Category: Diabetes 101

Computer security firm StaffSecurity has revealed flaws in the software controlling insulin pumps that could allow malicious attackers to take control of the pump and even endanger the health of the user.

The vulnerability was revealed at a computer security conference held in Las Vegas. Jay Radcliffe, himself a diabetic, broke the news about the security flaws: “My initial reaction was that this was really cool from a technical perspective. The second reaction was one of maybe sheer terror, to know that there’s no security around the devices which are a very active part of keeping me alive,” said Radcliffe. If hackers were able to exploit the flaws in the devices, they could alter their operation and modify the wearer’s insulin levels.

Research teams at the Massachusetts Institute of Technology and University of Massachusetts are staying one step ahead of these vulnerabilities, already working to remove the security flaws. The teams are developing jammers that patients would wear, thereby disrupting any attempts to execute malicious software through a wireless connection to the pump.

Hackers have exposed security flaws in medical devices in the past. The 2009 Conficker viruses infected hospital computer systems and hundreds of MRI devices around the world, although there was no damage reported. The research teams at MIT and the University of Massachusetts stress that while the security flaws are serious and could potentially cause health problems, there have been no reports in which medical devices were intentionally used to threaten a patient’s health. The teams are working to stay a step ahead of software vulnerabilities and to close them before they become a problem.

 

New Research On Obesity and Insulin Resistance: While researchers know that it is obesity that leads to many cases of type 2 diabetes, researchers are partly stumped as to why excessive weight leads to insulin resistance and then to diabetes. At the Joslin Diabetes Center, scientists have found a new way in which obesity affects the body. They have found that in altering the production of proteins in which affects other proteins that are combined together.

The scientists began by examining levels of proteins in the livers of obese people in the lab of Mary-Elizabeth Patti, M.D., they’re findings consisted of a decrease in the number of certain proteins that regulate RNA splicing.

Dr. Patti, the Assistant Professor of Medicine at Harvard Medical School explains, “When a gene is transcribed by the cell, it generates a piece of RNA. That piece of RNA can be split up in different ways, generating proteins that have different functions.” Additionally, Dr. Patti stated, “In the case of these proteins whose production drops in the livers of obese people, this process changes the function of other proteins that can cause excess fat to be made in the liver. That excess fat is known to be a major contributor to insulin resistance.”

Through this study, researchers also showed that the RNA splicing proteins were decreased in the samples of the liver muscle from the obese people studied during their tests.

Through more research, the representative RNA-splicing protein called SFRS10 was examined. The SFRS10 levels dropped in muscle and liver in obese people and in over-fed mice as well. The tests showed that the SFRS10 helped to regulate the protein referred to as LPIN1, which plays a huge and important role in synthesizing fat. In their research of mice, researchers found that when they suppressed the production of SFRS10, more triglycerides developed which is a type of fat that circulates in blood.

Dr. Patti discusses the research further, “More broadly, this work adds a novel insight into how obesity may induce insulin resistance and diabetes risk by changing critical functions of cells, including splicing. This information should stimulate the search for other genes for which differences in splicing may contribute to risk for type 2 diabetes. Ultimately, we hope that modifying these pathways with nutritional or drug therapies could limit the adverse consequences of obesity.”

The World Health Organization Collaborating Center, International Diabetes Center, and Mayo Clinic of Minneapolis, MN, have named Phil Southerland as the new Director of Health Care Policy, Planning and Patient Advocacy.

Southerland, 29, is the CEO of Team Type 1 and a known advocate for global diabetes awareness.

Southerland’s new job as the Director will include providing support for the Center’s five-year collaborative effort with the Chinese Ministry of Health to promote diabetes self-care with programs sponsored by the Center for Disease Control and Prevention. Southerland will work to eliminate discrimination against children and young adults with Type 1 diabetes in China. Southerland will also help with similar programs in the Middle East, the Asia Pacific region and in Latin America. The goal of Southerland’s efforts will be to show that those with diabetes can be healthy and productive so long as they receive adequate medical care for their conditions.

Dr. Roger Mazze, Head of the WHO Collaborating Center, IDC and Mayo Clinic, believes that Southerland is more than qualified for the job. “Due to Phil’s extraordinary experience in working with governments around the world and influencing policy to provide the necessary services and supplies for children with diabetes, we felt it was important to have him work with us on this significant undertaking in China. He will assist our efforts around the world to improve patient self-care and help governments align their policies to ensure people with diabetes enjoy the same rights and opportunities as all individuals within their countries.”

