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Fat Cells Help Pancreas Secrete Insulin

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Research carried out at Washington University School of Medicine in St. Louis shows that the body’s fat cells help the pancreas secrete insulin, a finding which could lead to new methods in improving glucose metabolism in type 2 diabetics or insulin-resistant people.

In the November 7, 2007 issue of Cell Metabolism, scientists at the School of Medicine describe a study using laboratory mice where fat cells release a protein that aids insulin secretion from pancreatic beta cells, the sole source of insulin. The protein is an enzyme that the pancreatic cells produce in minimal amounts; the enzyme enhances glucosde-stimulated insulin secretion from pancreatic beta cells.

The enzyme secreted by fat cells is called Nampt (NMN) and is an important component of the insulin-secretion pathway. "We think this secretion process allows fat cells to communicate with the pancreas and aid its function," says senior author Shin-ichiro Imai, M.D., Ph.D., assistant professor of medicine and of molecular biology and pharmacology. "I suspect this process could be critical for compensating pancreatic beta cell function in the face of increasing insulin resistance." "Our work marks a conceptual breakthrough," continued Imai. "Nampt synthesizes a compound in the bloodstream, and when that compound reaches the pancreas it stimulates insulin secretion. This is a surprising mechanism by which a circulating metabolite modulates pancreatic function."

Imai believes that the compound produced by Nampt could be used to raise insulin secretion from pancreatic cells, and so improve the way the body handles sugar. NMN was measured in the bloodstreams of laboratory mice at a concentration sufficient to enhance insulin secretion from pancreatic cells; previously it not known that NMN circulated in the bloodstream.

In conjunction with the Office of Technology Management at the University, Imai has patented the use of Nampt and NMN for the prevention and treatment of metabolic complications, such as type 2 diabetes.

Source: Cell Metabolism, November 7, 2007.

Charcot Foot Condition on the Increase Among Diabetics

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With the number of diabetes cases growing nationwide, more diabetes patients are developing a somewhat rare, but dangerous foot complication called Charcot foot, according to a number of physicians with the American College of Foot and Ankle Surgeons.

Charcot foot is a sudden softening of the foot’s bones caused by severe neuropathy, or nerve damage, a common diabetic foot complication. It can cause joint loss, fractures, collapse of the arch, massive deformity, ulcers, amputation and even death. It cannot be reversed, but early detection can arrest its effects.

Symptoms, which appear suddenly, include warm and red skin, swelling and pain. A diabetic with a red, swollen foot or ankle requires emergency medical care because these symptoms can also indicate deep vein thrombosis, or an infection.

"More people with diabetes, their families and their care providers need to know about Charcot foot," says J.T. Marcoux, DPM, one of a few Massachusetts foot and ankle surgeons who perform Charcot foot reconstructions. "When I diagnose a patient with this complication, I telephone their primary care doctor and educate them about it as well."

Apathy and diabetic denial are major factors in preventing the treatment of Charcot foot among diabetics, say Keith Jacobson, DPM, and Dr. Marcoux. "I’ve had patients who are literally blind, on dialysis and neuropathic, who refuse to admit they have diabetes," says Jacobson. "I’ve seen horrific deformities with this condition."

Meanwhile Kim Schraeder, one patient who was successfully treated for Charcot foot by Dr. Jacobson, is back walking on both feet and is carefully watched by her children for any reoccurrence of the condition. "They’re all like hawks now." she says. "If I’m sitting here with bare feet, they’ll look to make sure they’re not red, hot or swollen."

Source: American College of Foot and Ankle Surgeons

Increased Waist Circumference Flags Health Problems

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The consequences of growing a "spare tire" means more than having to wear an oversize Hawaiian shirt to the pool.

According to a recently published study by Dr. Steven Kaplan, professor of urology at Cornell University, increased waist circumference provides "powerful correlation" for predicting whether male patients have an increased incidence of erectile and ejaculatory problems, diabetes, hypertension increased blood pressure, a high lipid level and an enlarged prostate.

Angry Men at Higher Risk for Heart Disease, Diabetes

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It’s not healthy to be hostile, according to a recent study from Duke University.

Steven Boyle, Ph.D., a researcher at Duke University Medical Center, says men who regularly exhibit strong feelings of anger or depression may face increased risk of coronary heart disease.

The study was conducted on 313 men who were given a standard psychological test that measures hostility, anger and depression.

Men whose psychological screening showed the highest level of hostility, depressive symptoms and anger had a 7.1 percent increase in levels of an immunity protein known as C3, while men with lower levels of hostility, depression and anger showed no during the decade-long study.

According to the study’s co-author, Edward Suarez, Ph.D., the lifestyle of individuals with a hostile attitude, "often leads to greater stress and possibly changes in the way the body functions that could lead to disease.”

The study appears in the August issue of the journal Brain, Behavior, and Immunity.

