for six months experienced even less need for insulin.

Lowering the levels of insulin suppressing glucagon appears to be of much more benefit to type 1 diabetics than had been anticipated. "Over a protracted period of time, as their diabetes continues to be well controlled, there is delightful improvement in patients' well being," says study leader Dr. Paresh Dandona.

Prescription Byetta (generic name exenatide) is a similar GLP-1 receptor agonist also recently approved by the FDA. Exenatide mimics the action of incretin hormones to lower blood sugar. Byetta is injected twice daily. Byetta has not yet been tested in type 1 diabetes, but the researchers believe both type 2 diabetes drugs would have the same effects.

Both liraglutide and exenatide are normally prescribed in combination with diet, exercise, and other diabetes medication. Neither Victoza or Byetta are FDA approved for use in type 1 diabetes, and Dandona advises that they should only be prescribed off-label by an endocrinologist specializing in diabetes treatment. Dandona is pursuing funding for a larger study.

Type 1 Diabetics Respond Well to New Type 2 Diabetes Medication

June 8th, 2011

Type 1 diabetics given a recently approved type 2 diabetes medication in addition to their insulin therapy experienced a "dramatic change" in their health. They had more stable blood sugar levels, needed less insulin, and even lost an average ten pounds over six months.

The FDA approved Victoza as a once-daily injection to treat type 2 non insulin dependent diabetes in adults in early 2010. Although it is injected, Victoza is not a type of insulin. Victoza (generic name liraglutide) belongs to a new class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists.

GLP-1 receptor agonists mimic the action of a natural peptide which helps the pancreas to make more insulin after a meal. They also slow the absorption of sugar in the stomach, act as an appetite suppressant, and lower levels of glucagon, a hormone which counteracts the effect of insulin.

Researchers at the State University of New York conducted a clinical study with 14 type 1 diabetics whose blood sugar was well controlled using an insulin pump. Although their insulin therapy was effective, all the study participants showed unpredictable peaks and dips in their blood sugar levels.

When Victoza was added to their insulin therapy, all 14 saw their blood sugar quickly stabilize. Within a week, their fasting and blood sugar levels fell an average 15 percent. The longer they took Victoza, the less insulin they required. Both their mealtime and all-day insulin dosing lowered about 30 percent. Those that continued in the study for six months experienced even less need for insulin.

Lowering the levels of insulin suppressing glucagon appears to be of much more benefit to type 1 diabetics than had been anticipated. "Over a protracted period of time, as their diabetes continues to be well controlled, there is delightful improvement in patients' well being," says study leader Dr. Paresh Dandona.

Prescription Byetta (generic name exenatide) is a similar GLP-1 receptor agonist also recently approved by the FDA. Exenatide mimics the action of incretin hormones to lower blood sugar. Byetta is injected twice daily. Byetta has not yet been tested in type 1 diabetes, but the researchers believe both type 2 diabetes drugs would have the same effects.

Both liraglutide and exenatide are normally prescribed in combination with diet, exercise, and other diabetes medication. Neither Victoza or Byetta are FDA approved for use in type 1 diabetes, and Dandona advises that they should only be prescribed off-label by an endocrinologist specializing in diabetes treatment. Dandona is pursuing funding for a larger study.

Insulin has Direct Effects On the Brain

June 9th, 2011

Researchers from the Max Planck Institute for Neurological Research (MPINR) claim to have proven that insulin has direct effects on the reward centers of the brain. In a recent article in Cell Metabolism outlining their work the MPINR team explained that they set out to better understand the "reward" aspects of food and how insulin influences brain function.

Unlike earlier studies that had focused on insulin's effect on the feeding behavior related hypothalamus, the team focused on neurons in the brain that release dopamine, a brain chemical that plays a role in reward and motivation. They found that insulin causes the dopamine-releasing neurons to fire more frequently.

Mice whose insulin receptors were inactivated to no longer respond to insulin overate and became obese. They also showed an altered response to sugar and cocaine when their food supply was limited, further suggesting that the brain's reward centers require insulin to function normally.

The findings suggest that insulin resistance may help to explain why many obese individuals find it so difficult to resist food and lose weight. "Insulin resistance may drive a vicious cycle," explains MPINR's Jens Bruning, "There is no evidence that this is the beginning of the road to obesity, but it may be an important contributor to obesity and to the difficulty we have in dealing with it.

The next step is to conduct functional magnetic resonance imaging (MRI) scans in human subjects who have had insulin artificially delivered to the brain to observe its effects on their reward centers.

To read the article in Cell Metabolism, >CLICK HERE.<

Insulin has Direct Effects On the Brain

June 9th, 2011

Researchers from the Max Planck Institute for Neurological Research (MPINR) claim to have proven that insulin has direct effects on the reward centers of the brain. In a recent article in Cell Metabolism outlining their work the MPINR team explained that they set out to better understand the "reward" aspects of food and how insulin influences brain function.

Unlike earlier studies that had focused on insulin's effect on the feeding behavior related hypothalamus, the team focused on neurons in the brain that release dopamine, a brain chemical that plays a role in reward and motivation. They found that insulin causes the dopamine-releasing neurons to fire more frequently.

Mice whose insulin receptors were inactivated to no longer respond to insulin overate and became obese. They also showed an altered response to sugar and cocaine when their food supply was limited, further suggesting that the brain's reward centers require insulin to function normally.

The findings suggest that insulin resistance may help to explain why many obese individuals find it so difficult to resist food and lose weight. "Insulin resistance may drive a vicious cycle," explains MPINR's Jens Bruning, "There is no evidence that this is the beginning of the road to obesity, but it may be an important contributor to obesity and to the difficulty we have in dealing with it.

The next step is to conduct functional magnetic resonance imaging (MRI) scans in human subjects who have had insulin artificially delivered to the brain to observe its effects on their reward centers.

To read the article in Cell Metabolism, >CLICK HERE.<

Poor Sleep in Diabetics Leads to 82% Higher Insulin Resistance

June 13th, 2011

man in bed

There are complex cause and effect relationships between sleep and diabetes. Poor sleep is considered a risk factor for diabetes, while diabetes is considered a contributor to poor sleep.

Sleep disorders such as insomnia, excessive snoring and obstructive sleep apnea are more common in people with type 2 diabetes. As a result, many diabetics don't sleep as well as people without the disease.

Recently, researchers conducting a study titled Cross-Sectional Associations Between Measure Of Sleep And Markers Of Glucose Metabolism Among Persons With And Without Diabetes" monitored the sleep patterns of 40 type 2 diabetics over six nights. They were first interviewed about their normal sleeping patterns, and blood samples were taken to measure their glucose and insulin levels.

Participants wore activity monitors on their wrists to measure their movements through the night. A poor sleep was defined by both the data from the wrist monitors, and the patient's description of how long it took them to fall asleep and how many times they woke up through the night.

The poor sleepers had significantly higher blood glucose levels in the morning - 23 percent higher than those who got a restful sleep. Even more striking, their blood insulin levels were 48 percent higher. The researchers crunched the two numbers to calculate that poor sleepers with diabetes had 82% higher insulin resistance than diabetics who were able to get a good sleep.

"Poor sleep quality in people with diabetes was associated with worse control of their blood sugar levels," said the study's lead author, Kristen Knutson, PhD, an assistant professor of medicine, "people who have a hard time controlling their blood glucose levels have a higher risk of complications. They have a reduced quality of life. And they have a reduced life expectancy."

The logical next step, according to the researchers, is to see if improving the quality of sleep in diabetics can help them lower insulin resistance give them better long term diabetes control and improve their quality of life.

"This suggests that improving sleep quality in diabetics would have a similar beneficial effect as the most commonly used anti- diabetes drugs," said Eve Van Cauter, PhD, professor of medicine and co-author of the study, which was recently published in Diabetes Care.

The researchers also want to solve the "chicken and egg" aspect of chronic poor sleep and chronic insulin resistance, and determine which leads to the other. In the meantime, they're suggesting that diabetics with insomnia add sleep treatment to their diabetes medication.

"Super Mice" Suggest Promising New Approach to Diabetes Medication

June 14th, 2011

lab mice

Scientists at the prestigious Mayo Clinic are excited about a promising prospective treatment for type 2 diabetes. Type 2 diabetes is a result of the body losing sensitivity to insulin and no longer being able to respond to it. Current diabetes treatments concentrate on increasing insulin levels - either by administering insulin injections, or by stimulating the pancreas to produce more insulin.

A Mayo Clinic Department of Neuroscience research team, led by Malcolm Leissring, Ph.D, took a different approach - blocking the breakdown of insulin after it was released by the pancreas. Conducting studies in mice, the researchers genetically deleted an insulin-degrading enzyme, or IDE, which breaks insulin down into smaller pieces to help control insulin levels in the blood.

The IDE-less rodents were "super mice" in regards to their ability to lower their blood sugar after a meal (a problem for many diabetics). They also had higher insulin levels, weighed less, and had better overall blood sugar control.

"Insulin levels in the blood reflect the balance between how much is secreted and how fast it is broken down," explains Leissring, "Blocking the breakdown of insulin is simply an alternative method for achieving the same goals as existing diabetes therapies."

Unfortunately, IDE inhibitors will need some work before they can be used in humans. The "super mice" eventually overdosed on the trial diabetes drug, becoming insulin resistant and developing classic type 2 diabetes. "It's an example of too much of a good thing becoming bad for you, explains researcher Samer Abdul-Hay, Ph.D, "Deleting all IDE is overkill". He believes that drugs that only partially or temporarily inhibit IDE could be effective long-term diabetes medications.

The study also raises some interesting questions about how diabetes starts. Diabetes is usually believed to cause hyperinsulinemia, or excess insulin levels in the blood. But as the "super mice" with IDE-elevated insulin levels aged, it worked the other way around - the mice lost insulin receptors, became insulin resistant, and developed type 2 diabetes.

Dr. Leissring and his team are currently working on developing more IDE inhibitors, stressing that they in the "early, but exciting days" of their research, and are still unsure if the results will apply to humans. The American Diabetes Association recently awarded them a five-year development grant - a solid indication of its interest in and support for this new avenue of diabetes research.

"Super Mice" Suggest Promising New Approach to Diabetes Medication

June 14th, 2011

lab mice

Scientists at the prestigious Mayo Clinic are excited about a promising prospective treatment for type 2 diabetes. Type 2 diabetes is a result of the body losing sensitivity to insulin and no longer being able to respond to it. Current diabetes treatments concentrate on increasing insulin levels - either by administering insulin injections, or by stimulating the pancreas to produce more insulin.

A Mayo Clinic Department of Neuroscience research team, led by Malcolm Leissring, Ph.D, took a different approach - blocking the breakdown of insulin after it was released by the pancreas. Conducting studies in mice, the researchers genetically deleted an insulin-degrading enzyme, or IDE, which breaks insulin down into smaller pieces to help control insulin levels in the blood.

The IDE-less rodents were "super mice" in regards to their ability to lower their blood sugar after a meal (a problem for many diabetics). They also had higher insulin levels, weighed less, and had better overall blood sugar control.

"Insulin levels in the blood reflect the balance between how much is secreted and how fast it is broken down," explains Leissring, "Blocking the breakdown of insulin is simply an alternative method for achieving the same goals as existing diabetes therapies."

Unfortunately, IDE inhibitors will need some work before they can be used in humans. The "super mice" eventually overdosed on the trial diabetes drug, becoming insulin resistant and developing classic type 2 diabetes. "It's an example of too much of a good thing becoming bad for you, explains researcher Samer Abdul-Hay, Ph.D, "Deleting all IDE is overkill". He believes that drugs that only partially or temporarily inhibit IDE could be effective long-term diabetes medications.

The study also raises some interesting questions about how diabetes starts. Diabetes is usually believed to cause hyperinsulinemia, or excess insulin levels in the blood. But as the "super mice" with IDE-elevated insulin levels aged, it worked the other way around - the mice lost insulin receptors, became insulin resistant, and developed type 2 diabetes.

Dr. Leissring and his team are currently working on developing more IDE inhibitors, stressing that they in the "early, but exciting days" of their research, and are still unsure if the results will apply to humans. The American Diabetes Association recently awarded them a five-year development grant - a solid indication of its interest in and support for this new avenue of diabetes research.

FDA: Long-Term Use of Actos May Be Associated With Bladder Cancer

June 17th, 2011

The U.S. Food and Drug Administration (FDA) is informing the public that use of the diabetes medication Actos (pioglitazone) for more than one year may be associated with an increased risk of bladder cancer. Information about this risk will be added to the Warnings and Precautions section of the label for pioglitazone-containing medicines. The patient Medication Guide for these medicines will also be revised to include information on the risk of bladder cancer.

This safety information is based on FDA's review of data from a planned five-year interim analysis of an ongoing, ten-year epidemiological study1, described in FDA's September 2010 ongoing safety review and in the Data Summary. The five-year results showed that although there was no overall increased risk of bladder cancer with pioglitazone use, an increased risk of bladder cancer was noted among patients with the longest exposure to pioglitazone, and in those exposed to the highest cumulative dose of pioglitazone.

To read the Safety Announcement on the FDA website, >CLICK HERE.<

FDA: Long-Term Use of Actos May Be Associated With Bladder Cancer

June 17th, 2011

The U.S. Food and Drug Administration (FDA) is informing the public that use of the diabetes medication Actos (pioglitazone) for more than one year may be associated with an increased risk of bladder cancer. Information about this risk will be added to the Warnings and Precautions section of the label for pioglitazone-containing medicines. The patient Medication Guide for these medicines will also be revised to include information on the risk of bladder cancer.

This safety information is based on FDA's review of data from a planned five-year interim analysis of an ongoing, ten-year epidemiological study1, described in FDA's September 2010 ongoing safety review and in the Data Summary. The five-year results showed that although there was no overall increased risk of bladder cancer with pioglitazone use, an increased risk of bladder cancer was noted among patients with the longest exposure to pioglitazone, and in those exposed to the highest cumulative dose of pioglitazone.

To read the Safety Announcement on the FDA website, >CLICK HERE.<

Caffeine Increases Insulin Resistance

June 20th, 2011

Add your daily cup of java to the list of things that can makeit more difficult to control your diabetes. A growing body of research indicates that caffeine disrupts glucose metabolism and increases insulin resistance, even in people that don't have diabetes.

The findings raise concerns that caffeine's tendency to increase insulin resistance could increase the risk of developing diabetes, or lead to poor control of the disease in those that already have it.

In people with type 2 diabetes, the expected rise in blood sugar after eating carbohydrates is exaggerated if they also drink a caffeinated beverage. This larger than anticipated rise in blood glucose could throw off diabetics' calculations of the required dosage of diabetes medication, including insulin injections.