Southerland was diagnosed with Type 1 diabetes himself at only seven months of age. He founded Team Type 1 in 2005 to aid diabetics in taking an active role in the management of their disease by sponsoring a bicycling team to promote the group. Despite Southerland’s young age, Team Type 1 has become a global initiative, making a difference in the lives of countless diabetics across the world. Team Type 1 now features a highly competitive athletics program, sponsoring over 100 athletes from 11 countries in addition to its philanthropic efforts throughout the world, which includes work in developing countries and a sports research wing focused on diabetics.

“Every day, our athletes are proving that with proper care and access to insulin and supplies, anything is possible with diabetes,” said Southerland of Team Type 1’s success. “Every child in the world should have the opportunity to live a full, healthy life, free from the discrimination that often accompanies a diagnosis. I’m honored to be able to assist the World Health Organization in its global mission to make that a reality.”

The World Health Organization funds over 800 collaborating centers around the world that perform activities and events in support of the WHO. The International Diabetes Center and Mayo Clinic was featured as a collaborating center in 1986 for its work in diabetes education as well as in information technology and translation. It is one of only two diabetes centers designated by the WHO in the United States; 32 such centers have been designated worldwide.

An event sponsored by the Congressional Black Caucus Foundation made an effort to raise diabetes awareness in the black community of North Carolina. The Spirit of Healthy Living tour visited Greenville, North Carolina, recently and spent time at the Greenville Community Christian Church. The Church is located at 1104 N. Memorial Drive. Spirit of Healthy Living is a faith-based initiative that seeks to educate black communities about the risks and dangers involved with Type 2 diabetes.

Muriel Cooper is the senior media manager for the Congressional Black Caucus Foundation. Cooper stated that the event goal, dubbed Wellness and Diabetes Day, was to “partner with churches because we know churches represent a significant influence over their congregations. . . while we start the relationship, we are looking for local communities to continue it.” Spirit of Healthy Living hopes that by connecting to communities through their faith, they can make inroads into helping those communities understand diabetes and the risks it poses.

The Wellness and Diabetes Day was opened with Congressman G.K. Butterfield delivering an opening speech, followed by a variety of educational activities including healthy cooking demonstrations, free health screenings, and activities for children and youth.

“Anyone in their community who is concerned about their health and being healthy and/or preventing illness was welcome to come,” said Cooper. The event was family-friendly, open to the public and free to attend, and Cooper hoped that the event would educate families together about being healthy, hoping that it will “start promoting healthy lifestyles within families.”

The issue of diabetes is especially important among black communities because studies have demonstrated that they are more at risk of developing Type 2 diabetes. “We know in the African-American community, it is the fifth leading cause of death,” said Cooper. The event sought to educate the black community about ways to reduce their risk of developing Type 2 diabetes and to help those with diabetes keep it under control.

There is a diabetes self-management program offered by the Pitt County Health Department in addition to a support group for diabetics to share their experiences. The Brody School of Medicine, part of East Carolina University, maintains a Diabetes Self-Care Program that aids diabetics in managing the disease. According to Robin High, the nutrition program director of Pitt County Health Department, these support groups function alongside the diabetes education programs so that diabetics receive aid “not just from our diabetes team but also from each other.”

For additional information on diabetes information and assistance, individuals may log on to spiritofhealth.org. Or, if someone would like more information on local diabetes support programs in the Greenville, North Carolina, area, contact Robin High at 902-2388 at the Pitt County Health Department or at 744-3038 to reach the Brody School of Medicine Diabetes Program.

Glucose Test May Predict Risk of CVD In Diabetes Patients: The most important way to manage ones diabetes is to manage the hemoglobin A1C level within the body.  There are many reasons as to why this level is particular is important but one major reason is that by managing it, it can help reduce the risk of cardiovascular disease, also known as CVD.

Through research, diabetes had been noted as a risk factor for cardiovascular disease. However, with patients already suffering from diabetes, the risk is much higher.

Nina P. Paynter, Ph.D., from Brigham and Women’s Hospital, Boston, and colleagues, used data from participants of the Women’s Health Study and the Physician’s Health Study II states, “Simulated cost-benefit analyses have suggested that this variability in CVD risk could provide an opportunity for tailored preventive therapy in diabetic patients.”

Researchers wanted to investigate the importance of HbA 1c levels through a test that reflects the average blood glucose level throughout a period of two months/ three months. Through this test, researchers could see how the HbA 1c affected diabetes and how it was being managed.

Through the test, 24,674 women where used, 685 having diabetes and 11,280 men were used, 563 having diabetes. Through questionnaires, researchers obtained health history and received blood samples to check cholesterol, C-reactive protein and HbA 1c levels. Researchers followed up for a middle point of 10.2 years for women and a midpoint of 11.8 years for men to look for new cases of cardiovascular disease. Their findings consisted of 125 cardiovascular cases in the 685 female surveyors with diabetes and 170 in the 563 male surveyors with diabetes.

