Blood Glucose and the Glycemic Index

December 16th, 2010

Proper diet is crucial for diabetics, as food can have both short and long term effects on blood glucose control. For reasons researchers have yet to uncover, blood sugar levels soar after eating, and many diabetics need to time their insulin injections around meal times to aid in controlling blood sugar. One thing researchers do know - the higher the glycemic index of a food, the more impact it has on blood glucose.

The glycemic index (GI) is a measure of the influence that a particular food has on blood sugar levels. It takes into account the fact that different types of carbohydrates perform differently in our bodies. The GI ranks carbohydrates on a scale of 1 to 100 based on how quickly they raise blood sugar.

Low GI foods are in the range of 0 to 55, medium are ranked 56 to 69, and high are scored 70 and above. Foods with a high GI are rapidly digested and absorbed, resulting in a rapid spike in blood sugar and insulin demand. Foods with a low GI are digested and absorbed more slowly, resulting in a more gradual increase in blood sugar and insulin. Because they're digested more gradually, low GI foods reduce hunger and keep you feeling full longer.

In general, the more fiber a food has, the lower its GI. Whole grains like oats, barley and bran, nuts, eggs, milk, meat, legumes, fructose, most fruits and vegetables, and low carbohydrate foods are low on the GI. Whole wheat products, basmati rice sweet potatoes and sucrose rank medium on the GI. Most high carbohydrate foods like potatoes, watermelon, white bread, white rice, candy, pastries, most baked goods, low fiber breakfast cereals and glucose are all high on the glycemic index. The resourceful Australians have developed a low GI potato called "Carisma", but sadly, it's not yet available in North America.

A low GI diet reduces the body's insulin levels and insulin resistance, and improves overall blood glucose control in both type 1 and type 1 diabetics. As a rule, diabetics are advised to eat foods that are low to medium on the GI, but a diabetic who is experiencing a period of low blood sugar may want to eat a high GI food to quickly raise their blood sugar. You can use a glycemic index chart to search for low glycemic food choices, and to check the glycemic index of your favorite foods. Bear in mind that other factors will affect the impact a food has on blood sugar, such as fat and protein content, ripeness, cooking method, the combination of foods eaten, the time of day, and your insulin and activity levels.

Recent studies indicate that the risk of diabetes and other diseases is closely related to the overall GI of our diets. A US study of national data spanning almost 90 years found that the rising consumption of high GI 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. The World Health Organization recommends a low GI diet to prevent and combat the "diseases of affluence" that are rampant in North America - diabetes, obesity and heart disease.

Artificial Sweeteners Assist in Diabetes Control

January 24th, 2011

sugar cubes

Historically, diabetics have been warned to avoid eating sugar, an almost impossible challenge for those with a sweet tooth. Nowadays, the emphasis has shifted to eating complex carbohydrates with a low glycemic index, and limiting total carbohydrate intake - known as an insulin resistance diet. Diabetics can indulge in the odd sugary treat, but do need to limit their sugar intake more than non-diabetics (especially those who are struggling with diabetes control). Artificial sweeteners provide a convenient way of doing that.

Natural sugars like fructose, honey, corn syrup, molasses, brown sugar, and cane sugar, are simple carbohydrates that quickly raise your blood sugar levels. Reduced calorie sweeteners like sorbital, lactitol, maltitol, mannitol and xylitol are sugar alcohols often used in sugar-free candy, gum and baked goods. They are also a type of carbohydrate and may raise your blood sugar, although not as much as natural sugars. Low calorie sweeteners are artificial sweeteners created in a lab. They don't contain calories, are low or no carb, and do not affect blood glucose levels.

Artificial sweeteners have gotten a bad rap for being "non-natural" and unpleasant tasting over the years, but today's new and improved sweeteners can be a godsend for diabetics who crave sweets. The FDA and the American Diabetes Association both recommend the following low calorie artificial sweeteners as safe for use by non-insulin dependent and insulin dependent diabetics:

1) Aspartame -sold as NutraSweet and Equal. Aspartame may lose some sweetness at high temperatures. It's 160 to 220 times sweeter than sugar. People with a genetic condition called phenylketonuria can't metabolize aspartame.

2) Acesulfame potassium (acesulfame-K) - also known as Sweet One and Sunett. It's 200 times sweeter than sugar. Ace-K is often mixed with other sweeteners to mask its slightly bitter taste, especially in soft drinks. Can be used for cooking and baking.

3) Saccharin - an old stand by, marketed as Sweet N Low and Sugar Twin. Has a slightly bitter aftertaste. Can be used in both hot and cold foods. It's 200 to 300 times sweeter than sugar. Not recommended for pregnant or breastfeeding mothers.