This is further complicated by the fact that people metabolize coffee at different speeds, and that both slow and fast metabolizers are common in the general population.

Caffeine is not only found in coffee, but also in tea, soft drinks and in energy drinks. Caffeine's impact on glucose metabolism was reported on in the inaugural issue of the Journal of Caffeine Research: The International Multidisciplinary Journal of Caffeine Science.

"The links that have been revealed between diabetes and the consumption of caffeine beverages - especially coffee - are of monumental importance when it is acknowledged that more than 80 percent of the world's population consumes caffeine daily," says the new journal's editor in chief, Jack E. James.

Weird Warning for Diabetics With Pets

June 24th, 2011

Jack Russell terrier

The Director of the Amputation Prevention Center at the Valley Presbyterian Hospital in Van Nuys, Dr. Lee C. Rogers, has a warning for diabetic pet owners who have suffered a loss of feeling due to nerve damage.

The warning stems from an incident in which a two-year-old Jack Russell terrier chewed off the infected big toe of its owner while she slept. The 48-year-old Des Moines woman woke in the morning to find part of her toe missing, and blood on her bed and her pet's face.

"She didn't feel it at all," said Rogers, a podiatrist who treated the woman, "When she woke up, there was blood all over the place." Rogers eventually had to amputate the woman's leg after she developed an infection - leaving her a double amputee.

Rogers is now cautioning diabetics who have lost feeling in their limbs to cover their feet and any wounds while sleeping. "Pets have a tendency to lick wounds, and that simple lick can turn into a bite if there is no response from its owner," warns Rogers, adding that there has also been cases of dog's saliva infecting their owners with dangerous bacteria.

About 60 to 70 percent of diabetics have some sort of nerve damage, or diabetic neuropathy, due to poor diabetes control. Diabetic neuropathy results from years of high blood glucose levels, and often begins with a loss of sensation in the feet.

Diabetic neuropathy is a leading cause of amputation, although staff at the Amputation Prevention Center have achieved a limb salvage rate of 96 percent since opening its doors in January of 2010. The Center uses cutting-edge technology and a unique team approach. It recorded an average healing rate of 52 days in its 350 patients the first year, less than half the national average of 120 days.

Oddly, this is not the first known incident of this type. Last year a Michigan man with type 2 diabetes lost part of his big toe when his Jack Russell bit it off after the man passed out from a night of drinking. Doctors who treated him after the incident said they would have had to amputate the toe anyway.

Diabetic neuropathy is not an inevitable part of having diabetes. It can be avoided, or at the very least, minimized with proper diabetes control. Both type 1 and type 2 diabetics can control their condition with lifestyle changes like diet and exercise, careful blood glucose monitoring, and oral diabetes medication insulin injections if needed.

Weird Warning for Diabetics With Pets

June 24th, 2011

Jack Russell terrier

The Director of the Amputation Prevention Center at the Valley Presbyterian Hospital in Van Nuys, Dr. Lee C. Rogers, has a warning for diabetic pet owners who have suffered a loss of feeling due to nerve damage.

The warning stems from an incident in which a two-year-old Jack Russell terrier chewed off the infected big toe of its owner while she slept. The 48-year-old Des Moines woman woke in the morning to find part of her toe missing, and blood on her bed and her pet's face.

"She didn't feel it at all," said Rogers, a podiatrist who treated the woman, "When she woke up, there was blood all over the place." Rogers eventually had to amputate the woman's leg after she developed an infection - leaving her a double amputee.

Rogers is now cautioning diabetics who have lost feeling in their limbs to cover their feet and any wounds while sleeping. "Pets have a tendency to lick wounds, and that simple lick can turn into a bite if there is no response from its owner," warns Rogers, adding that there has also been cases of dog's saliva infecting their owners with dangerous bacteria.

About 60 to 70 percent of diabetics have some sort of nerve damage, or diabetic neuropathy, due to poor diabetes control. Diabetic neuropathy results from years of high blood glucose levels, and often begins with a loss of sensation in the feet.

Diabetic neuropathy is a leading cause of amputation, although staff at the Amputation Prevention Center have achieved a limb salvage rate of 96 percent since opening its doors in January of 2010. The Center uses cutting-edge technology and a unique team approach. It recorded an average healing rate of 52 days in its 350 patients the first year, less than half the national average of 120 days.

Oddly, this is not the first known incident of this type. Last year a Michigan man with type 2 diabetes lost part of his big toe when his Jack Russell bit it off after the man passed out from a night of drinking. Doctors who treated him after the incident said they would have had to amputate the toe anyway.

Diabetic neuropathy is not an inevitable part of having diabetes. It can be avoided, or at the very least, minimized with proper diabetes control. Both type 1 and type 2 diabetics can control their condition with lifestyle changes like diet and exercise, careful blood glucose monitoring, and oral diabetes medication insulin injections if needed.

Dramatic Increase in Life Expectancy for Type 1 Diabetics

June 27th, 2011

ScienceDaily (2011-06-25) -- The life expectancy of people diagnosed with Type 1 diabetes between 1965 and 1980 dramatically increased, compared to people diagnosed with Type 1 diabetes between 1950 and 1964, according to a new study. ... > http://www.sciencedaily.com/releases/2011/06/110624182309.htm read full article

Inexpensive TB Vaccine could be a Revolutionary Diabetes Drug

June 28th, 2011

An inexpensive vaccine that's been used for over 90 years to combat tuberculosis may have the ability to reverse type 1 diabetes. Although the early results were met with skepticism, seven studies in mice over the last ten years have established that the generic drug BCG (bacillus Calmette-Guerin) can prevent immune system T cells from destroying insulin-producing cells, allowing the pancreas to regenerate and once again produce insulin.

A research team from the Massachusetts General Hospital Immunobiology Laboratory led by Dr. Denise Faustman, PhD, successfully reproduced the results in a small group of human subjects, using very small doses of the vaccine. Those diabetics receiving the vaccine, all of whom had been Type 1 for an average 15 years, showed both a decrease in pancreas cell-destroying T cells, and an increase in the insulin precursor C-peptide - an indicator of insulin production.

The results were temporary, and it is likely that the vaccination would have to be repeated on a regular basis. The team believed using higher doses would have led to a more positive effect, but trial dosages were limited by the FDA. They are now negotiating with the FDA to use higher concentrations in a larger trial.

Type 1 diabetes is an auto-immune condition in which the body attacks its own insulin-producing beta cells in the pancreas. The body needs insulin to fuel itself and regulate blood sugar, so type 1 diabetics must take daily insulin injections to manage their blood sugar levels.

BCG works by increasing the levels of an immune system protein called tumor necrosis factor, or TNF. High levels of TNF block other parts of the immune system from attacking the body, especially the pancreas. This is a major shift in direction in diabetes treatment, as it was not previously believed possible to restore pancreas function in insulin dependent diabetics.

Doctors and researchers are surprised and excited at the unanticipated prospect of controlling the immune system to restore the body' ability to produce normal insulin levels. "If this is reproducible and correct, it could be a phenomenal finding," enthuses Dr. Robert Henry of the University of California, San Diego.

The research was largely funded by the Iacocca Foundation, founded in 1984 by auto manufacturer magnate Lee Iacocca and his daughters after his wife died from diabetes complications at age 57. The Foundation has committed to continued financial assistance for phase II clinical testing of the potentially revolutionary diabetes medication.

Inexpensive TB Vaccine could be a Revolutionary Diabetes Drug

June 28th, 2011

An inexpensive vaccine that's been used for over 90 years to combat tuberculosis may have the ability to reverse type 1 diabetes. Although the early results were met with skepticism, seven studies in mice over the last ten years have established that the generic drug BCG (bacillus Calmette-Guerin) can prevent immune system T cells from destroying insulin-producing cells, allowing the pancreas to regenerate and once again produce insulin.

A research team from the Massachusetts General Hospital Immunobiology Laboratory led by Dr. Denise Faustman, PhD, successfully reproduced the results in a small group of human subjects, using very small doses of the vaccine. Those diabetics receiving the vaccine, all of whom had been Type 1 for an average 15 years, showed both a decrease in pancreas cell-destroying T cells, and an increase in the insulin precursor C-peptide - an indicator of insulin production.

The results were temporary, and it is likely that the vaccination would have to be repeated on a regular basis. The team believed using higher doses would have led to a more positive effect, but trial dosages were limited by the FDA. They are now negotiating with the FDA to use higher concentrations in a larger trial.

Type 1 diabetes is an auto-immune condition in which the body attacks its own insulin-producing beta cells in the pancreas. The body needs insulin to fuel itself and regulate blood sugar, so type 1 diabetics must take daily insulin injections to manage their blood sugar levels.

BCG works by increasing the levels of an immune system protein called tumor necrosis factor, or TNF. High levels of TNF block other parts of the immune system from attacking the body, especially the pancreas. This is a major shift in direction in diabetes treatment, as it was not previously believed possible to restore pancreas function in insulin dependent diabetics.

Doctors and researchers are surprised and excited at the unanticipated prospect of controlling the immune system to restore the body' ability to produce normal insulin levels. "If this is reproducible and correct, it could be a phenomenal finding," enthuses Dr. Robert Henry of the University of California, San Diego.

The research was largely funded by the Iacocca Foundation, founded in 1984 by auto manufacturer magnate Lee Iacocca and his daughters after his wife died from diabetes complications at age 57. The Foundation has committed to continued financial assistance for phase II clinical testing of the potentially revolutionary diabetes medication.

Consider an Online Canadian Pharmacy When You Buy Lantus

June 30th, 2011

Lantus is a popular basal, or long acting, insulin used in the treatment of both type 1 and type 1 diabetes mellitus. The diabetes medication is suitable for both adult and pediatric patients with Type 1 diabetes, and for adults with Type 2 diabetes who require long-acting insulin injections to control hyperglycemia.

Lantus long acting insulin has some key benefits: it is used only once daily, it has no pronounced peak; it lowers basal glucose levels for a full 24 hours; and it can be used with oral diabetes medications and/or short-acting insulin for better diabetes control. One of the biggest advantages of Lantus is that, due to its lack of peak, it decreases the risk of nocturnal hypoglycemia.

Lantus (insulin glargine), marketed by Sanofi-Aventis, currently leads the long acting insulin market, generating sales of almost $4 billion a year globally. Lantus is available in both conventional vials and the discreet and convenient pre-filled Lantus SoloSTAR insulin pen.

Many diabetics help manage the cost of daily insulin injections by buying their diabetes medication from a Canadian online pharmacy. The Canadian government regulates prescription drug prices, and does not allow pharmaceutical companies to engage in expensive direct to consumer marketing, helping to keep drug prices lower.

The Canadian government also allows drug companies to manufacturer cheaper (but chemically identical) generic versions of brand name drugs sooner than in the States. Canadian pharmacies are anticipating they will be able to provide their customers with affordable generic Lantus in the near future, so revisit longactinginsulin.com for updates.

It is not uncommon for a prescription purchased through a Canadian online pharmacy to be 50% cheaper than one purchased in the US, and not unheard of for it to be up to 90% cheaper. To buy Janumet online from a Canadian pharmacy, you must have a current valid prescription.

Be sure you are dealing with a reputable online Canada pharmacy by ensuring it does not offer drugs without a prescription, does not sell controlled substances such as narcotics, has clear contact information including a physical address, has a licensed pharmacist available to answer questions, and is accredited by the Canadian International Pharmacy Association.

Like all types of insulin, Lantus is only part of a complete program of diabetes treatment that may also include diet, exercise, weight control, and regular blood sugar monitoring. Any decisions about your diabetes medication should be made together with your doctor or another health care professional.

Consider an Online Canadian Pharmacy When You Buy Lantus

June 30th, 2011

Lantus is a popular basal, or long acting, insulin used in the treatment of both type 1 and type 1 diabetes mellitus. The diabetes medication is suitable for both adult and pediatric patients with Type 1 diabetes, and for adults with Type 2 diabetes who require long-acting insulin injections to control hyperglycemia.

Lantus long acting insulin has some key benefits: it is used only once daily, it has no pronounced peak; it lowers basal glucose levels for a full 24 hours; and it can be used with oral diabetes medications and/or short-acting insulin for better diabetes control. One of the biggest advantages of Lantus is that, due to its lack of peak, it decreases the risk of nocturnal hypoglycemia.

Lantus (insulin glargine), marketed by Sanofi-Aventis, currently leads the long acting insulin market, generating sales of almost $4 billion a year globally. Lantus is available in both conventional vials and the discreet and convenient pre-filled Lantus SoloSTAR insulin pen.

Many diabetics help manage the cost of daily insulin injections by buying their diabetes medication from a Canadian online pharmacy. The Canadian government regulates prescription drug prices, and does not allow pharmaceutical companies to engage in expensive direct to consumer marketing, helping to keep drug prices lower.

The Canadian government also allows drug companies to manufacturer cheaper (but chemically identical) generic versions of brand name drugs sooner than in the States. Canadian pharmacies are anticipating they will be able to provide their customers with affordable generic Lantus in the near future, so revisit longactinginsulin.com for updates.

It is not uncommon for a prescription purchased through a Canadian online pharmacy to be 50% cheaper than one purchased in the US, and not unheard of for it to be up to 90% cheaper. To buy Janumet online from a Canadian pharmacy, you must have a current valid prescription.

Be sure you are dealing with a reputable online Canada pharmacy by ensuring it does not offer drugs without a prescription, does not sell controlled substances such as narcotics, has clear contact information including a physical address, has a licensed pharmacist available to answer questions, and is accredited by the Canadian International Pharmacy Association.

Like all types of insulin, Lantus is only part of a complete program of diabetes treatment that may also include diet, exercise, weight control, and regular blood sugar monitoring. Any decisions about your diabetes medication should be made together with your doctor or another health care professional.

What is Brittle Diabetes?

July 4th, 2011

Brittle diabetes is an uncontrolled form of type 1, or insulin dependent, diabetes. It's also referred to as uncontrolled or labile (open to change) diabetes. While most diabetics experience some fluctuations in blood sugar, brittle diabetics have dramatic, regular, yet unpredictable swings in glucose levels, even when doing their best to control their condition with insulin injections, exercise and diet.

These wildly fluctuating blood glucose levels can result in either high blood sugar (hyperglycemia) or low blood sugar (hypoglycemia). Symptoms of hypoglycemia include:

  • trembling
  • dizziness
  • cold sweats
  • tiredness
  • weakness
  • headache
  • blurred vision
  • racing or pounding heart
  • irritability
  • confusion

Severe low blood sugar can result in disorientation, convulsions, and loss of consciousness.

