Diabetes a Common Cause of Gastroparesis

March 1st, 2011

Diabetes is the most common cause of gastroparesis, or delayed gastric emptying. That's because high blood sugar causes chemical changes in nerves, including the vagus nerve, which controls the movement of food through the digestive tract. High blood sugar also damages the blood vessels that carry oxygen and nutrients to the nerves, further impairing their functioning.

When the vagus nerve is damaged, then the passage of food through from the stomach through the digestive track slows, or even stops. People commonly suffer from a wide range of gastroparesis symptoms, making the condition difficult to diagnose. Frequency and severity of symptoms also vary widely from individual to individual. Common symptoms are:

? heartburn

? nausea

? upper abdominal pain

? loss of appetite

? bloating

? stomach spasms

? weight loss

? vomiting undigested food

? feeling full after eating small amounts

? gastroesophageal reflux

? high or low blood glucose levels

Food that stays undigested in the stomach can harden into solid masses called bezoars. Bezoars not only cause nausea and vomiting; they can be dangerous if they block the passage of food into the small intestine. Undigested food can also ferment, leading to bacteria overgrowth.

Gastroparesis can complicate diabetes control in both type 1 and type 2 diabetes by delaying food in the stomach from entering the intestine. This irregular passage of food through the digestive system results in erratic and unpredictable blood glucose levels. When the food is finally absorbed, blood sugar levels may rise unexpectedly.

As a result, diabetics with gastroparesis must check their blood glucose frequently. They may need to adjust their insulin therapy, change the type of insulin they take, or take their insulin after meals instead of before to maintain proper insulin levels.

Gastroparesis is usually a chronic condition. While it can't be cured, it can be treated. People with gastroparesis are advised to eat six small meals a day instead of three large meals, and to avoid hard to digest high fiber and high fat foods and carbonated drinks. Severe cases may require a liquid diet, or even a feeding tube.

Patients are often given a dopamine antagonist such as prescription domperidone for gastroparesis. Domperidone (generic Motilium) treats both the condition and gastroparesis symptoms such as nausea, vomiting, bloating and a "full" feeling. Some sufferers will require antibiotics. Other potential treatments still in the early stages include gastric electrical stimulation, the use of botulinum toxin, and experimental medications.

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.

American Idol Stars Warn Against Neglecting Diabetes

June 21st, 2011

American Idol runner-up singer/songwriter Crystal Bowersox has revealed that she was hospitalized for two days with diabetic ketoacidosis (DKA) during last year's finals. Bowersox now admits to neglecting her disease, sometimes going an entire day without testing her blood sugar.

With her diabetes now under control, she currently checks her blood glucose levels at least 10 times a day. "When you know what your reading is, you know what to do," says Bowersox, who now strives to be a good role model for fellow insulin dependent diabetics, "The only way you can live your life is by monitoring your diabetes."

Bowersox, a type 1 diabetic since age 6, is now an advocate for the Juvenile Diabetes Research Foundation and the Diabetes Research Institute. Fellow Idol contestant Kevin Covais, also a type 1 diabetic, has joined Bowersox in her advocacy for both diabetes organizations.

DKA usually results from not monitoring and controlling blood sugar and insulin levels, especially around mealtimes. Insulin dependent diabetics also need to take into consideration their stress and activity levels when calculating the correct insulin dosage.

To read more about Bowersox's and Covais's experiences and their advice for fellow diabetics, visit Yahoo News

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.

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.

Scientists Cure Diabetes in Rat's Using Animals Own Stem Cells

October 17th, 2011

diabetes cured in rats

From Diabeteshealth.com

Using stem cells that they extracted from the brains of diabetic lab rats, and turning them into insulin-producing pancreatic cells, Japanese scientists may be on the road to a virtual cure for diabetes that comes from people's own brains. Led by Tomoko Kuwabara of the National Institute of Advanced Industrial Science and Technology in Tsukuba Science City, Japan, a team of scientists extracted neural tissue from the rats' olfactory bulbs or their hippocampuses. The former is the part of the brain is involved with smell while the former is involved with memory.

Because of both sites' location in the brain, extraction was easily done through the nose. The rats involved had either type 1 or type 2 diabetes. The scientists then extracted stem cells from the tissue and applied a human protein to them, Wnt3a, which "switches on" insulin production.

After two weeks, the cells had multiplied to the point that the researchers could lay collagen sheets impregnated with them gently on top of the diabetic rats' pancreases. Seven days later, the concentration of insulin in the blood of all the rats, whether type 1 or type 2, matched that of non-diabetic rats. Blood glucose levels were normal. To read the entire story on diabeteshealth.com, >Click Here.<

Updated Glycemic Index for Diabetic Diet

October 24th, 2011

insulin spike chartGlycemicEdge.com, a leading nutrition and health wellness community site, has updated and expanded its popular glycemic index food list and now features food scores from 12 categories of foods and nearly 200 individual foods.

The glycemic index is a scoring system which rates foods on a 0-100 basis according to their impact on digestion and insulin levels, based on the type of carbohydrates used. The glycemic index diet plan has become increasingly popular for wellness, weight loss, and has been particularly well received by pre-diabetics, diabetics, and those following a heart healthy cardiovascular health plan.

According to Wayne Mitchell of GlycemicEdge.com, the best part about the glycemic index diet is it's realistic approach to choosing foods while not banishing carbs. "Low carb and no carb diets are really challenging to follow. They also don't have the health benefits that "low GI" or good carb foods provide. With low glycemic foods, you get the benefit of feeling "fuller" with foods that put much less strain on your digestive system and pancreas, controlling the release of insulin."

Another popular benefit for low glycemic foods is weight loss, as your metabolism adjusts and switches from primarily burning carbs as a fuel source to burning fat. Whole grains and complex carbohydrates are emphasized while simple carbohydrates and foods which result in a sudden, rapid insulin spike during digestion rank high on the GI scale and should be avoided.

"Our users love the ability to compare foods, find some surprising foods that are good low GI choices, and print and take lists with them when they do their shopping and planning for their families. About 70% of our users are moms planning for their families, and the charts and food lists are a great resource to make this easier for them."

Users can print the lists for free and are invited to share questions and submit food scores of their own to help grow community awareness. Also featured are south beach diet food list and printable shopping guides.