4) Sucralose - this increasingly popular sweetener is a relative newcomer to the market, sold as Splenda. It's 600 times sweeter than sugar. It can be used in cooking and baking, and is being added to a growing number of processed foods.

5) Neotame - a high intensity sweetener made by Nutrasweet. Chemically similar to aspartame, it's an incredible 7,000 to 13,000 times sweeter than sugar. Unlike aspartame, it can be used for baking. Also unlike aspartame, it's safe for use by people with phenylketonuria. Neotame is popular with food manufacturers because the low quantities needed to add sweetness cut production costs.

In addition, Stevia, an all natural sweetener derived from a South American shrub, is being extoled as the sweetener of choice for diabetics. Stevia has no calories, and a zero glycemic index. It's up to 300 times sweeter than sugar, so a little bit goes a long way. Renowned alternative health guru Dr. Andrew Weil writes, "The only non-caloric sweetener I recommend is stevia. It's safe for diabetics and widely used as a sweetener around the world."

Of particular interest to diabetics, stevia has long been considered a therapeutic herb for hyperglycemia, stimulating the release of insulin and enhancing glucose tolerance. It is used as an inexpensive diabetic medication in South America. Interestingly, although it's been shown to lower blood sugar in diabetics, particularly type 2 diabetics, it does not lower blood sugar in people without the condition. Because of it's affect on blood sugar, it is recommended that diabetics test their blood glucose regularly when they first introduce stevia to their diet. They may need to adjust their diabetes medication - some stevia users insist the herb reduced or eliminated their need for insulin therapy. As an added bonus for diabetics with hypertension, stevia is also known to lower high blood pressure.

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."

Ten Superfoods for an Insulin Resistance Diet

January 24th, 2011

salmon steak

The key to diabetes treatment is controlling blood sugar (glucose) levels, and diet plays a vital role in that complicated process. The main dietary goals in diabetes are balancing blood sugar and cholesterol levels, and achieving and/or maintaining a healthy weight.

Traditionally, theemphasis in a diabetic diet was on avoiding sugar. Modern guidelines place more emphasis on total carbohydrate intake and the type of carbohydrates eaten - sometimes referred to as an insulin resistance diet. Often, type 2 diabetics can control their disease with diet and exercise alone, avoiding the need for diabetes medications.

The American Diabetes Association has released a list of the top ten "diabetes superfoods". All of the foods on the list have a low glycemic index (a scale of how quickly a carbohydrate raises blood sugar), but rank high in essential nutrients like vitamins, calcium, magnesium, potassium and fiber. The ten diabetic superfoods on the American Diabetes Association's list are:

1) Beans - Kidney, pinto, navy, black and other beans are nutritional powerhouses that are low fat and very high in fiber. One-half cup provides as much protein as an ounce of meat. Rinse canned beans before you serve them to reduce the amount of sodium.

2) Dark green leafy vegetables - As a general rule, the darker in color a vegetable is, the more nutritional value it has. Spinach, chard, kale, collards and other dark leafy greens are low in both calories and carbohydrates.

3) Citrus fruit - Oranges, grapefruit, lemons and limes all offer a dose of vitamin C and a helping of soluble fiber. But remember that grapefruit juice can interferes with the action of some medications, including pain relievers and prescription drugs used to treat high blood pressure, cholesterol and abnormal heart rhythms.

4) Sweet potatoes - Sweet potatoes are lower on the glycemic index than regular potatoes, and full of vitamin A and fiber.

5) Berries - Berries are low calorie, low carb, and high in antioxidants and fiber. And several studies have shown that blueberries lessen insulin resistance.

6) Tomatoes - Tomatoes are a versatile superfood containing vitamin C, vitamin E, iron and other nutrients. Cooked tomatoes are even better for you than raw, as cooking makes tomatoes' healthy antioxidant compounds like lycopenes easier for your body to absorb.

7) Omega-3 rich fish - Omega-3's are essential fatty acids found in fish (especially salmon), some nuts, and some plants. Omega-3 oils are credited with reducing inflammation, lowering bad cholesterol and raising good cholesterol, reducing blood clots and playing a crucial role in brain function. Be warned: some type 2 diabetics may have a slight rise in fasting blood sugar when taking fish oils.

8) Whole grains - Avoid processed grains with the fiber-rich bran and germ removed from them. Barley, bran and oats are good grain choices that rate lower on the glycemic index. The fermentation process used for sourdough bread lowers its glycemic index, making it another good choice, especially sourdough rye bread.

9) Nuts - Filling nuts provide protein, magnesium and fiber. Some nuts and seeds, such as walnuts and flax seed, are also a source of omega-3 fatty acids. But they're high in fat and calories, so eat them in moderation.

10) Low fat or fat-free milk and yogurt - Dairy products provide much-needed calcium, and many are fortified with vitamin D.

