Show #36 - June 7, 2010

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Welcome to Diabetic Feed for the week of June 7, 2010. I'm Christelle Marchand.

Diabetic Feed introduces you to the latest news, information, and people that make an impact in the diabetic community.

Whether you're a diabetic, know someone with diabetes, or are just curious to learn more about a disease that affects over 21 million people in the U.S. alone, we hope that you'll hear something new.

This week's podcast is strictly a news edition, but we'll be beginning our interview episodes in upcoming weeks. So, let's get straight to it.

According to a study published in the U.K. journal The Lancet, the low-dose combination of avandia and metformin, also known as glucophage,

cuts the risk of progression to type 2 diabetes by two-thirds in people at risk of diabetes.

Both drugs have been shown to reduce the development of diabetes in patients with impaired glucose tolerance.

Metformin reduces liver glucose production, while avandia, manufactured by Glasgow-SmithKline, increases insulin sensitivity.

Avandia has been on the market since 1999 and has recently been shown to be linked to a 43% increased risk of heart attacks in several studies.

The CANOO study investigated whether combining the two,

avandia and metformin, at half the maximum dose, would help prevent diabetes while minimizing side effects.

Researchers concluded this combination was highly effective in the prevention of type 2 diabetes in patients with impaired glucose tolerance,

without a proliferation of side effects that these two drugs could have produced when taken in full-strength dosages.

Quote,

These results lend support to the notion of the use of low-dose combination therapies

as an effective means to manage diabetes.

These треб questiones linked ginseng, parole, chlamydia, broken berries, and perpendicidal baby medicine.

Referring to the controversies surrounding risks associated with using avandia,

The researchers believe that half the maximum dose

of Rosiglitosone, avandia,

could provide important therapeutic effect,

with, perhaps, fewer adverse consequences,

but did not elaborate on the cardiovascular risks of the drug.

The researchers stated,

larger long-term studies to assess this low dose combination

would be needed to establish

overall long-term safety,

safety, risks, and benefits. Continuous subcutaneous insulin infusion therapy,

often known as insulin pump therapy, has been shown in a study conducted by a group in Bergamo,

Italy to increase the number of glucose excursions, or in layman's terms, the swings

between highs and lows, in comparison to multi-daily injections of insulin, but only when the patients

have already established good metabolic control. The study subjects included 36 type 1 insulin

pump therapy patients with an average A1c of 8.3%, with a variation of 1.5%, and 77 type 1

multiple daily injection, otherwise known as MDI, patients with an average A1c of 8.5%,

with a variation of 1.4%. All patients used insulin analogs. To evaluate glucose variability

interstitial glucose concentration was measured continuously over a 72-hour period by a Medtronic

continuous glucose monitoring system. The results showed that while the baseline clinical data of

the two groups were not significantly different, the patients using insulin pumps with an A1c of

7.5 and under showed a significantly lower glucose variability than the MDI group. However,

the insulin pump therapy patients whose A1c's were above 9.2%

showed higher glucose variability than the MDI group. The researchers concluded that this was

likely the consequence of a more frequent use of correction boluses in patients of the insulin pump

therapy group than in those of the MDI group. The data also suggested that insulin pump therapy

is helpful in stabilizing blood glucose levels when strict metabolic control is difficult to

maintain with multiple daily injections without disabling hypoglycemia or disturbing glucose

fluctuations.

Novartis Pharmaceuticals recently announced that it's seeking approval to market the drug

Lucentis in Europe as a treatment for diabetic macular edema. Despite the prevalence of eye

disease amongst people with diabetes, 40-45% of whom already have some evidence of it,

there are currently no approved vision-improving therapies for the problem.

This would be the first disease-modifying drug for a diabetes complication.

Macular edema is common in diabetes. The lifetime risk,

for diabetics to develop macular edema, is about 10%. Up to 30% of patients with DME will experience

moderate visual loss. Similar regulatory submission in the United States is anticipated upon completion

of ongoing Phase III trials in 2012. Lucentis works by blocking the effects of a protein

called vascular endothelial growth factor, or VEGF, which causes the tiny vessels in the eye

to leak and promote new blood vessel growth.

The drug is currently approved in both the United States and Europe as a treatment for

age-related macular degeneration. If your tattoo's glowing, your blood sugar may be elevated. In the

future, people with diabetes may be able to monitor their blood sugar levels using a glucose

tattoo. The researchers at the Massachusetts Institute of Technology, MIT, are developing

a new type of continuous glucose monitor that relies on fluorescent nanoparticle ink

wrapped in a glucose-sensitive polymer.

Injected under the skin to detect blood sugar levels, with a watch size or smaller monitor

worn over the skin. Michael Strano, senior researcher and associate professor of chemical

engineering at MIT, explains, quote,

Carmen nanotubes will fluoresce in infrared light, and we can decorate the tubes so they

fluoresce in response to glucose. When you shine a light on the nanotubes, they'll shine

light back at a different wavelength to a watch-type diode that could tell how much

glucose is around.

The nano ink starts to disappear after about six months when patients will need to be re-injected

with the ink. Strano said the researchers are currently trying the nanoparticles in

animals.

While this is a novel concept, Dr. Joel Zahnstein, director of the Clinical Diabetes Center at

Montefiore Medical Center in New York City, is not so sure. Quote,

Everyone is looking for a painless way to monitor blood sugar. And this technology sounds

good, but I have no idea if it's going to work or not.

From here to reality, we'll take a lot of steps and research.

He also added that there's always the possibility of an adverse reaction to anything placed

inside the body.

Our cells don't like foreign bodies. Already, immune cells very carefully try to reject

the continuous glucose monitor sensor and form scar tissue around it, he said.

That's it for this week's edition of Diabetic Feed. For more information about these articles

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Thanks go out to my partner and producer, Jonna Pregliano. Join us at Diabetic Feed for

the latest news and information about diabetes. Until then, have a healthy week.

I'm Jonna Pregliano, and I'll see you next time on Diabetic Feed.