Symptoms of hyperglycemia include:

  • thirst
  • headache
  • blurred vision
  • frequent urination
  • trouble concentrating
  • fatigue

Hyperglycemia is frequently accompanied by ketosis, or elevated levels of ketones. Ketones are compounds caused by the breakdown of fatty acids in the body.

Ketosis is not normal, but it's not necessarily harmful. However extreme ketosis can lead to ketoacidosis, a dangerous condition in which the blood's ph is lowered to very acidic levels. Ketoacidosis can result in a life threatening diabetic coma. One telltale sign of ketoacidosis is a fruity or nail polish remover-like odor on the diabetic's breath (caused by acetone, a byproduct of ketone breakdown).

Luckily, only about 2 percent of diabetics suffer from brittle diabetes. It is most common in young (aged 15 to 30) women, especially overweight women. Brittle diabetes can be caused or made worse by:

  • poor diabetes control (high sugar diet, missing doses of diabetes medication)
  • gastrointestinal absorption problems
  • poor insulin absorption
  • thyroid problems (hypothyroidism)
  • adrenal gland problems
  • drug and alcohol interactions
  • hormonal imbalances
  • stress
  • depression

Brittle diabetes often has to be treated in a hospital, where food intake, insulin injections, and blood sugar levels can be closely controlled and monitored. As there may be a psychological component to brittle diabetes, psychotherapy is helpful in some cases.

What is Brittle Diabetes?

July 4th, 2011

Brittle diabetes is an uncontrolled form of type 1, or insulin dependent, diabetes. It's also referred to as uncontrolled or labile (open to change) diabetes. While most diabetics experience some fluctuations in blood sugar, brittle diabetics have dramatic, regular, yet unpredictable swings in glucose levels, even when doing their best to control their condition with insulin injections, exercise and diet.

These wildly fluctuating blood glucose levels can result in either high blood sugar (hyperglycemia) or low blood sugar (hypoglycemia). Symptoms of hypoglycemia include:

  • trembling
  • dizziness
  • cold sweats
  • tiredness
  • weakness
  • headache
  • blurred vision
  • racing or pounding heart
  • irritability
  • confusion

Severe low blood sugar can result in disorientation, convulsions, and loss of consciousness.

Symptoms of hyperglycemia include:

  • thirst
  • headache
  • blurred vision
  • frequent urination
  • trouble concentrating
  • fatigue

Hyperglycemia is frequently accompanied by ketosis, or elevated levels of ketones. Ketones are compounds caused by the breakdown of fatty acids in the body.

Ketosis is not normal, but it's not necessarily harmful. However extreme ketosis can lead to ketoacidosis, a dangerous condition in which the blood's ph is lowered to very acidic levels. Ketoacidosis can result in a life threatening diabetic coma. One telltale sign of ketoacidosis is a fruity or nail polish remover-like odor on the diabetic's breath (caused by acetone, a byproduct of ketone breakdown).

Luckily, only about 2 percent of diabetics suffer from brittle diabetes. It is most common in young (aged 15 to 30) women, especially overweight women. Brittle diabetes can be caused or made worse by:

  • poor diabetes control (high sugar diet, missing doses of diabetes medication)
  • gastrointestinal absorption problems
  • poor insulin absorption
  • thyroid problems (hypothyroidism)
  • adrenal gland problems
  • drug and alcohol interactions
  • hormonal imbalances
  • stress
  • depression

Brittle diabetes often has to be treated in a hospital, where food intake, insulin injections, and blood sugar levels can be closely controlled and monitored. As there may be a psychological component to brittle diabetes, psychotherapy is helpful in some cases.

Diabetes Drug Metformin Safer for the Heart

July 12th, 2011

The type 2 diabetes drug metformin is safer for the heart than other older diabetes medication, according to a two-year study. The findings are important because older patients with diabetes are at particular risk for cardiovascular disease, and because many of them are prescribed a class of diabetes medications called sulfonylureas that may raise this risk.

The controversial diabetes drug Avandia, which has been linked to heart problems, is a sulfonylureas diabetes drug. Sulfonylureas have also been linked to episodes of low blood sugar, and to weight gain.

Sulfonylureas drugs and metformin (also known by the brand name Glucophage) lower blood sugar in different ways. Metformin works by suppressing sugar production in the liver, while sulfonylureas work by increasing insulin production. To read more about the study findings on WebMD, >CLICK HERE.<

Diabetes Drug Metformin Safer for the Heart

July 12th, 2011

The type 2 diabetes drug metformin is safer for the heart than other older diabetes medication, according to a two-year study. The findings are important because older patients with diabetes are at particular risk for cardiovascular disease, and because many of them are prescribed a class of diabetes medications called sulfonylureas that may raise this risk.

The controversial diabetes drug Avandia, which has been linked to heart problems, is a sulfonylureas diabetes drug. Sulfonylureas have also been linked to episodes of low blood sugar, and to weight gain.

Sulfonylureas drugs and metformin (also known by the brand name Glucophage) lower blood sugar in different ways. Metformin works by suppressing sugar production in the liver, while sulfonylureas work by increasing insulin production. To read more about the study findings on WebMD, >CLICK HERE.<

American Diabetes Association Releases Diabetes 24/7

July 14th, 2011

The American Diabetes Association has released new software to help diabetics enhance their diabetes control. The online tool, called Diabetes 24/7, is a personal health record which allows diabetics to store and track relevant medical information such as glucose readings, diabetes medications and test results. Healthcare providers such as doctors, pharmacies, laboratories and clinics can also access the information, with the patient's permission.

Diabetes 24/7 is designed to integrate with the free Microsoft program Health Vault, where the information is securely stored. Health Vault provides users with an easily accessible place to import, organize and share important healthcare records and information, all under the user's control. The site also offers a variety of online health management tools.

To learn more about Diabetes 24/7 on the American Diabetes Association website, >CLICK HERE<.

FDA Panel Recommends Against Approval of new Diabetes Medication

July 27th, 2011

diabetes medication

A panel of Food & Drug Administration advisors has voted 9 to 6 against the approval of the new oral diabetes drug, dapaglifozin. Dapaglifozin was developed by Bristol-Myers Squibb, and was to be marketed by AstraZeneca. The panel expressed concerns about both the medication's safety and its effectiveness, especially in the elderly.

Dapaglifozin proved as effective as current oral diabetes medications in otherwise healthy diabetics, but was not as effective in those with impaired kidney function. The panel was primarily concerned about a potential risk of breast and bladder cancers. In a two-year study, there were nine cases of bladder cancer and nine cases of breast cancer in the just under 5478 patients taking the new diabetes medication, compared to only one case of bladder cancer and one case of breast cancer in the 3156 patients in the control group.

There were also indications of possible kidney damage, and increased risks of genital and urinary tract infections. The panel also complained of insufficient data on which patient population the diabetes drug was best suited to, and on potential interactions with other medications.

Dapaglifozin belongs to a class of medications called SGLT2 inhibitors. SGLT2 inhibitors work by inhibiting the return of glucose filtered by the kidneys to the blood stream, redirecting it through the urinary tract to be excreted in the urine. It's believed the resulting high sugar levels in the urine is the cause of the increase in genital and urinary tract infections.

One advantage of SGLT2 inhibitors is that they work independently of insulin injections, allowing for more freedom in combining them with other diabetes medications. People taking dapaglifozin in clinical trials also lost an average of five pounds, and experienced a slight drop in blood pressure.

The panel recommendation will not only likely result in the FDA rejecting the diabetes medication, but it will also effect the approval of similar SGLT2 inhibitors being developed by a number of other major pharmaceutical companies, including Johnson & Johnson, GlaxoSmithKline, Boehringer Ingelheim and Eli Lilly.

The panel is calling for more clinical studies of the proposed diabetes drug. The FDA will make a final decision by the end of October, 2011, but given the panel's request for more trials, the approval of dapaglifozin is expected to be about two years away.

Arthritis Drug a Future Diabetes Medication?

August 9th, 2011

A collaborative group of researchers including the American Diabetes Association and the Juvenile Diabetes Research Foundation has been testing the medication abatacept (CTLA4 immunoglobin fusion protein) as a possible treatment for type 1 diabetes. Abatacept, better known by its brand name Orencia, is FDA approved to treat autoimmune diseases such as rheumatoid arthritis and multiple sclerosis.

Type 1 diabetes is an autoimmune disease in which T-cells in the body's immune system mistakenly attack the insulin producing beta cells in the pancreas. With the pancreas producing little or no insulin, type 1 diabetics must rely on insulin injections to regulate their blood sugar levels. Those type 1 diabetes who continue to produce some insulin have an easier time keeping their blood sugar in the normal range, and have less risk of diabetes complications.

Abatacept blocks the activation of the immune system's aggressive and destructive T-cells. The researchers hoped the medication would protect the remaining beta cells in the pancreas from being destroyed, allowing them to continue to make at least a little of their own insulin.

Researchers recruited 112 newly diagnosed type 1 diabetics aged 6 to 45, all of whom still had some functioning beta cells. Two thirds of the participants were given abatacept intravenously over two years, and one third was given a placebo. The two-year study ended recently, although participants will be followed up for another two years. Initial results are encouraging, with the participants who received the abatacept showing 59% more insulin production than the control group.

"I have spent my career on the quest to find a treatment and cure for type 1 diabetes, and thus it was very gratifying when we unblinded the clinical results and discovered that abatacept had benefit," said principle investigator Dr. Tihamer Orban. "From my experience though," he cautioned, "abatacept is not likely to be the complete answer, and type 1 diabetes patients will likely benefit from cocktail combinations with other drugs. This synergistic approach has a great future."

Orban's is the CEO of the clinical stage biotechnology company, Orban Biotech. Orban Biotech has launched a pre-clinical study evaluating the combination of abatacept with the company's antigen-based therapy insulin B chain vaccine. The vaccine, which is entering into a Phase II trial, is designed to arrest the autoimmune response and re-establish tolerance towards insulin, preserving the body's own insulin production.

This study is one of several which show promise of novel ways to improve diabetes control, and perhaps free insulin dependent diabetics from the need for frequent insulin injections and other diabetes medication.

Arthritis Drug a Future Diabetes Medication?

August 9th, 2011

A collaborative group of researchers including the American Diabetes Association and the Juvenile Diabetes Research Foundation has been testing the medication abatacept (CTLA4 immunoglobin fusion protein) as a possible treatment for type 1 diabetes. Abatacept, better known by its brand name Orencia, is FDA approved to treat autoimmune diseases such as rheumatoid arthritis and multiple sclerosis.

Type 1 diabetes is an autoimmune disease in which T-cells in the body's immune system mistakenly attack the insulin producing beta cells in the pancreas. With the pancreas producing little or no insulin, type 1 diabetics must rely on insulin injections to regulate their blood sugar levels. Those type 1 diabetes who continue to produce some insulin have an easier time keeping their blood sugar in the normal range, and have less risk of diabetes complications.

Abatacept blocks the activation of the immune system's aggressive and destructive T-cells. The researchers hoped the medication would protect the remaining beta cells in the pancreas from being destroyed, allowing them to continue to make at least a little of their own insulin.

Researchers recruited 112 newly diagnosed type 1 diabetics aged 6 to 45, all of whom still had some functioning beta cells. Two thirds of the participants were given abatacept intravenously over two years, and one third was given a placebo. The two-year study ended recently, although participants will be followed up for another two years. Initial results are encouraging, with the participants who received the abatacept showing 59% more insulin production than the control group.

"I have spent my career on the quest to find a treatment and cure for type 1 diabetes, and thus it was very gratifying when we unblinded the clinical results and discovered that abatacept had benefit," said principle investigator Dr. Tihamer Orban. "From my experience though," he cautioned, "abatacept is not likely to be the complete answer, and type 1 diabetes patients will likely benefit from cocktail combinations with other drugs. This synergistic approach has a great future."

Orban's is the CEO of the clinical stage biotechnology company, Orban Biotech. Orban Biotech has launched a pre-clinical study evaluating the combination of abatacept with the company's antigen-based therapy insulin B chain vaccine. The vaccine, which is entering into a Phase II trial, is designed to arrest the autoimmune response and re-establish tolerance towards insulin, preserving the body's own insulin production.

This study is one of several which show promise of novel ways to improve diabetes control, and perhaps free insulin dependent diabetics from the need for frequent insulin injections and other diabetes medication.

Diabetics May Be Wasting Billions on Unnecessary Medication

August 11th, 2011

Type 2 diabetes patients may be wasting billions of dollars on unnecessary medication. Three doctors who recently evaluated the effectiveness of commonly prescribed fibrates in diabetes patients with high cholesterol have said that the drugs have not been proven effective. The doctors, who conducted the research for the FDA, reported their findings in a commentary in the New England Journal of Medicine.

Diabetics are at high risk of cardiovascular disease, and fibrates are commonly prescribed along with statins and diabetes medication to lower the risk of heart attacks. The statins and fibrates were thought to work in combination to lower "bad" LDL cholesterol and raise "good" HDL cholesterol levels.

But, although fibrates such as Tricor (fenofibrate), Lopid (gemfibrozil) and Trilipix (fenofibric acid) are routinely prescribed to diabetics, there have been few studies assessing their effectiveness. "Thousands and thousands of Americans take fibrates every day," said one of the commentary's authors, Dr Sanjay Kaul from the Cedars-Sanai Heart Institute, "But so far there are no long-term studies showing that fibrates lower cardiovascular risk or improve survival among diabetes patients who are also on statins."

The commentary authors are calling for more studies, and recommending doctors only prescribe fibrates along with statins to diabetics at high risk of heart attack, and only after they have achieved healthy LDL levels.

While no diabetic should adjust their diabetes medication without consulting their physician, many type 2 diabetics may be able to lower the cost of their diabetes medicine without affecting their diabetes control based on this new recommendation.

Diabetics May Be Wasting Billions on Unnecessary Medication

August 11th, 2011

Type 2 diabetes patients may be wasting billions of dollars on unnecessary medication. Three doctors who recently evaluated the effectiveness of commonly prescribed fibrates in diabetes patients with high cholesterol have said that the drugs have not been proven effective. The doctors, who conducted the research for the FDA, reported their findings in a commentary in the New England Journal of Medicine.

Diabetics are at high risk of cardiovascular disease, and fibrates are commonly prescribed along with statins and diabetes medication to lower the risk of heart attacks. The statins and fibrates were thought to work in combination to lower "bad" LDL cholesterol and raise "good" HDL cholesterol levels.