The bottom line is that a healthy diabetes diet is not much different from that recommended for the general public - high fiber, high protein, and low in fat. Diabetics need to limit their sugar and simple carbohydrate intake more than non-diabetics, and should avoid drinking alcohol. Weight control is especially important for diabetics, as insulin resistance is often associated with excess fatty tissue. Diabetes occurs more frequently in people who eat a lot of fat, and it's recommended that diabetics eat both less overall and less saturated fat, restricting fat to under 30% of their daily calories.

If you are insulin dependent and making changes to your diet or eating patterns, remember that it may have an effect on your blood sugar and insulin levels, and you may need to adjust your insulin therapy accordingly.

Asthma Inhalers Increase Risk of Diabetes and Insulin Resistance

January 25th, 2011

inhaler

Use of asthma inhalers containing corticosteroids has been linked to a 34% increase of developing type 2 diabetes, and to accelerated diabetes progression in those already diagnosed with the condition. Higher dose inhalers were linked to even higher risks - a 64% increase in type 2 diabetes diagnoses, and a 34% increase in existing diabetes progressing to the point of requiring insulin therapy.

Theses figures came out of a large Canadian study of the records of more than 380,000 asthma and chronic obstructive pulmonary disease (COPD) patients treated with inhaled corticosteroids. "Patients instituting therapy with high doses of inhaled corticosteroids should be assessed for possible hyperglycemia, and treatment with high doses of inhaled corticosteroids limited to situations where the benefit is clear," warn the researchers, from the Jewish General Hospital and McGill University in Montreal.

More than 30,000 of the asthma/COPD patients included in the study were diagnosed with diabetes over a span of five and a half years -over 14 patients per 1000 inhalers. Nearly 2100 patients who had been previously diagnosed with diabetes experienced a deterioration in their condition, going from controlling blood sugar with oral diabetes medication torelying on insulin injections.

Dr. Stuart Weiss, an endocrinologist at the New York Medical Center makes the point that the issue may be a common underlying cause of both diabetes and asthma/COPD, rather than corticosteroids. "We know that steroids increase insulin resistance, and that people treated with steroids require more aggressive diabetes management," he says, "What may be at the root of this problem is the fact that those who are most at risk for diabetes are the same people who have the worst asthma and COPD that requires steroid treatment in the first place." Weiss believes that "the overconsumption of processed foods and the lack of consumption of green vegetables" lead to pre-inflammatory conditions that raise the risk of both diabetes and asthma/COPD. He warns that if Americans don't improve their diets "the incidence of both these diseases will continue to go up at a dramatic rate."

DR. Rohit Katial, a professor of medicine at National Jewish Health, is concerned that the study contained no information about obesity, a significant risk factor for both diabetes and respiratory problems. "For the people on higher doses of medications, was their BMI (body mass index) higher? We don't know."

What the medical experts do agree upon is the need for doctors to prescribe the lowest possible dose of corticosteroids to asthma and COPD patients, and to educate patients about the risks of insulin resistance, becoming insulin dependent, and the possible need for more intensive insulin therapy.

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.

Researchers Able to Decrease Insulin Resistance in Mice

February 25th, 2011

blue swirl
Science Daily reported today that a research team from La Jolla Institute has shed new light on the problem of insulin resistance, a discovery that may lead to new therapies to reduce the severity of type 2 diabetes.

Recently, type 2 diabetes has been linked to chronic low grade inflammation. The La Jolla team identified an immune system signaling molecule called adenosine that contributes to insulin resistance by triggering inflammation, and was able to decrease insulin resistance in mice by blocking the actions of the molecule.

Click here >Science Daily< to read the full article.

International Diabetes Association Supports Bariatric Surgery as Treatment Option in Diabetes Control

March 31st, 2011

surgery

The International Diabetes Association (IDA) has taken the position that bariatric (weight loss) surgery should be considered early on as a cost-effective treatment option to avoid serious complications in type 2 diabetics who are moderately or severely obese.

The IDA 2011 position statement was released around the same time that the FDA expanded the approval of the Lap-Band Adjustable Gastric Banding System procedure for use in a wider range of obese patients, including diabetics.

The Lap-Band procedure was first approved by the FDA in 2001 for patients with a body mass index (BMI) of 40 or higher, or for those with a BMI of 35 and at least one other serious obesity-related condition, such as diabetes mellitus or high blood pressure.

Lap-Band gastric banding is now approved for those with a BMI of 30 to 35. But bariatric surgery of any kind should only be used when conventional methods weight loss methods such as diet and exercise have failed. Any such surgery must be accompanied by long-term lifestyle changes such as diet and exercise to be successful.

Both gastric banding and sleeve gastrectomy are minimally invasive laparoscopic surgeries, performed through small incisions in the abdomen. In gastric banding surgery, an inflatable silicone device is place on the top portion of the stomach to create a small pouch.