Source: Health Behavior News Service

FDA Panels to Evaluate Avandia Heart Risks

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Two Food and Drug Administration advisory panels will meet to discuss the results of a study done by Cleveland Clinic cardiovascular medicine chairman and a leading author, Steven Nissen, claiming that the popular diabetes drug "Avandia" may increase the risk of heart attack in patients.

Nissen’s study is based on 42 clinical trials. Results showed that people on Avandia were at 43% higher risk of having a heart attack.

Glaxo, the drug maker, reported a fall of 23% in Avandia sales after the study was published.
The advisory panel may recommend anything from no action to a black box label. However, Glaxo spokeswoman Mary Anne Rhyne maintains that these drugs are safe and the decline in sales is only in new prescriptions.

US Presidential Candidates Plan to Cure Diabetes

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US Presidential Candidates, Senator Chris Dodd (D-Connecticut) and former Governor Bill Richardson (D-New Mexico) seem to be showing a lot of interest in finding a permanent cure to diabetes.

Both of them indicated their intentions during Monday night’s debate.
While answering a question on fixing Medicare, Medicaid, and Social Security, Richardson responded that almost 33% of Medicare money is spent only on diabetes. He added that they need to put in bipartisan efforts to prevent diabetes and to find a cure for it.
Dodd although made his statement by mistake—while speaking about a video related to Alzheimer’s—he said that he will promote stem cell research to find a cure for diabetes.

Richardson, who made a stronger statement, has not included any plan about combating diabetes on his campaign website.

Source: Wired

A Soft-Drink a Day Increases Heart Disease Risk Factors

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Adults who drink at least one soft drink per day are 30% more likely to develop new-onset diabetes or have low levels of good cholesterol.

A recent study in Circulation: Journal of the American Heart Association reports that drinking at least one soft drink a day of a diet or regular soft drink are at greater risk for heart disease than those who don’t. The study was conducted on 3,500 middle aged men and women. The study found that soft-drink consumers are more likely to develop matabolic syndrome, a combination of
a combination of factors like high blood pressure and elevated triglycerides — are more likely to suffer diabetes and heart disease.

Adults who consume at least one soft drink a day are more likely to develop risk factors for heart disease than those who don’t, even if the beverage is diet, according to a study published today in Circulation: Journal of the American Heart Association.

Researchers studying about 3,500 middle-aged men and women as part of a larger, long-term heart study found an association between daily soft drink consumption and an increased risk of developing metabolic syndrome.

The American Heart Association defines metabolic syndrome as:

  • Abdominal obesity (excessive fat tissue in and around the abdomen)
  • Atherogenic dyslipidemia (blood fat disorders — high triglycerides, low HDL cholesterol and high LDL cholesterol — that foster plaque buildups in artery walls)
  • Elevated blood pressure
  • Insulin resistance or glucose intolerance (the body can’t properly use insulin or blood sugar)
  • Prothrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor–1 in the blood)
  • Proinflammatory state (e.g., elevated C-reactive protein in the blood)

    • Metabolic syndrome is a growing problem in America, where an estimated 50 million people exhibit symptoms and have greater risk of coronary heart disease and other diseases related to plaque buildups in artery walls.

Novartis’ Diabetes Drug Galvus Closer to Approval in EU

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Novartis’ diabetes drug, Galvus, is one step closer to approval in the European Union after an EU advisory committee issued a positive opinion on the drug.

Galvus is a once-daily oral medicine for patients with type 2 diabetes. The company reports that Galvus significantly reduced blood sugar levels in people age 65 and older without the increased risk of side effects that often limits more aggressive treatment in these patients.
Galvus is awaiting FDA approval in the United States, where the agency has twice delayed approval of Galvus pending further data to show that skin lesions and kidney impairments seen in an earlier animal study have not occurred in humans.
A similar drug called Januvia is marketed by Merck, and was approved by the FDA in October 2006.
Recommendations by the European Committee for Human Medicinal Products usually lead to approval of the drug for sale in all the European Union countries, and Novartis indicated that it expects a final decision within the next 90 days.

Older Type 2 Diabetes Drugs Work Well

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While new diabetes drugs have been introduced on the market, recent studies have found that the older drugs, such as second generation sulfonylureas and metformin (sold under the brand names Glucophage, Diabex, Diaformin, Fortamet, Riomet, Glumetza, and others) work just fine in controlling blood glucose for most patients.

These older drugs are less expensive, and, according to researchers, a drug such as Metformin appears to have the best benefit, particularly when risk is accounted for.

Metformin was first approved by the FDA for diabetes treatment in 1994 and marketed in the United States for diabetes treatment in 1995 by Bristol Myers Squibb under the brand name Glucophage.

The study did not examine the effectiveness of the most recent class of anti-diabetes drugs called incretin mimetics, such as exenatide (Byetta) and sitagliptin (Januvia).