But, although fibrates such as Tricor (fenofibrate), Lopid (gemfibrozil) and Trilipix (fenofibric acid) are routinely prescribed to diabetics, there have been few studies assessing their effectiveness. "Thousands and thousands of Americans take fibrates every day," said one of the commentary's authors, Dr Sanjay Kaul from the Cedars-Sanai Heart Institute, "But so far there are no long-term studies showing that fibrates lower cardiovascular risk or improve survival among diabetes patients who are also on statins."

The commentary authors are calling for more studies, and recommending doctors only prescribe fibrates along with statins to diabetics at high risk of heart attack, and only after they have achieved healthy LDL levels.

While no diabetic should adjust their diabetes medication without consulting their physician, many type 2 diabetics may be able to lower the cost of their diabetes medicine without affecting their diabetes control based on this new recommendation.

Mealtime Insulin Injections May be Replaced by an Insulin Inhaler

August 12th, 2011

There's good news for insulin dependent diabetics who rely on fast-acting mealtime insulin injections to keep their blood sugar under control. MannKind Corporation has the go-ahead to continue clinical testing of its investigational inhaled insulin, AFREZZA. The drug maker and the FDA met to confirm the protocols for two new studies, one in type 1 diabetics, and one in type 2 diabetics.

AFREZZA is an ultra-rapid acting inhaled insulin which uses patented technology to deliver powdered insulin from a thumb-sized device into the lungs. The lungs are an effective option for delivering diabetes medication, largely because of their huge surface area (about the size of a tennis court).MannKind focuses on the discovery, development and commercialization of therapeutic products for patients with diseases such as diabetes and cancer. Now in late stage clinical investigation, AFREEZA is its lead product candidate. Shares of the company jumped 20% at the news that the design of the follow-up clinical trials had been confirmed.

MannKind has been seeking approval for its new generation diabetes medication since March of 2009, but was asked twice to run additional clinical trials in order to provide the FDA with more information. One of the approval delays was due to the drug maker updating the design of its insulin inhaler after applying for approval of the earlier design. The FDA was concerned that there was not enough data to support a switch to the new generation device, and asked that both models be tested together.

Clinical trials of the initial design of the insulin inhaler were promising. Participants reported being pleased with the innovative insulin delivery device, and experienced less hypoglycemia and weight gain than did controls using a standard combination of long-acting insulin glargine and twice a day 70 30 insulin injections.

Insulin can't be taken orally, as digestive juices break it down before it can be used by the body. Currently, the only means of delivering insulin are subcutaneous insulin injections or intravenously. Because AFREEZA is a short-acting mealtime insulin, type 1 diabetics will need to combine it with long-acting insulin injections for complete diabetes control.

Dr. Larry Deeb, a pediatric endocrinologist from the University of Florida College of Medicine, says that failure to comply with regular insulin dosing is one of the major issues in diabetes, often because of the discomfort and inconvenience of insulin injections. Deeb says that finding an alternative insulin delivery method is crucial, especially for children and the needle-phobic.

Should it be approved, AFREEZA would be the second inhaled insulin to hit the market. Pfizer received approval to market a similar product, Exubera, several years ago, but, surprisingly, the product never caught on with diabetics, and was withdrawn from the market a year later.

AFREZZA is easier to use, faster acting and boasts better bioavailability than Exubera, enabling diabetics to achieve more satisfactory insulin levels using smaller amounts. Despite Exubera's unexpected failure, AFREEZA is expected to be a blockbuster diabetes drug when it becomes available.

Mealtime Insulin Injections May be Replaced by an Insulin Inhaler

August 12th, 2011

There's good news for insulin dependent diabetics who rely on fast-acting mealtime insulin injections to keep their blood sugar under control. MannKind Corporation has the go-ahead to continue clinical testing of its investigational inhaled insulin, AFREZZA. The drug maker and the FDA met to confirm the protocols for two new studies, one in type 1 diabetics, and one in type 2 diabetics.

AFREZZA is an ultra-rapid acting inhaled insulin which uses patented technology to deliver powdered insulin from a thumb-sized device into the lungs. The lungs are an effective option for delivering diabetes medication, largely because of their huge surface area (about the size of a tennis court).MannKind focuses on the discovery, development and commercialization of therapeutic products for patients with diseases such as diabetes and cancer. Now in late stage clinical investigation, AFREEZA is its lead product candidate. Shares of the company jumped 20% at the news that the design of the follow-up clinical trials had been confirmed.

MannKind has been seeking approval for its new generation diabetes medication since March of 2009, but was asked twice to run additional clinical trials in order to provide the FDA with more information. One of the approval delays was due to the drug maker updating the design of its insulin inhaler after applying for approval of the earlier design. The FDA was concerned that there was not enough data to support a switch to the new generation device, and asked that both models be tested together.

Clinical trials of the initial design of the insulin inhaler were promising. Participants reported being pleased with the innovative insulin delivery device, and experienced less hypoglycemia and weight gain than did controls using a standard combination of long-acting insulin glargine and twice a day 70 30 insulin injections.

Insulin can't be taken orally, as digestive juices break it down before it can be used by the body. Currently, the only means of delivering insulin are subcutaneous insulin injections or intravenously. Because AFREEZA is a short-acting mealtime insulin, type 1 diabetics will need to combine it with long-acting insulin injections for complete diabetes control.

Dr. Larry Deeb, a pediatric endocrinologist from the University of Florida College of Medicine, says that failure to comply with regular insulin dosing is one of the major issues in diabetes, often because of the discomfort and inconvenience of insulin injections. Deeb says that finding an alternative insulin delivery method is crucial, especially for children and the needle-phobic.

Should it be approved, AFREEZA would be the second inhaled insulin to hit the market. Pfizer received approval to market a similar product, Exubera, several years ago, but, surprisingly, the product never caught on with diabetics, and was withdrawn from the market a year later.

AFREZZA is easier to use, faster acting and boasts better bioavailability than Exubera, enabling diabetics to achieve more satisfactory insulin levels using smaller amounts. Despite Exubera's unexpected failure, AFREEZA is expected to be a blockbuster diabetes drug when it becomes available.

New Class of Injectable Diabetes Medication for Type 2 Diabetics

August 16th, 2011

Liraglutide, marketed as Victoza, is a new approach to blood sugar control in type 2 diabetes. Although it is an injectable diabetes medication, it is not insulin, does not contain insulin, and is not taken with insulin. Victoza is not used to treat insulin dependent type 1 diabetes (although there has been a successful clinical trial using the diabetes drug along with insulin injections).

In type 2 diabetes, by far the most common form of the disease, the body either doesn't make enough insulin, or can not properly respond to the insulin it does make. Insulin is produced by beta cells in the pancreas. As type 2 diabetes progresses, beta cells stop working and die off, and even less insulin is produced. Victoza helps the beta cells in the pancreas make and release insulin.

Liraglutide belongs to a new class of diabetes drugs called incretin mimetics GLP-1 analogues. GLP-1 is a naturally occurring hormone that signals the pancreas to release insulin in response to high blood sugar levels. The hormone also prevents the liver from releasing too much sugar, and slows gastric emptying to avoid blood sugar spikes.

Liraglutide is almost identical (97%) to the GLP-1 hormone. Like GLP-1, Victoza makes more insulin available in your blood, and helps to lower your blood sugar levels. It is taken once a day as an injection, alone or in combination with another diabetes medication such as metformin.

Victoza is injected using a dial-a-dose injection pen, much like the long acting insulin Lantus SoloSTAR. The pen uses extremely short, thin (30 or 32 gauge) disposable needles. Victoza is injected into the fat under the skin with the push of a button on the top of the pen. After injection, it is slowly dispersed into the body. It can be taken with or without food and, unlike insulin injections, the dose does not need to be adjusted based on food intake or activity levels.

The FDA approved Victoza in early 2010, with a black box warning that it should only be prescribed to patients in which the potential benefits outweigh the potential risks. The black box warning stems largely from animal studies in which high doses of liraglutide appeared associated with thyroid tumors (including cancer) in mice. The FDA has ordered Victoza's manufacturer, Novo Nordisk, to conduct ongoing testing and monitoring, including a 15-year cancer registry.

Liraglutide is not recommended as a first-line diabetes medication. As with all diabetes drugs, Victoza should be used in combination with diet and exercise. Victoza can not be taken by people with certain medical conditions, including gastroparesis (delayed stomach emptying) and has not been tested in children. The most common Victoza side effects are nausea, headache and diarrhea.

Novo Nordisk has focused a great deal of its marketing campaign on the fact that most type 2 diabetics taking liraglutide lose weight. Marketing of the diabetes drug got off to a rocky start in Britain, when Novo Nordisk breached the Association of the British Pharmaceutical Industry's code of contact by promoting it before it was approved, and not providing information about Victoza side effects.

Exenatide (marketed as prescription Byetta) is another diabetes medication in the new class of incretin mimetics. Byetta, which requires twice a day injections, has similar actions to Victoza. It is not a GLP-1 analogue, but mimics the action of incretin (gastrointestinal) hormones, including GLP-1, to lower blood sugar. Both drugs arrived on the market in the same time frame, sparking a Byetta vs Victoza debate that is still ongoing.

New Class of Injectable Diabetes Medication for Type 2 Diabetics

August 16th, 2011

Liraglutide, marketed as Victoza, is a new approach to blood sugar control in type 2 diabetes. Although it is an injectable diabetes medication, it is not insulin, does not contain insulin, and is not taken with insulin. Victoza is not used to treat insulin dependent type 1 diabetes (although there has been a successful clinical trial using the diabetes drug along with insulin injections).

In type 2 diabetes, by far the most common form of the disease, the body either doesn't make enough insulin, or can not properly respond to the insulin it does make. Insulin is produced by beta cells in the pancreas. As type 2 diabetes progresses, beta cells stop working and die off, and even less insulin is produced. Victoza helps the beta cells in the pancreas make and release insulin.

Liraglutide belongs to a new class of diabetes drugs called incretin mimetics GLP-1 analogues. GLP-1 is a naturally occurring hormone that signals the pancreas to release insulin in response to high blood sugar levels. The hormone also prevents the liver from releasing too much sugar, and slows gastric emptying to avoid blood sugar spikes.

Liraglutide is almost identical (97%) to the GLP-1 hormone. Like GLP-1, Victoza makes more insulin available in your blood, and helps to lower your blood sugar levels. It is taken once a day as an injection, alone or in combination with another diabetes medication such as metformin.

Victoza is injected using a dial-a-dose injection pen, much like the long acting insulin Lantus SoloSTAR. The pen uses extremely short, thin (30 or 32 gauge) disposable needles. Victoza is injected into the fat under the skin with the push of a button on the top of the pen. After injection, it is slowly dispersed into the body. It can be taken with or without food and, unlike insulin injections, the dose does not need to be adjusted based on food intake or activity levels.

The FDA approved Victoza in early 2010, with a black box warning that it should only be prescribed to patients in which the potential benefits outweigh the potential risks. The black box warning stems largely from animal studies in which high doses of liraglutide appeared associated with thyroid tumors (including cancer) in mice. The FDA has ordered Victoza's manufacturer, Novo Nordisk, to conduct ongoing testing and monitoring, including a 15-year cancer registry.

Liraglutide is not recommended as a first-line diabetes medication. As with all diabetes drugs, Victoza should be used in combination with diet and exercise. Victoza can not be taken by people with certain medical conditions, including gastroparesis (delayed stomach emptying) and has not been tested in children. The most common Victoza side effects are nausea, headache and diarrhea.

Novo Nordisk has focused a great deal of its marketing campaign on the fact that most type 2 diabetics taking liraglutide lose weight. Marketing of the diabetes drug got off to a rocky start in Britain, when Novo Nordisk breached the Association of the British Pharmaceutical Industry's code of contact by promoting it before it was approved, and not providing information about Victoza side effects.

Exenatide (marketed as prescription Byetta) is another diabetes medication in the new class of incretin mimetics. Byetta, which requires twice a day injections, has similar actions to Victoza. It is not a GLP-1 analogue, but mimics the action of incretin (gastrointestinal) hormones, including GLP-1, to lower blood sugar. Both drugs arrived on the market in the same time frame, sparking a Byetta vs Victoza debate that is still ongoing.

Diabetes Videos on WebMD

August 18th, 2011

More and more people are turning to the web for information on health issues, including diabetes. WebMD is one of the most highly respected sources of timely and trusted medical news and information on the web. The site's Health A to Z section includes a comprehensive Diabetes Health Centre sub-section.

Aware that many people prefer to get their information in other ways rather than reading, WebMD has incorporated a number of alternative means of delivering information into their site, including interactive quizzes, tools such as a Food & Fitness Planner, and short documentary-style videos.

The diabetes-related videos feature real people in real life settings - diabetes patients, parents of diabetic children, researchers, and health care professionals. Currently, the site contains sixty diabetes videos on diverse topics, including:

  • Basic diabetes information (type 1 diabetes, type 2 diabetes, pre-diabetes, diabetes diagnosis, diabetes control, diabetes medication-)

  • Diabetes management (diet, foot care, glucose monitoring, A1C testing, hypoglycemia and hyperglycemia-)

  • Diabetes in children (preschool, young children, adolescents-)

  • Insulin delivery methods (insulin pumps, insulin inhalers, islet cells transplant-)

  • Diabetes research and studies (diabetes vaccine, stem cells, investigational diabetes medications, glucose monitoring tattoo, cord blood study-)

  • New diabetes treatments (islet cells transplant, continuous glucose monitors, botox for foot wounds, silicone eye oil for retinopathy-)

  • Alternative diabetes treatment (vinegar for diabetes, antioxidants, hyperbaric oxygen, medicinal properties of kudzu-)

  • Diabetes complications (foot ulcers, diabetic retinopathy, diabetic neuropathy, diabetes and depression, kidney disease-)

Should a topic be of particular interest, every video is surrounded by links to related in-depth information. To view a WebMD Diabetes Health Centre video on a study on the use of vinegar as a diabetes medication >CLICK HERE.<

Diabetes Drug Metformin Combined with Exercise Has Surprise Effect on Glucose Control

August 22nd, 2011

It's common enough for researchers to look at the impacts of prescribed drugs on the body. And if you're a diabetes researcher who believes that exercise has great benefits for those with type 2 diabetes, you're hoping your research will show that. But when Normand Boulé looked at the dual impacts of exercise and metformin - two of the most commonly-prescribed modalities for glucose control -the hoped-for double whammy wasn't the result.

Researchers looking at the effects of the oral diabetes medication metformin and exercise in Type 2 diabetes patients found that a combination of these modalities didn't lower glucose control as much as hoped. Surprisingly, study participants showed better glucose control when sedentary. Researchers think that because prescription metformin and exercise both act to lower glucose levels, the combination may have triggered a counter regulatory response by the body to prevent glucose levels dipping too much.