The researchers stated, “We found that in these large population-based cohorts of both men and women, presence of diabetes alone did not confer a 10-year risk of CVD higher than 20 percent, and measurement of HbA 1c level in diabetic subjects improved risk prediction compared with classification as cardiovascular risk equivalent. They propose that the difference in risk between the sexes may be partly attributed to the increase in CVD risk with age and the delayed risk in women. Our findings suggest that the improvement in CVD risk prediction, and possibly calibration, obtained with adding HbA 1c levels is highest in lower-risk populations.”

New Drug Raises HGL Cholesterol And Helps Control Type 2: According to new research, a medication that was designed to help improve the levels of “good” cholesterol could also help to control blood sugar in people who have diabetes and are taking a cholesterol-lowering drug.

This finding came from researchers who were analyzing data from a clinical trial for a drug called torcetrapib. Torcetrapib is a cholesterol ester transfer protein inhibitor, a drug that increases high-density lipoproteins also known as HDL levels.

This study was completed on 6,661 people who have type 2 diabetes who showed improvement in their blood sugar levels while taking torcetrapib and a stain medication that helped to reduce low-density lipoproteins, also known as LDL levels.

Philip Barter, M.B.B.S., Ph.D., a professor of medicine and director of the Heart Research Institute at the University of Sydney in Australia says, “The possibility that CETP inhibitor drugs may not only reduce the risk of heart attack and stroke, but may also improve the control of blood sugar in people with diabetes, is an exciting prospect that may translate into real health benefits for people with diabetes.”

According to the World Health Organization about 220 million people across the globe have diabetes and about 95 percent have type 2 diabetes, which adds an increase to heart disease, stroke and other heart problems.

Barter states, “While the experimental drug was not as effective in taming diabetes as drugs that are commonly used for that purpose, it did reduce the adverse impact on blood sugar commonly seen with statin use, inhibition of CETP has the potential to prevent a worsening of diabetic control that often occurs in people taking statin drugs.”

The clinical trial was called ILLUMINATE (Investigation of Lipid Level Management to Understand its Impact in Atherosclerotic Events) and was completed on 15,000 people from age 45 to 75. Every person that the trial was completed on had either a history of heart attack, stroke, chest pain, peripheral vascular disease or cardiac revascularization (angioplasty or bypass) and all were on medication to control their diabetes.

Swamp Gas May Be Used in New Diabetes Treatments: Hydrogen sulfide, more commonly known as “swamp gas” – is responsible for various disagreeable odors, from the smell of rotting plants and sewer systems to certain industrial fumes. Yet a new study supported by the National Institutes of Health, the Juvenile Diabetes Foundation, and Shriners Hospital for Children and conducted by the University of Texas Medical Branch at Galveston suggests that this foul-smelling compound plays an important role in shielding blood vessels from the effects of diabetes.

The University of Texas Medical Branch states in a new paper published in the Proceedings of the National Academy of Science that experiments with diabetic rats and human endothelial cells – the cells that make up the inside layer of our blood vessels – have shown that hydrogen sulfide levels play an important role in the possibility of diabetic complications in the blood vessels. It has been shown in recent years that hydrogen sulfide occurs naturally in the human body, playing a role in the circulatory system.

The UTMB research group, headed by Dr. Csaba Szabo, began their experiments by exposing human endothelial cells to sugar at a level similar to what the cells of a diabetic person would experience. The results were predictable: “Upon exposure to such high sugar levels, the cells started to produce increasing amounts of highly reactive toxic free radicals, and as a consequence, they began to die,” Dr. Szabo stated. However, the presence of hydrogen sulfide affected the health of the endothelial cells: “Low hydrogen sulfide levels accelerated this process, while constant replacement of hydrogen sulfide protected the cells against the toxic effects of high sugar,” according to Dr. Szabo. Exposing the cells to this “swamp gas” was shown to have a protective effect against the complications of diabetes.

In treating diabetic rats, the research team showed that these rats had lower levels of hydrogen sulfide present in their circulatory systems than normal. They also improved the rats’ conditions by exposing them to hydrogen sulfide treatment for a month, improving the health of their blood vessels.

Dr. Szabo stressed the importance of the health of the endothelial cells in preventing diabetic complications. “The loss of endothelial cell function in diabetes is a first step that leads to many complications, such as eye disease, heart disease, kidney disease, foot disease and others.” He went on to state that this swamp gas research may be utilized in new diabetes treatments: “The observation that hydrogen sulfide can control an early checkpoint in all of these processes may open the door for new therapies.”