This pouch will only hold about cup of food, as opposed to the 6 cups a normal stomach will hold. The smaller stomach not only helps the patient eat less by making them feel full sooner, it also slows the passage of food into the rest of the stomach and the digestive tract. As the patient loses (or gains) weight, the band is adjusted to maintain comfort and effectiveness.

In a sleeve gastrectomy, the stomach is surgically reduced to about one-quarter of its normal size, leaving it the shape of a narrow "sleeve" or tube. The portion of the stomach that is removed secretes an appetite hormone called Ghrelin. Once removed, the patient's appetite is said to decrease. The procedure is irreversible.

A gastric bypass is a more complicated irreversible gastrointestinal surgery in which a pouch is created at the top of the stomach, and then connected directly to the middle of the small intestine, bypassing the rest of the stomach and the upper intestine, or duodenum. The part of the intestines that is bypassed is where vitamins and minerals are the most easily absorbed, meaning patients must guard against nutritional deficiencies following a gastric bypass.

Studies published in the Archives of Surgery comparing the newer laparoscopic gastric banding surgery and sleeve gastrectomy to the conventional gastric bypass surgery found that, while conventional bypass surgery resulted in higher weight loss, the less invasive Lap-Band procedure was "safer", with fewer complications.

Many bariatric surgery experts believe that surgery which bypasses the duodenum is the most effective for diabetes control because the duodenum plays a role in insulin resistance, and bypassing it reduces insulin resistance in patients with diabetes mellitus. A gastric bypass also results in the most weight loss. "It's very clear - bypass is better than band, period," states bariatric surgeon Dr. Guilherme M. Campos from the University of the Wisconsin School of Medicine, "And if you are diabetic with obesity, the best treatment is a Roux-en-Y gastric bypass."

Dark Cocoa May Lower Insulin Resistance

March 31st, 2011

dark cocoa

Dark cocoa has been linked to a reduction in risk factors for diabetes such as high blood pressure and high cholesterol. Dark cocoa has also been shown to lower insulin resistance in diabetics.

It's believed that the health benefits arise from the polyphenolic flavonoids in cocoa - antioxidants with the potential to prevent heart attacks which are also found in fruits, vegetables, tea, coffee and wine.

Most commercial chocolate is high in sugar and fat, offsetting its possible health benefits, so more research is needed about the risk/benefits ratio of eating a regular dark chocolate bar.

To read the entire article 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<.

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<.

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.

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<.

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.<

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.

Eating Red and Processed Meats Increases Risk of Diabetes

August 15th, 2011

A study published in the American Journal of Clinical Nutrition found that the more red meat people eat, especially processed meat, the higher their risk of developing type 2 diabetes.

Processed meats include the American staples bacon, sausage, hot dogs and most packaged sandwich meats. The study did not establish why red and processed meats increased the risk of developing diabetes. One theory is that the high amount of nitrates used as preservatives in processed meats may increase insulin resistance.

Others theorize that the large amount of iron in red meat leads to high iron stores in the body, which have been associated with an increased risk of type 2 diabetes. A third theory is that high meat consumption may contribute to obesity - a major risk factor for diabetes. The answer may lie in a combination of these factors.

To read more about the issue on WebMD, >CLICK HERE.<

Decade of Research Results in Discovery of a Diabetes Gene

October 11th, 2011

MADISON - Ten years of meticulous mouse breeding, screening, and record-keeping have finally paid off for Alan Attie and his lab members. The University of Wisconsin-Madison researchers' efforts, published Oct. 6 in the journal PLoS Genetics, pinpointed a gene that confers diabetes susceptibility in obese mice.

They also showed that the protein coded by the gene, called tomosyn-2, acts as a brake on insulin secretion from the pancreas. "It's too early for us to know how relevant this gene will be to human diabetes," says Attie, a UW-Madison biochemistry professor, "but the concept of negative regulation is one of the most interesting things to come out of this study and that very likely applies to humans."

In a properly tuned system, insulin secreted into the blood after eating helps maintain blood sugar at a safe level. Too little insulin (as in type 1 diabetes) or insulin resistance (as in type 2 diabetes) leads to high blood sugar and diabetic symptoms. Too much insulin can drive blood glucose dangerously low and lead to coma or even death in a matter of minutes.

"You can imagine that if you're in a fasted state, you don't want to increase your insulin, so it's very important to have a brake on insulin secretion," says Angie Oler, one of the lead authors. "It needs to be stopped when you're not eating and it needs to start again when you do eat."

The group honed in on tomosyn-2 while searching for genes that contribute to diabetes susceptibility in obese animals. Why study fat mice? To read the entire Press Release on FierceBiotech, >Click Here.<

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.<

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.