Read the full article on ScienceDaily-

Diabetes Drug Metformin Combined with Exercise Has Surprise Effect on Glucose Control

August 22nd, 2011

It's common enough for researchers to look at the impacts of prescribed drugs on the body. And if you're a diabetes researcher who believes that exercise has great benefits for those with type 2 diabetes, you're hoping your research will show that. But when Normand Boulé looked at the dual impacts of exercise and metformin - two of the most commonly-prescribed modalities for glucose control -the hoped-for double whammy wasn't the result.

Researchers looking at the effects of the oral diabetes medication metformin and exercise in Type 2 diabetes patients found that a combination of these modalities didn't lower glucose control as much as hoped. Surprisingly, study participants showed better glucose control when sedentary. Researchers think that because prescription metformin and exercise both act to lower glucose levels, the combination may have triggered a counter regulatory response by the body to prevent glucose levels dipping too much.

Read the full article on ScienceDaily-

Flying Can Cause Changes in Insulin Pump Performance

August 30th, 2011

Diabeticlive.com is warning insulin dependent diabetes planning to take a plane that changes in cabin air pressure while flying may alter the functioning of insulin pumps. The research arose out of an incident involving a young diabetic traveler using an insulin pump whose blood sugar levels dropped unexpectedly one hour into a flight.

After uncovering reports of similar incidents involving insulin pumps delivering incorrect insulin doses while being used on planes, a team of researchers from John Hunter Children's Hospital in Australia decided to perform some tests.

They placed ten insulin pumps on a commercial flight. When they analyzed them later, they found the pumps delivered 1 to 1.4 extra units of insulin after take-off, and that a small amount of insulin was drawn back into the pumps when descending for a landing.

To read the entire story on diabeticlive.com, including the researchers' suggestions for diabetics with insulin pumps who plan to travel byplane, >CLICK HERE.<

Do You Need a Diabetes Emergency Survival Kit?

September 1st, 2011

Essential Preparedness Products (EPP) is marketing an emergency survival kit designed specifically for diabetics. The Diabetic med-Ecase is light weight, watertight, airtight, crush resistant, and will float in water.

The survival kit comes complete with glucose tablets, alcohol swabs, a syringe container, an ice pack, a log book to track insulin injections, diabetes medication bottles and a 7-day pill dispenser. Water purification tablets can be purchased as an add-on..

The rugged yellow case has customized compartments for insulin vials, insulin syringes, insulin pens, blood sugar meters, glucagon, and blood and ketone testing stripes. Users fill them with their own personal diabetes medication and supplies.

EPP focuses on emergency preparedness for those with serious medical conditions, creating customized med-Ecases containing necessary medications and supplies in preparation for an emergency, natural disaster, or just travel. Their Diabetic med-Ecase can be ordered online through the EPP website for $69.99.

Do You Need a Diabetes Emergency Survival Kit?

September 1st, 2011

Essential Preparedness Products (EPP) is marketing an emergency survival kit designed specifically for diabetics. The Diabetic med-Ecase is light weight, watertight, airtight, crush resistant, and will float in water.

The survival kit comes complete with glucose tablets, alcohol swabs, a syringe container, an ice pack, a log book to track insulin injections, diabetes medication bottles and a 7-day pill dispenser. Water purification tablets can be purchased as an add-on..

The rugged yellow case has customized compartments for insulin vials, insulin syringes, insulin pens, blood sugar meters, glucagon, and blood and ketone testing stripes. Users fill them with their own personal diabetes medication and supplies.

EPP focuses on emergency preparedness for those with serious medical conditions, creating customized med-Ecases containing necessary medications and supplies in preparation for an emergency, natural disaster, or just travel. Their Diabetic med-Ecase can be ordered online through the EPP website for $69.99.

Insulin Jet Injectors Evolving

September 12th, 2011

Despite lackluster success to date, the market research firm Kalorama is predicting that the worldwide market for jet injectors will double over the next five years. Jet injectors are a needleless drug delivery system that distribute a fine jet of medication under such high pressure that it is able to penetrate the skin.

"Needle-free devices have come a long way to the present state and are playing an increasingly important role in the novel drug delivery technology markets," Kalorama drug delivery analyst Mary Anne Crandall wrote in a report titled Needle-Free Drug Delivery Markets. She predicts that their ease of use, safety and cost effectiveness, combined with evolving technology, will result in a future boom in jet injector sales.

"Needle free has been a part of insulin marketing for some time," says Crandall, "And now we are also seeing it with vaccines and [other] treatments." There are now over a dozen FDA approved needle-free jet injectors on the market, most designed for specific purposes such as administering vaccines, delivering hormone treatments, and administering growth hormone to children.

Bioject's VitaJet has traditionally been marketed as an insulin jet injector, although it is now being promoted for other home injection applications. There are insulin jet injectors specially designed for children, and even one for dogs and cats, the Zoe Pet Jet.

There are still some limitations to widespread usage of jet injectors. For example, jet injectors can't efficiently administer drugs intramuscularly. They are well suited to delivering subcutaneous insulin doses, but existing jet injectors are cumbersome compared to an insulin syringe or insulin pen, and require maintenance.

Currently, cost is also an issue, although Crandall believes prices will erode in the near future, spurring further sales. While initially expensive, jet injectors are designed to last for years. The pressurized gas cartridges needed to power many jet injectors (others use a spring loaded device) are an ongoing expense.

The number one issue may be discomfort. Although some diabetics find a needleless insulin injection quite tolerable, many find the pressure required to force the insulin through the skin painful. Some report bruising, swelling and even bleeding at the injection site, although that may be the result of an incorrect injector setting.

There are some obvious benefits to a needle free jet injection system, the most apparent being the option for the needle phobic to avoid needles. Other advantages are the speed and ease of use, safety (no bent or broken needles, or "sharps" to dispose of ), less risk of contamination, a better spread of insulin into the subcutaneous tissue, no scar tissue build up at the injection site, and no need to keep buying syringes.

"Needle-free jet injection devices can and should play a major role in solving the problems of needle stick injuries and needle phobia in the United States," according to Crandall. With the industry aware of and working on the drawbacks of the promising drug delivery devices, Crandall is probably right.

New Disposable Insulin Delivery Device About to Hit the Market

September 14th, 2011

Valeritas, an American medical technology company focused on the development and commercialization of innovative drug delivery solutions, is poised to begin marketing a new disposable insulin delivery device called the V-Go Disposable Insulin Delivery Device.

The V-Go is designed to provide an alternative to multiple daily insulin injections for adult type 2 diabetics using basal-bolus insulin therapy. The V-Go delivers a continuous preset rate of basal insulin (20, 30 or 40 units of insulin per 24 hours) and allows for on demand bolus dosing at mealtimes (in two unit increments up to 36 units).

Users fill the V-Go with their desired insulin dose using an included disposable filling accessory, the V-Go EZ Fill. The small, lightweight (about 1 ounce when full) device delivers insulin subcutaneously for 24 hours, after which it is replaced with a new one. The discreet device is worn under a patient's clothing, and should not be exposed to direct sunlight or high temperatures, although it can be submerged in up to three feet of water.

The non-electronic V-Go was tested using both Humalog insulin lispro and Novolog (insulin aspart), and achieved FDA approval at the end of 2010. The company has been pursuing financing to market it ever since, and has just announced that it has raised $150 million to bring the V-Go Disposable Insulin Delivery Device to market.

"Millions of adult patients suffer from type 2 diabetes and require insulin," says Valeritas CEO Kristine Peterson, "We believe the V-Go will be an important treatment option to assist in the management of their diabetes." To visit the V-Go site and to sign up for email updates on the availability of the innovative insulin delivery device, >Click Here.<

Insulin Nasal Spray Tested as an Alzheimer's Treatment

September 16th, 2011

insulin nasal spray

Ateam of Department of Veteran Affairs (VA) researchers were intrigued by studies that suggested that low levels of insulin in the brain could contribute to Alzheimer's disease. The researchers, led by Dr. Suzanne Craft, decided to test the benefits of restoring normal insulin levels in the brains of Alzheimer's patients.

Insulin is an important hormone which plays a major role in turning blood sugar into energy for cells. A lack of insulin, or an inability to properly use it, results in diabetes. Diabetes is a known risk factor for Alzheimer's, although the connection is not yet clear.

Alzheimer's is a disease in which cognitive functioning declines over time, causing progressive memory loss, loss of motor and language skills, impaired reasoning, emotional instability, and eventually full-blown dementia. The disease is associated with abnormal protein deposits in the brain called plaques.

The VA team used an insulin nasal spray that could deliver insulin rapidly and directly to the brain without increasing insulin levels elsewhere in the body. They recruited 104 adults with mild amnestic cognitive impairment or mild to moderate Alzheimer's disease. They divided the participants into three groups, with one group receiving 20 international units (IU) of insulin, one receiving 40 IU, and the third receiving an inactive saline placebo. The insulin dose or placebo was delivered daily through a nasal spray for four months.

Memory, cognition and functioning ability tests were conducted on the participants both before and after the four month period. The patients in the treated groups showed an increase in brain glucose metabolism following insulin therapy. Both insulin doses improved the patients' general cognition and functioning about 20%, and the 20 IU insulin dose also improved memory. The group receiving the placebo showed a slight decline in cognitive abilities. The treatment did not result in any major side effects, although some participants did report a mild headache or a runny nose.

Insulin appears to protect the brain against the toxic effects of beta-amyloid, the protein behind the brain plaques present in Alzheimer's. It also prevents the formation of a toxic form of the protein tau, a biomarker for Alzheimer's found in the cerebrospinal fluid. Insulin also promotes cell repair and growth, which may also help combat degenerative brain disease.

VA Chief Research and Development Officer Dr. Joel Kupersmith says, "VA researchers are exploring a number of possible approaches to help prevent of effectively treat this devastating disease, and these are among the most promising results to date." The research is even more important and encouraging because there is currently no effective treatment to delay or treat Alzheimer's disease.

There are a great many unanswered questions about the connection between insulin and Alzheimer's, and it's still premature to consider insulin a new treatment. Researchers still don't know much of the daily insulin injections required by many diabetics gets into the brain, and what effects it may have in the brain of the average diabetic.

Researchers are calling for further studies to explore the use of insulin to treat Alzheimer's, and to hopefully establish an optimal insulin dosage and dosing schedule. Any treatment which could improve the lives of the estimated 5.4 million Americans that suffer from Alzheimer's and their caregivers can not come soon enough.

Diabetic Emergency: Treating Hypoglycemia with Glucagon

September 19th, 2011

glucagon kit

Like insulin, glucagon is a hormone made in the pancreas. But the two hormones have opposite effects - insulin lowers blood sugar, while glucagon raises it. This means glucagon can be used to treat an episode of severe hypoglycemia (low blood sugar) in diabetics.

Severe hypoglycemia is rare in most insulin dependent diabetics, but can cause a loss of consciousness and should be considered a medical emergency. Type 1 diabetics are advised to have a glucagon kit on or near them at all times, as are the parents and caregivers of children with diabetes.

About.com diabetes coach Gary Gilles has written a valuable guide to treating severe low blood sugar with glucagon, describing when and how glucagon should be used. Glucagon is administered as an injection, but unlike an insulin injection, it should be injected deep into the muscle.

To read Gilles' article on About.com, >Click Here.<

Overcoming Injection Anxiety

September 20th, 2011

Have you or someone close to you been newly diagnosed as an insulin dependent diabetic? Are you anxious about giving yourself or your dependent insulin injections? Many diabetics say that giving themselves an insulin injection is the hardest part of the condition.

Or perhaps you're an experienced diabetic who hasn't kept up to date on the latest insulin delivery methods like spring loaded syringes, insulin pens and insulin jet injectors. Skipping doses of diabetes medication can lead to poor blood sugar control and diabetes complications. WebMD feature writer Stephanie Watson offers some practical advice in an article titled Overcoming Objections to Injections.

Overcoming Injection Anxiety

September 20th, 2011

Have you or someone close to you been newly diagnosed as an insulin dependent diabetic? Are you anxious about giving yourself or your dependent insulin injections? Many diabetics say that giving themselves an insulin injection is the hardest part of the condition.

Or perhaps you're an experienced diabetic who hasn't kept up to date on the latest insulin delivery methods like spring loaded syringes, insulin pens and insulin jet injectors. Skipping doses of diabetes medication can lead to poor blood sugar control and diabetes complications. WebMD feature writer Stephanie Watson offers some practical advice in an article titled Overcoming Objections to Injections.

Edible Film a Possible Insulin Delivery Platform

September 22nd, 2011

In another promising development in the world of diabetes medication, the specialty pharmaceutical company MonoSol Rx is testing its unique PharmFilm as a possible oral insulin delivery platform. PharmFilm is a quick-dissolving film that can be impregnated with medication and placed under the tongue or against the inside of the cheek. The medication is quickly absorbed into the bloodstream through the mouth's mucosal membranes.

The FDA has already approved two applications of the edible film - Zuplenz to treat nausea and vomiting, and Suboxone to treat opiod dependence. MonoSol Rx is now testing two new applications for PharmFilm, one dispenses a drug to treat ADHD, and the other delivers insulin for diabetics.

Currently, insulin can only be administered through injection, as it is destroyed by acids in the digestive system. Because the postage stamp sized insulin film dissolves so quickly in the mouth, the diabetes medication bypasses the digestive tract and passes directly into the circulatory system.

MonoSol Rx and Midatech are just two of many companies racing to develop different ways to administer insulin without injections, including insulin patches, insulin inhalers, and insulin nasal sprays.

The insulin film can be manufactured in different sizes to accommodate different insulin dosages. The advantages of a dissolving insulin film for insulin dependent diabetics (especially children with diabetes and their caregivers) are obvious - no insulin injections; precise insulin dosing; a convenient, discreet and portable medication, and instant onset of action.

MonoSol Rx is collaborating with Midatech Group Ltd, a leading edge nanotechnology company which develops biocompatible nanoparticles (tiny synthetic molecules that are designed to carry and deliver drugs) to bring the oral diabetes medication to market. The insulin film has been successfully tested transbuccally (inside the cheek) in pigs and monkeys, and the partners plan to begin human trials this year.

A spokesperson for Midatech Group said, "The results of insulin PharmFilm in our primate study validate the film delivery of active insulin across the buccal mucosa for the first time. In addition, we have preclinical proof-of-concept that these results can be achieved in a controlled dose precisely tailored to suit individual needs. We anticipate results from our human clinical trials, slated to commence in the second quarter of 2011, to revolutionize treatment methods and insulin delivery for diabetics worldwide."

According to the Centers for Disease Control, nearly 24 million people in the United States are currently living with diabetes - the seventh leading cause of death in the country. Many of these diabetics (about 30%) are, or will become, insulin dependent and require insulin injections. Many are struggling with complications involving their heart, kidneys, nerves, eyes, and circulation.

Insulin is a hormone which moves blood sugar into the cells to give the body energy. Diabetics either don't produce any insulin (type 1 diabetes), can't make enough insulin, and/or can't properly make use of the little insulin they do produce (type 2 diabetes).

Edible Film a Possible Insulin Delivery Platform

September 22nd, 2011

In another promising development in the world of diabetes medication, the specialty pharmaceutical company MonoSol Rx is testing its unique PharmFilm as a possible oral insulin delivery platform. PharmFilm is a quick-dissolving film that can be impregnated with medication and placed under the tongue or against the inside of the cheek. The medication is quickly absorbed into the bloodstream through the mouth's mucosal membranes.

The FDA has already approved two applications of the edible film - Zuplenz to treat nausea and vomiting, and Suboxone to treat opiod dependence. MonoSol Rx is now testing two new applications for PharmFilm, one dispenses a drug to treat ADHD, and the other delivers insulin for diabetics.

Currently, insulin can only be administered through injection, as it is destroyed by acids in the digestive system. Because the postage stamp sized insulin film dissolves so quickly in the mouth, the diabetes medication bypasses the digestive tract and passes directly into the circulatory system.

MonoSol Rx and Midatech are just two of many companies racing to develop different ways to administer insulin without injections, including insulin patches, insulin inhalers, and insulin nasal sprays.

The insulin film can be manufactured in different sizes to accommodate different insulin dosages. The advantages of a dissolving insulin film for insulin dependent diabetics (especially children with diabetes and their caregivers) are obvious - no insulin injections; precise insulin dosing; a convenient, discreet and portable medication, and instant onset of action.

MonoSol Rx is collaborating with Midatech Group Ltd, a leading edge nanotechnology company which develops biocompatible nanoparticles (tiny synthetic molecules that are designed to carry and deliver drugs) to bring the oral diabetes medication to market. The insulin film has been successfully tested transbuccally (inside the cheek) in pigs and monkeys, and the partners plan to begin human trials this year.

A spokesperson for Midatech Group said, "The results of insulin PharmFilm in our primate study validate the film delivery of active insulin across the buccal mucosa for the first time. In addition, we have preclinical proof-of-concept that these results can be achieved in a controlled dose precisely tailored to suit individual needs. We anticipate results from our human clinical trials, slated to commence in the second quarter of 2011, to revolutionize treatment methods and insulin delivery for diabetics worldwide."

According to the Centers for Disease Control, nearly 24 million people in the United States are currently living with diabetes - the seventh leading cause of death in the country. Many of these diabetics (about 30%) are, or will become, insulin dependent and require insulin injections. Many are struggling with complications involving their heart, kidneys, nerves, eyes, and circulation.

Insulin is a hormone which moves blood sugar into the cells to give the body energy. Diabetics either don't produce any insulin (type 1 diabetes), can't make enough insulin, and/or can't properly make use of the little insulin they do produce (type 2 diabetes).

Insulin "Master Switch" Discovered

September 26th, 2011

Australian researchers have discovered a gene that regulates other genes in beta cells - the cells in the pancreas that make insulin. What's more, they've discovered that this gene, called Id1, is "switched on" by a high fat diet.

"We're saying that Id1 is the molecular link between environmental factors - such as a high fat diet - and beta cell dysfunction," said Dr. Ross Laybutt from Sydney's Garvan Institute of Medical Research, "Not only does the presence of Id1 appear to initiate all the other gene expression changes that take place in dysfunctional beta cells, its absence completely protects the beta cell."

Laybutt and his team intend to treat diabetic mice with a chemical compound that is already in development to block Id1 in cancer. If they can delay diabetes or improve insulin secretion in mice, they believe there is new hope for people with diabetes.

Theoretically, blocking Id1 could eliminate the need for diabetes medication for type two diabetics. To read the press release from Australia's Garvan Institute of Medical Research in Sydney, >Click Here.<

Insulin "Master Switch" Discovered

September 26th, 2011

Australian researchers have discovered a gene that regulates other genes in beta cells - the cells in the pancreas that make insulin. What's more, they've discovered that this gene, called Id1, is "switched on" by a high fat diet.

"We're saying that Id1 is the molecular link between environmental factors - such as a high fat diet - and beta cell dysfunction," said Dr. Ross Laybutt from Sydney's Garvan Institute of Medical Research, "Not only does the presence of Id1 appear to initiate all the other gene expression changes that take place in dysfunctional beta cells, its absence completely protects the beta cell."

Laybutt and his team intend to treat diabetic mice with a chemical compound that is already in development to block Id1 in cancer. If they can delay diabetes or improve insulin secretion in mice, they believe there is new hope for people with diabetes.

Theoretically, blocking Id1 could eliminate the need for diabetes medication for type two diabetics. To read the press release from Australia's Garvan Institute of Medical Research in Sydney, >Click Here.<

Woman Murders Husband with Massive Insulin Injection

September 29th, 2011

The prosecutor in Alicante, Spain has requested a prison term of 29 years for a woman accused of murdering her husband with a lethal insulin dose.

Fifty-one-year-old Gregoria CS, a Spanish woman on diabetes medication since 1998, was responsible for administering medication to her husband, Juan Antonio GC, diagnosed with HIV.

Gregoria allegedly first dosed her husband with insulin on March 30th, 2007 after a family row, resulting in his admission to hospital in a hypoglycemic crisis. He remained in hospital for a month.

On a second occasion on June 28th, 2010, she injected her sleeping husband in the neck with a massive dose using three insulin pens, and when he woke up smothered his cries for help with a pillow.

The next morning the couple's children raised the alarm when their father would not wake up.He was transferred to hospital in Elche with severe hypoglycemia and was stabilized, but remained in a vegetative state until his death on February 4th, 2011.

The woman had accused her husband of psychological abuse. The prosecutor's requested term of imprisonment comprises 11 years for the first murder attempt and 18 years for the second.

From the online newspaper, RoundTownNews.

Is It Safe To Reuse An Insulin Syringe?

September 30th, 2011

Is it safe to reuse an insulin syringe? Bethany from California asked this question of Conditions Expert Dr. Otis Brawley on the health website CNN Health. Dr. Otis' answer reads in part:

"Insulin syringes are expensive, and many patients want to reuse needles to save money. Many also reuse the lancets used to prick the skin and draw blood to measure blood sugar.

You are right that the reuse of insulin syringes and lancets is dangerous. A used needle can have bacteria from the skin in and on it. Bacteria can contaminate the bottle of insulin when reinserted into the bottle. The bottled insulin is a growth medium that can allow the bacteria to reproduce. Insulin is stored in a refrigerator to prevent bacterial growth.

Certain types of bacteria when injected can be especially devastating and can even cause death. In the U.S., several thousand diabetic patients die each year due to bad sterile technique causing abscesses, skin infection and sepsis, which is generalized infection involving the blood.

There are some insulin injection devices that are designed to be reused. Insulin for these devices comes in cartridges with a needle. A new cartridge and needle is used with each dose. The cartridge system is not very useful for the patients who have to mix immediate and long acting insulin at a dose.

All of these risks [of diabetes complications] can be reduced through good blood sugar control, good diet, exercise, and taking diabetes medications properly. Mild diabetes can be controlled through diet and exercise. Moderate disease often requires oral diabetes medications, and more severe Type 2 disease requires oral diabetes medicines and insulin injections."

To read Dr. Otis' answer in its entirety, including sound advice on avoiding diabetes complications, >Click Here.<

$100,000 Reward Offered for Glucose-Sensitive Insulin

October 3rd, 2011

The Juvenile Diabetes Research Foundation (JDRF) announced a $100,000 Challenge for the development of a new glucose-sensitive insulin medication that will be used in the treatment of patients with diabetes. The JDRF is a global organization that promotes awareness of Type 1 diabetes in addition to sponsoring research into new treatments for diabetes and educating diabetics about how to properly manage the disease.

The JDRF is utilizing the InnoCentive.com platform to issue the challenge. InnoCentive is a service that connects businesses and organizations seeking solutions to problems in a wide variety of fields with scientists and research teams who develop solutions custom-tailored for the "challenge."

The best solution is awarded a cash prize, usually between $10,000 and $100,000. The JDRF's challenge will award $100,000 to any research group that develops a diabetes medication that improves blood sugar management, lessens the need for frequent blood sugar testing, and reduces the risk of diabetic complications.

The winning solution will be a glucose-responsive insulin medication that senses glucose levels in the blood of the patient and automatically releases insulin into the bloodstream when necessary. A glucose-sensitive medication would require fewer insulin doses - a single dose a day, or even less - and would reduce the burden of frequent blood sugar testing and insulin injections for diabetics.

According to Aaron Kowalski, Ph.D., assistant Vice President of Treatment Therapies at the JDRF, "Insulin treatment requires diligent monitoring and burdensome administration, often several times a day, every day. This remains the only way to regulate blood sugar levels for the millions of individuals with insulin dependent diabetes worldwide. Although research has propelled the development of better and faster-acting insulins, the disease is still hard to control because of the way insulin is administered to patients."

"What we need is sophisticated insulin that will take the guesswork out of managing diabetes by developing a novel insulin that works in the same way insulin works in people without diabetes," continued Dr. Kowalski. "By fostering novel approaches from diverse problem solvers within and outside the diabetes field, we hope this Challenge with InnoCentive will help speed progress toward the development of glucose-responsive insulin - progress urgently needed by people with diabetes."

InnoCentive.com is headquartered in Waltham, Massachusetts. The company's founders were first inspired to create a service connecting businesses with qualified researchers in 1998, and launched InnoCentive in 2001.

$100,000 Reward Offered for Glucose-Sensitive Insulin

October 3rd, 2011

The Juvenile Diabetes Research Foundation (JDRF) announced a $100,000 Challenge for the development of a new glucose-sensitive insulin medication that will be used in the treatment of patients with diabetes. The JDRF is a global organization that promotes awareness of Type 1 diabetes in addition to sponsoring research into new treatments for diabetes and educating diabetics about how to properly manage the disease.

The JDRF is utilizing the InnoCentive.com platform to issue the challenge. InnoCentive is a service that connects businesses and organizations seeking solutions to problems in a wide variety of fields with scientists and research teams who develop solutions custom-tailored for the "challenge."

The best solution is awarded a cash prize, usually between $10,000 and $100,000. The JDRF's challenge will award $100,000 to any research group that develops a diabetes medication that improves blood sugar management, lessens the need for frequent blood sugar testing, and reduces the risk of diabetic complications.

The winning solution will be a glucose-responsive insulin medication that senses glucose levels in the blood of the patient and automatically releases insulin into the bloodstream when necessary. A glucose-sensitive medication would require fewer insulin doses - a single dose a day, or even less - and would reduce the burden of frequent blood sugar testing and insulin injections for diabetics.

According to Aaron Kowalski, Ph.D., assistant Vice President of Treatment Therapies at the JDRF, "Insulin treatment requires diligent monitoring and burdensome administration, often several times a day, every day. This remains the only way to regulate blood sugar levels for the millions of individuals with insulin dependent diabetes worldwide. Although research has propelled the development of better and faster-acting insulins, the disease is still hard to control because of the way insulin is administered to patients."

"What we need is sophisticated insulin that will take the guesswork out of managing diabetes by developing a novel insulin that works in the same way insulin works in people without diabetes," continued Dr. Kowalski. "By fostering novel approaches from diverse problem solvers within and outside the diabetes field, we hope this Challenge with InnoCentive will help speed progress toward the development of glucose-responsive insulin - progress urgently needed by people with diabetes."

InnoCentive.com is headquartered in Waltham, Massachusetts. The company's founders were first inspired to create a service connecting businesses with qualified researchers in 1998, and launched InnoCentive in 2001.

Enhanced Long Acting Insulin to Challenge Lantus

October 4th, 2011

(From Bloomberg Businessweek) Drugs to treat diabetes, mostly injectable insulin, have become a $34 billion annual business crowded with manufacturers of relatively similar products. Novo Nordisk wants to stand out from the pack. Following the example of consumer product companies, the Danish drugmaker is betting that it can add product enhancements to basic insulin and command higher prices in wealthier nations.

Explains Chief Executive Officer Lars Sørensen, pounding his desk for emphasis: "A country like the US ought to be able to offer people the most modern insulins and not giving them Third World insulins." Novo Nordisk, which gets half its $11.1 billion sales from insulin, this year is seeking U.S. and European regulatory approval for its newest treatment, degludec, in a bid to unseat Sanofi's Lantus as the world's best-selling diabetes medication.

Sørensen says degludec is "the fundamental part" of a strategy to boost Novo Nordisk's sales by shifting patients in developed nations from older, cheaper types of insulin that must be taken just before mealtimes to more expensive chemically altered versions that are absorbed more slowly and act longer.

Degludec's advantage is that it can be administered at any time, providing diabetes patients with greater flexibility, whereas Lantus insulin must be injected at the same time every day, although not necessarily at mealtimes. Trial results presented at a conference in Lisbon in September showed that degludec works as well as Lantus at controlling blood sugar.

To read the full article on Bloomberg Businessweek, >Click here.<

Enhanced Long Acting Insulin to Challenge Lantus

October 4th, 2011

(From Bloomberg Businessweek) Drugs to treat diabetes, mostly injectable insulin, have become a $34 billion annual business crowded with manufacturers of relatively similar products. Novo Nordisk wants to stand out from the pack. Following the example of consumer product companies, the Danish drugmaker is betting that it can add product enhancements to basic insulin and command higher prices in wealthier nations.

Explains Chief Executive Officer Lars Sørensen, pounding his desk for emphasis: "A country like the US ought to be able to offer people the most modern insulins and not giving them Third World insulins." Novo Nordisk, which gets half its $11.1 billion sales from insulin, this year is seeking U.S. and European regulatory approval for its newest treatment, degludec, in a bid to unseat Sanofi's Lantus as the world's best-selling diabetes medication.

Sørensen says degludec is "the fundamental part" of a strategy to boost Novo Nordisk's sales by shifting patients in developed nations from older, cheaper types of insulin that must be taken just before mealtimes to more expensive chemically altered versions that are absorbed more slowly and act longer.

Degludec's advantage is that it can be administered at any time, providing diabetes patients with greater flexibility, whereas Lantus insulin must be injected at the same time every day, although not necessarily at mealtimes. Trial results presented at a conference in Lisbon in September showed that degludec works as well as Lantus at controlling blood sugar.

To read the full article on Bloomberg Businessweek, >Click here.<

Novo Nordisk Files for Approval of Ultra Long Acting Insulin

October 5th, 2011

Insulin

Novo Nordisk today announced the submission to the U.S. Food and Drug Administration of two new drug applications for ultra-long-acting insulin degludec and the co-formulation, insulin degludec/insulin aspart. These insulin analogs have been developed for the treatment of people with type 1 and type 2 diabetes.

"We are very excited about being able to file for the approval of insulin degludec and insulin degludec/insulin aspart now also in the US," said Mads Krogsgaard Thomsen, Executive Vice President and Chief Science Officer at Novo Nordisk. "This is another significant milestone for Novo Nordisk and for the millions of people with diabetes who require insulin injections."

As with the European applications submitted on September 26, the U.S. filings are based on results from the BEGIN and BOOST clinical trial programs, which involved nearly 10,000 type 1 and type 2 diabetes patients. Data from the trials have shown insulin degludec to lower blood glucose levels, while demonstrating a low rate of hypoglycemia, especially at night.

The trials also showed that insulin degludec can be administered once daily at any time of the day with the possibility to change the insulin injection time from day to day according to the needs of the individual patient.

Novo Nordisk intends to make both diabetes medications available in a prefilled insulin delivery device. In the clinical trials, insulin degludec was studied in insulin pens that could either deliver up to 80 units or in a concentrated formulation up to 160 units in a single injection.

Insulin degludec is an ultra-long-acting basal insulin analog discovered and developed by Novo Nordisk. It forms multi-hexamers upon subcutaneous injection, resulting in a soluble depot from which there is a slow, continuous and extended release of insulin degludec. This may contribute to a lowering of blood glucose levels and low rates of hypoglycemia, especially at night.

Insulin degludec/insulin aspart contains the ultra-long-acting basal insulin degludec with a bolus boost of insulin aspart. Insulin degludec/insulin aspart is the first and only soluble insulin co-formulation of ultra-long-acting insulin degludec and insulin aspart providing both fasting and post-prandial control.

FDA Approves First Combo Drug for Diabetes And High Cholesterol

October 7th, 2011

The U.S. Food and Drug Administration today approved Juvisync (sitagliptin and simvastatin), a fixed-dose combination (FDC) prescription medication that contains two previously approved medicines in one tablet for use in adults who need both sitagliptin and simvastatin.

About 20 million people in the United States have type 2 diabetes, and they often have high cholesterol levels as well. These conditions can lead to increased risk of heart disease, stroke, kidney disease and blindness, among other chronic conditions, particularly if left untreated or poorly treated.

Sitagliptin is a dipeptidyl peptidase 4 (DPP-4) inhibitor that enhances the body's own ability to lower elevated blood sugar and is approved for use in combination with diet and exercise to improve glycemic control in adults with type 2 diabetes. Simvastatin is an HMG-CoA reductase inhibitor, or statin, approved for use with diet and exercise to reduce the amount of "bad cholesterol" (low-density lipoprotein cholesterol or LDL-C) in the blood.

"This is the first product to combine a type 2 diabetes drug with a cholesterol lowering drug in one tablet," said Mary H. Parks, M.D., director of the Division of Metabolism and Endocrinology Products in the FDA's Center for Drug Evaluation and Research. "However, to ensure safe and effective use of this product, tablets containing different doses of sitagliptin and simvastatin in fixed-dose combination have been developed to meet the different needs of individual patients. Dose selection should factor in what other drugs the patient is taking."

This FDC is based on substantial experience with both sitagliptin and simvastatin, and the ability of the single tablet to deliver similar amounts of the drugs to the bloodstream as when sitagliptin and simvastatin are taken separately. Juvisync is a convenience combination and should only be prescribed when it is appropriate for a patient to be placed on both of these drugs.

Juvisync was approved in dosage strengths for sitagliptin/simvastatin of 100 mg/10 mg, 100 mg/20 mg and 100 mg/40 mg. The company has committed to develop FDC tablets with the sitagliptin 50 mg dose, as Juvisync 50 mg/10 mg, 50 mg/20 mg and 50 mg/40 mg. Pending availability of the FDC tablets containing 50 mg of sitagliptin, patients who require this dose should continue to use the single ingredient sitagliptin tablet. There is no plan to develop FDCs with the sitagliptin 25 mg dose as use of this dose is quite low.

Simvastatin is currently marketed in dosage strengths of 5, 10, 20, 40, and 80 mg. Due to recent restrictions placed on the use of the 80 mg dose because of a higher risk of muscle toxicity, there will not be a FDC using this dose. There is also no plan to develop FDCs with the simvastatin 5 mg dose as use of this dose is quite low as well.

The FDA has recently become aware of the potential for statins to increase blood sugar levels in patients with type 2 diabetes. This risk appears very small and is outweighed by the benefits of statins for reducing heart disease in diabetes. However, the prescribing information for Juvisync will inform doctors of this possible side effect. The company will also be required to conduct a post-marketing clinical trial comparing the glucose lowering ability of sitagliptin alone compared to sitagliptin given with simvastatin.

Juvisync is approved with a Medication Guide that provides important information to patients. The most common side effects of Juvisync include upper respiratory infection; stuffy or runny nose and sore throat; headache; muscle and stomach pain; constipation; and nausea. Juvisync is manufactured by MSD International GmbH Clonmel, Co. in Tipperary, Ireland.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation's food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

Chewable Oral Diabetes Medication Enters Clinical Testing

October 12th, 2011

diabetes medication

Boston Therapeutics, Inc., a developer of diabetes therapeutics, announced the initiation of its first clinical trial of its investigational diabetes medication, PAZ320, when added to other oral diabetes medication or insulin injections in patients with type 2 diabetes. Boston Therapeutics is a leader in the specialized field of glyco-pathology, focused on understanding the importance of carbohydrates in biochemistry and the progression of diseases.

"We have already seen significant reduction of post-meal elevation of glucose in preclinical models with PAZ320," said David Platt, Ph.D., Chief Executive Officer of Boston Therapeutics. "We are excited about our collaboration with endocrinologist Dr. Sushela Chaidarun, PhD. and Dr. Laura E. Trask at Dartmouth Hitchcock Medical Center, and the possibility to help millions of people with high blood sugar and diabetes."

PAZ320 is a chewable complex carbohydrate-based compound designed to reduce the post-meal elevation of blood glucose. A proprietary polysaccharide designed to be taken before meals, it works in the gastrointestinal system, blocking the action of the carbohydrate-hydrolyzing enzymes that break carbohydrates down into glucose and release it into the bloodstream.

This clinical study will evaluate the safety and efficacy of PAZ320 when added to oral diabetes medications or insulin injections. The study population will consist of adults aged 18-75 years with type 2 diabetes, either on oral agents or insulin with a BMI of 25-35 kg/m2 and with A1c of less than 9.0%. The study will be conducted at Dartmouth-Hitchcock Medical Center in New Hampshire - one of America's oldest and most respected medical schools

"Given the many complications that stem from uncontrolled diabetes, it is important to implement measures that will better control glucose levels throughout the day," said Dr. Trask, Co-Principal Investigator of the study, along with Dr. Chaidarun. "By providing another way to appropriately control the postprandial glucose increase following a meal, diabetics may better control their glucose level."

Boston Therapeutics has also developed SUGARDOWN, a chewable complex carbohydrate-based dietary supplement that is taken before carbohydrate-containing meals to reduce the absorption of glucose from the intestinal tract and moderate post-meal blood glucose.

Chewable Oral Diabetes Medication Enters Clinical Testing

October 12th, 2011

diabetes medication

Boston Therapeutics, Inc., a developer of diabetes therapeutics, announced the initiation of its first clinical trial of its investigational diabetes medication, PAZ320, when added to other oral diabetes medication or insulin injections in patients with type 2 diabetes. Boston Therapeutics is a leader in the specialized field of glyco-pathology, focused on understanding the importance of carbohydrates in biochemistry and the progression of diseases.

"We have already seen significant reduction of post-meal elevation of glucose in preclinical models with PAZ320," said David Platt, Ph.D., Chief Executive Officer of Boston Therapeutics. "We are excited about our collaboration with endocrinologist Dr. Sushela Chaidarun, PhD. and Dr. Laura E. Trask at Dartmouth Hitchcock Medical Center, and the possibility to help millions of people with high blood sugar and diabetes."

PAZ320 is a chewable complex carbohydrate-based compound designed to reduce the post-meal elevation of blood glucose. A proprietary polysaccharide designed to be taken before meals, it works in the gastrointestinal system, blocking the action of the carbohydrate-hydrolyzing enzymes that break carbohydrates down into glucose and release it into the bloodstream.

This clinical study will evaluate the safety and efficacy of PAZ320 when added to oral diabetes medications or insulin injections. The study population will consist of adults aged 18-75 years with type 2 diabetes, either on oral agents or insulin with a BMI of 25-35 kg/m2 and with A1c of less than 9.0%. The study will be conducted at Dartmouth-Hitchcock Medical Center in New Hampshire - one of America's oldest and most respected medical schools

"Given the many complications that stem from uncontrolled diabetes, it is important to implement measures that will better control glucose levels throughout the day," said Dr. Trask, Co-Principal Investigator of the study, along with Dr. Chaidarun. "By providing another way to appropriately control the postprandial glucose increase following a meal, diabetics may better control their glucose level."

Boston Therapeutics has also developed SUGARDOWN, a chewable complex carbohydrate-based dietary supplement that is taken before carbohydrate-containing meals to reduce the absorption of glucose from the intestinal tract and moderate post-meal blood glucose.

Discovery of Pancreatic Insulin Switches Could Lead to New Diabetes Drugs

October 19th, 2011

Researchers at the Salk Institute have discovered how a hormone turns on a series of molecular switches inside the pancreas that increases the production of insulin. The finding, published in the Proceedings of the National Academy of Sciences, raises the possibility that new designer diabetes drugs might be able to turn on key molecules in this pathway to help the 80 million Americans who have type 2 diabetes or pre-diabetic insulin resistance.

The molecular switches command pancreatic beta islet cells, the cells responsible for insulin, to grow and multiply. Tweaking these cells might offer a solution to type 1 diabetes, the form of diabetes caused by destruction of islet cells, and to type II diabetes, the form caused by insulin resistance.

"By understanding how pancreatic cells can be encouraged to produce insulin in the most efficient way possible, we may be able to manipulate those cells to treat or even prevent diabetes," says the study's lead author, Marc Montminy, a professor in the Clayton Foundation Laboratories for Peptide Biology at Salk.

To read the full article on ScienceDaily, >Click Here.<

Diabetes Drug Byetta Approved as Add-On to Long Acting Insulin

October 20th, 2011

The US.Food and Drug Administration has approved a new use for Amylin Pharmaceuticals Inc. and Eli Lilly's BYETTA injection. BYETTA is now approved as an add-on therapy to insulin glargine, with or without metformin and/or a thiazolidinedione (TZD). It should be used in conjunction with diet and exercise for adults with type 2 diabetes who are not achieving adequate glycemic control on insulin glargine alone.

"This expanded use for BYETTA is important for clinical care, in that it provides a new option for the many patients with type 2 diabetes who are not achieving treatment goals," said John Buse, M.D., Ph.D., professor of medicine, director of the Diabetes Care Center and chief of the Division of Endocrinology at the University of North Carolina School of Medicine in Chapel Hill.

"BYETTA is well-suited for use with insulin glargine, offering a simple fixed-dose regimen that can help improve control of blood sugar overall and after meals. In a clinical trial, patients using BYETTA with insulin glargine achieved better glycemic control, without weight gain or an increased risk of hypoglycemia, compared to patients using insulin glargine alone."

BYETTA is not insulin and should not be taken instead of insulin. The diabetes medication should not be taken with short- and/or rapid-acting insulin. BYETTA should not be taken by type 1 diabetics, people with diabetic ketoacidosis or patients with a history of pancreatitis.

In the study supporting the expanded use, patients receiving insulin glargine, with or without metformin and/or a TZD, were randomized to receive BYETTA or placebo in addition to aggressive insulin titration. After 30 weeks of treatment, A1C decreased by 1.7 percentage points in patients adding BYETTA, compared with a decrease of 1.0 percentage point in patients treated with insulin glargine alone (p<0.001). A1C is a measure of average blood sugar over three months.

Nausea, which was the most common adverse event, occurred in 41 percent of patients treated with BYETTA compared with 8 percent of patients treated with insulin glargine alone.

BYETTA is an injectable diabetes medication that exhibits many of the same effects as the human incretin hormone GLP-1. GLP-1 improves blood sugar after food intake through multiple effects that work in concert on the stomach, liver, pancreas and brain.

BYETTA was the first glucagon-like peptide-1 (GLP-1) receptor agonist to be approved by the FDA for the treatment of type 2 diabetes, and is now the first and only GLP-1 receptor agonist approved for use in the U.S. as an adjunct to long-acting insulin glargine (Lantus), with or without certain oral agents.

The double-blind clinical trial evaluating BYETTA as an add-on therapy to insulin glargine was published in Annals of Internal Medicine.(i) In the study, 261 patients receiving insulin glargine with or without metformin and/or a TZD were randomized to receive BYETTA 10 micrograms or placebo. Patients who may have been at increased risk of hypoglycemia (A1C?8 percent) reduced their dose of insulin glargine by 20 percent.

Five weeks after randomization, all patients had insulin doses aggressively titrated to target fasting blood glucose. The primary endpoint was reduction in A1C; secondary endpoints included change in body weight along with other parameters of glucose control, cardiovascular health, hypoglycemia and patient-reported outcomes.

After 30 weeks of treatment, the proportion of participants achieving the target A1C?7 percent was 60 percent in the BYETTA group and 35 percent in the insulin glargine group (p<0.001). For the target A1C?6.5 percent, the proportions were 40 percent and 12 percent, respectively (p<0.001). Both groups showed lower fasting plasma glucose concentrations; however, after morning and evening meals, when BYETTA was administered, postprandial glucose control was significantly improved in patients treated with BYETTA, compared to placebo.

On average, weight decreased by 4 pounds in patients adding BYETTA, compared with an increase of 2 pounds in patients treated with insulin glargine alone (p<0.001). The greater improvement in A1C with BYETTA was not accompanied by an increase in hypoglycemia, compared to insulin glargine alone.

Diabetes Drug Byetta Approved as Add-On to Long Acting Insulin

October 20th, 2011

The US.Food and Drug Administration has approved a new use for Amylin Pharmaceuticals Inc. and Eli Lilly's BYETTA injection. BYETTA is now approved as an add-on therapy to insulin glargine, with or without metformin and/or a thiazolidinedione (TZD). It should be used in conjunction with diet and exercise for adults with type 2 diabetes who are not achieving adequate glycemic control on insulin glargine alone.

"This expanded use for BYETTA is important for clinical care, in that it provides a new option for the many patients with type 2 diabetes who are not achieving treatment goals," said John Buse, M.D., Ph.D., professor of medicine, director of the Diabetes Care Center and chief of the Division of Endocrinology at the University of North Carolina School of Medicine in Chapel Hill.

"BYETTA is well-suited for use with insulin glargine, offering a simple fixed-dose regimen that can help improve control of blood sugar overall and after meals. In a clinical trial, patients using BYETTA with insulin glargine achieved better glycemic control, without weight gain or an increased risk of hypoglycemia, compared to patients using insulin glargine alone."

BYETTA is not insulin and should not be taken instead of insulin. The diabetes medication should not be taken with short- and/or rapid-acting insulin. BYETTA should not be taken by type 1 diabetics, people with diabetic ketoacidosis or patients with a history of pancreatitis.

In the study supporting the expanded use, patients receiving insulin glargine, with or without metformin and/or a TZD, were randomized to receive BYETTA or placebo in addition to aggressive insulin titration. After 30 weeks of treatment, A1C decreased by 1.7 percentage points in patients adding BYETTA, compared with a decrease of 1.0 percentage point in patients treated with insulin glargine alone (p<0.001). A1C is a measure of average blood sugar over three months.

Nausea, which was the most common adverse event, occurred in 41 percent of patients treated with BYETTA compared with 8 percent of patients treated with insulin glargine alone.

BYETTA is an injectable diabetes medication that exhibits many of the same effects as the human incretin hormone GLP-1. GLP-1 improves blood sugar after food intake through multiple effects that work in concert on the stomach, liver, pancreas and brain.

BYETTA was the first glucagon-like peptide-1 (GLP-1) receptor agonist to be approved by the FDA for the treatment of type 2 diabetes, and is now the first and only GLP-1 receptor agonist approved for use in the U.S. as an adjunct to long-acting insulin glargine (Lantus), with or without certain oral agents.

The double-blind clinical trial evaluating BYETTA as an add-on therapy to insulin glargine was published in Annals of Internal Medicine.(i) In the study, 261 patients receiving insulin glargine with or without metformin and/or a TZD were randomized to receive BYETTA 10 micrograms or placebo. Patients who may have been at increased risk of hypoglycemia (A1C?8 percent) reduced their dose of insulin glargine by 20 percent.

Five weeks after randomization, all patients had insulin doses aggressively titrated to target fasting blood glucose. The primary endpoint was reduction in A1C; secondary endpoints included change in body weight along with other parameters of glucose control, cardiovascular health, hypoglycemia and patient-reported outcomes.

After 30 weeks of treatment, the proportion of participants achieving the target A1C?7 percent was 60 percent in the BYETTA group and 35 percent in the insulin glargine group (p<0.001). For the target A1C?6.5 percent, the proportions were 40 percent and 12 percent, respectively (p<0.001). Both groups showed lower fasting plasma glucose concentrations; however, after morning and evening meals, when BYETTA was administered, postprandial glucose control was significantly improved in patients treated with BYETTA, compared to placebo.

On average, weight decreased by 4 pounds in patients adding BYETTA, compared with an increase of 2 pounds in patients treated with insulin glargine alone (p<0.001). The greater improvement in A1C with BYETTA was not accompanied by an increase in hypoglycemia, compared to insulin glargine alone.

New Ultra Fast Acting Insulin Does Well in Clinical Trials

October 26th, 2011

insulin syringe

Halozyme Therapeutics, Inc., a San Diego-based pharmaceutical company, recently announced that its new "ultrafast" insulin, PH20, worked just as well as Humalog in two Phase 2 clinical trials. PH20 is an insulin analog, a type of insulin that is not produced by the human body, but functions the same way as the insulin that the body produces.

The injectable insulin analog was as effective as another insulin analog - Eli Lilly's Humalog - at controlling blood sugar levels. In addition, PH20 was more effective than Humalog at controlling post-meal blood glucose levels. Rates of hypoglycemia were similar in PH20 insulin users, and the hypoglycemic episodes that did occur were generally mild and no more serious than those experienced by patients using Humalog.

Researchers studied the effects of the investigational diabetes medication on controlling blood sugar levels in two clinical trials conducted on about 220 participants. One study involved patients with Type 1 diabetes, and the other involved patients with Type 2 diabetes. There was a 50 percent increase in the number of patients who regularly met guidelines for healthy post-meal blood glucose levels among those using PH20 insulin injections.

PH20 insulin is delivered using rHuPH20, or recombinant human hyaluronidase enzyme. Much of Halozyme's work is based on the subcutaneous delivery of medications with rHuPH20, which the company says decreases costs, increases efficiency, and makes medication more convenient for patients.

Halozyme said that it will be pursuing worldwide distribution of PH20, suggesting that it may be partnering with a larger pharmaceutical manufacturer.

New Ultra Fast Acting Insulin Does Well in Clinical Trials

October 26th, 2011

insulin syringe

Halozyme Therapeutics, Inc., a San Diego-based pharmaceutical company, recently announced that its new "ultrafast" insulin, PH20, worked just as well as Humalog in two Phase 2 clinical trials. PH20 is an insulin analog, a type of insulin that is not produced by the human body, but functions the same way as the insulin that the body produces.

The injectable insulin analog was as effective as another insulin analog - Eli Lilly's Humalog - at controlling blood sugar levels. In addition, PH20 was more effective than Humalog at controlling post-meal blood glucose levels. Rates of hypoglycemia were similar in PH20 insulin users, and the hypoglycemic episodes that did occur were generally mild and no more serious than those experienced by patients using Humalog.

Researchers studied the effects of the investigational diabetes medication on controlling blood sugar levels in two clinical trials conducted on about 220 participants. One study involved patients with Type 1 diabetes, and the other involved patients with Type 2 diabetes. There was a 50 percent increase in the number of patients who regularly met guidelines for healthy post-meal blood glucose levels among those using PH20 insulin injections.

PH20 insulin is delivered using rHuPH20, or recombinant human hyaluronidase enzyme. Much of Halozyme's work is based on the subcutaneous delivery of medications with rHuPH20, which the company says decreases costs, increases efficiency, and makes medication more convenient for patients.

Halozyme said that it will be pursuing worldwide distribution of PH20, suggesting that it may be partnering with a larger pharmaceutical manufacturer.

Eating Too Quickly Doubles the Risk of Insulin Resistance

November 8th, 2011

Yet another reason to listen to your mother and slow down and chew your food properly - eating too quickly has been associated with a doubled risk of developing impaired glucose tolerance, or pre-diabetes. As the name suggests, pre-diabetes is the forerunner to developing type 2 diabetes. Most diabetics have type 2 diabetes - a form of diabetes where your body no longer responds properly to insulin (called insulin resistance). Type 2 diabetes used to be described as non insulin dependent diabetes.

Insulin is the hormone that moves sugar (glucose) from the blood to the body's cells to provide them with energy. If your cells do not use insulin properly, the pancreas produces more insulin that normal to cope with the body's demands. Eventually, the pancreas cannot keep up, and excess glucose builds up in the bloodstream. Type 2 diabetes is characterized by high levels of glucose in the blood.

A recent Japanese study followed over 170 healthy individuals for three years, monitoring their eating habits. Snacking, eating late at night, skipping meals and eating out were not associated with developing pre-diabetes. The one and only eating habit associated with the development of insulin resistance was eating too quickly.

The researchers aren't sure why eating faster makes an individual more likely to develop pre-diabetes and type 2 diabetes, but suspect that eating rapidly results in higher post-meal blood glucose levels. Some doctors also point out that eating too quickly results in an overall increase in the amount of calories taken in. Since it takes about 20 minutes for the brain to receive the signal that the stomach is full, those who eat quickly continue eating without realizing that their stomach is filled.

Previous research has also shown that eating quickly results in increased weight gain. Insulin resistance generally increases with increased body fat, and there is a pronounced connection between obesity and diabetes. The two are so closely connected that it gave rise to the term "diabesity". Diabesity is currently epidemic across the developed world.

Insulin resistance has no symptoms. Pre-diabetes is sometimes called impaired glucose tolerance, and can be diagnosed with a fasting glucose test or a glucose tolerance test. The American Diabetes Association recommends that adults who are overweight and have one or more additional risk factors for diabetes should consider being tested. Additional risk factors include:

  • Having a parent or sibling with diabetes
  • Being physically inactive.
  • Being African American, Alaska native, American Indian, Asian American, Hispanic or Latino, or a Pacific Islander
  • Giving birth to a baby weighing more than 9 pounds or being diagnosed with gestational diabetes
  • Having high blood pressure or being treated for high blood pressure
  • Low HDL ("good") cholesterol levels or high triglyceride levels
  • Having polycystic ovary syndrome
  • Having a history of cardiovascular disease

People with pre-diabetes can avoid becoming diabetic and the need to take diabetes medication by losing weight, being physically active, eating a healthy diet, and, as we now know, not eating too quickly.

New Diabetes Drug Being Tested

February 27th, 2012

A new drug is currently being tested as a novel new way to control insulin production. The drug, which is currently in phase 2 clinical trials, is currently called TAK-875. The research, which was completed on 426 patients with type 2 diabetes, is being run by scientists out of the University of Michigan Health System. They published their results in this week's The Lancet.

TAK-875 is a free fatty acid receptor activator. The reason this drug is different from others, such as Amaryl or Duetact, is that it works in a glucose-dependant manner. That means that it only begins functioning when there is a significant amount of extra glucose in the system, such as after a meal. TAK-785 will then help the body with insulin production. Previous medications that are reputed to help produce insulin in this way are working in the body all the time, which significantly raises the risk of hypoglycemia, a dangerous lowering of blood glucose levels.

TAK-785, when used over 12 weeks, resulted in significantly lower blood glucose levels than a placebo. It was also generally well tolerated, with very few negative side effects being reported. To conclude, the researchers stated "TAK-875 significantly improved glycaemic control in patients with type 2 diabetes with minimum risk of hypoglycemia. The results show that activation of FFAR1 is a viable therapeutic target for treatment of type 2 diabetes."

In order to be brought to market, TAK-785 will have to complete more rigorous FDA testing as it goes through phase 3 clinical trials, which involves a significantly more populated randomized trial.

Diabetes Drug Linked to Lower Breast Cancer Risk

June 28th, 2012

Metformin (brand names: Fortamet, Glucophage, Glucophage XR, Glumetza), a widely prescribed drug for diabetes 2, may reduce the risk of breast cancer in some women, recently study said.

According to the research published in the Journal of Clinical Oncology, Metformin use in postmenopausal women with diabetes was associated with lower incidence of invasive breast cancer.

During the 12 years of follow-up, 3,273 cases of breast cancer were diagnosed. The researchers compared breast cancer risk in diabetic women on different diabetes medicines to breast cancer risk in non-diabetic women.

? Diabetic women treated with other medicines for diabetes had a slightly higher than average risk of breast cancer than women without diabetes

? Diabetic women treated with metformin had a 25% lower likelihood of developing breast cancer compared to women without diabetes

Other studies have suggested that diabetes drug Metformin may help lower the risk of prostate, pancreatic, liver and oral cancer, and a reducing incidence of a variety of cancers.

Metformin Side Effects

Metformin may have a dual effect on diabetes and cancer cells via an insulin mediated mechanism. It is well tolerated for most people but also has side effects. Here are a few to be aware of:

? Diarrhea

? Headache

? Indigestion

? Loss of appetite

? Weight loss or gain

? Nausea

? Stomach upset

Notify your doctor immediately if you experience any severe symptoms!

Visit the BreastCancerCare.us Breast Cancer Prevention section and generic Femara 2.5 mg drug to understand breast cancer prevention and numerous ways to reduce your breast cancer risk.

Is Alzheimer A Type 3 Diabetes?

June 20th, 2013

One of the most hopeless brain conditions that attacks man is Alzheimer. It's a form of dementia which worsens as it progresses. At present, there's no known cure for Alzheimer disease. Pharmaceutical companies around the globe are hard at work in discovering new drugs for its cure, but till now there's no concrete proof that there are drugs that could cure this disease. To better understand how Alzheimer works, here are factual revelations about this haunting disease.

Typecasting Alzheimer as type 3 diabetes

There have been ongoing debates and studies all aimed at classifying Alzheimer as a type 3 diabetes. Many medical societies all over the globe propose that Alzheimer disease should be given the title of type 3 diabetes. The reason for this proposal is based on recent studies regarding the growth of another form of diabetes characterized by factors like resistance to insulin and insulin growth. Comparative studies show that there is a substantial similarity between the disease characteristics of the proposed type 3 diabetes and Alzheimer; this is the reason why there is a prevailing proposal to classify Alzheimer as type 3 diabetes.

Reasons for proposing type 3 diabetes classification for Alzheimer

An in-depth discussion as to the official types of diabetes will give the reader an insight as to why there are many medical institutions pushing for the classification of Alzheimer as type 3 diabetes. At present, there is actually no type 3 diabetes term and classification officially and medically recognized. What the medical society has are proposals for the official classification of Alzheimer as the type 3 diabetes.

Today, there are only three main types of diabetes officially recognized by medical societies around the world. First is the Type 1 DM attributed to the body's failure to produce insulin requiring persons afflicted with this disease to inject insulin. The second type is Type 2 DM which is associated with a condition arising from insulin resistance or even absolute insulin deficiency. The third type is the gestational diabetes suffered by pregnant women without previous diagnosis for diabetes. Now, various medical groups are proposing for the official recognition of a new type of diabetes, the Alzheimer disease as Type 3 DM.

Alzheimer's disease is attributed to the protein misfolding occurring in the brain (proteopathy) caused by abnormal amassing of folded amyloid beta and amyloid tau proteins in the brain. It is essentially characterized by insulin resistance which is one of the signs of persons afflicted with diabetes. Because of this disease property, people suffering from Alzheimer's disease are prescribed to take diabetes drugs to prevent worsening or progress of dementia. In addition to this, most people suffering the worst case of diabetes are eventually afflicted with Alzheimer. The people with diabetes have the greater risk of being attacked by Alzheimer's disease.

The similarities of Alzheimer and diabetes' disease pathology and the fact that Alzheimer patients are given anti-diabetic drugs, are perhaps the underlying reason why there is insistence to classify Alzheimer as type 3 diabetes.