Body Muscle Mass Helps Fight Insulin Resistance: Body muscle mass helps prevent insulin resistance even in overweight individuals. Insulin resistance, in many cases, leads to a diagnosis of type 2 diabetes.  There is a possibility of stopping the progression from a diagnosis of insulin resistance to full-blown type 2 diabetes with building additional body muscle mass.  Insulin resistance is a condition where blood glucose levels are higher than the normal range and is a cause for concern in one’s overall health.

A recent study, the results of which are soon to be published in The Endocrine Society’s Journal of Clinical Endocrinology and Metabolism, was recently done at the University of California, Los Angeles.  The senior author of the study results, Preethi Srikanthan, M.D., stated, “Our findings represent a departure from the usual focus of clinicians, and their patients, on just losing weight to improve metabolic health.”  Srikanthan further added, “Instead, this research suggests a role for maintaining fitness and building muscle.  This is a welcome message for many overweight patients who experience difficulty in achieving weight loss, as any effort to get moving and keep fit should be seen as laudable and contributing to metabolic change.”

In studies in the past, it was discovered that low muscle mass is a risk factor for insulin resistance.  Until this time, however, no study had examined whether increasing the body muscle mass to average and then above average levels, separately from the overall body weight, would lead to improved blood sugar levels.

This study took into account the body muscle mass in relationship to insulin resistance and blood sugar metabolism disorders.  It was a nationally representative group sample of 13,644 people.  Those in the study were all older than 20 years of age, none were expecting a child and they all weighed more than a set figure.  This study reflected that the more muscle mass an individual had in relationship to body size the less likely the individual was to insulin sensitivity and, therefore, a lower risk of pre-diabetes.

Usually, research has indicated that individuals with a waist circumference within certain inches is a good indicator for pre-diabetes – the larger the waist measurement, the more likely an individual is to develop pre-diabetes or even diabetes.  Body mass index has been taken into account as well.

Dr. Srikanthan added, “Our research shows that beyond monitoring changes in waist circumference or BMI, we should also be monitoring muscle mass.”

More research would be needed to determine how much help can be garnered from intervention in a person’s life in regards to their exercise routine, to include lightweight weights and more cardio exercise.

Simply lifting soup cans in a repetitive manner (arm curls or over the head) while standing in the kitchen can benefit anyone.  As well, doing small push-ups from the kitchen counter can strengthen the arms.  Doing ten lunges when dusting can strengthen the leg muscles.  Small changes can be incorporated into an individual’s daily life that would help tone and build muscle mass.  In the process, an individual could be helping to prevent the diagnosis of pre-diabetes or even full-blow diabetes.

Cell Phones Helping Manage Diabetes: According to a new study from the University Of Maryland School Of Medicine, an interactive computer software program could be very effective in helping patients with type 2 diabetes, manage their diabetes using their mobile phone.

Patients who used the mobile health software were studied, it was seen that those using the mobile health software gained a reduction in the amount of hemoglobin A1C in their blood. The amount lowered was 1.9 percent over a period of one year. Through these findings, researchers are looking at other health management alternatives as well.

Charlene C. Quinn, Ph.D., R.N., an assistant professor of epidemiology and public health at the University Of Maryland School Of Medicine and the principal investigator states, “These results are very encouraging. The 1.9 percent decrease in A1C that we saw in this research is significant. Previous randomized clinical trials have suggested that just a 1 percent decrease in A1C will prevent complications of diabetes, including heart disease, stroke, blindness and kidney failure.”

Since the world is mostly dependent on internet use in today’s more technical savvy world, the study shows that more people are managing their diabetes better through the internet located on their mobile phones or other mobile communications devices. Not only can patients manage their diabetes, they can send their results directly to their doctor as well.

Dr. Quinn gives more details about the mobile software program, “Mobile health has the potential to help patients better self-manage any chronic disease, not just diabetes. This is one of the first large, reported, randomized clinical studies examining the mobile health industry, which is rapidly growing. The U.S. Food & Drug Administration just last month released draft guidance on how it intends to regulate the field. Our results can help define the science behind this new strategy for disease management.”

While this software is perfect for type 2 diabetic patients, it is not recommended for type 1 diabetic patients. People who have been diagnosed with type 2 diabetes either cannot produce enough insulin to process sugar into energy or their cells do not recognize the insulin at all. The important measure to manage diabetes is to control the amount of hemoglobin A1C is a person’s blood.  A1C is a molecule that is found in a person’s red blood cells that binds itself with sugar. If a person’s blood sugar level is high, their A1C level will be high as well. The recommended amount for a person’s A1C level is 7 percent. People with diabetes stand at about 9 percent or more which can increase any diabetic complications.

Dr. Quinn says, “We tell patients that they can meet these goals if they eat a healthy diet, exercise daily and take their medication as directed, but we don’t really give them the tools to do that.”

However, the new mobile software program is just the tool that type 2 diabetics need to manage their diabetes.

New Research – Stem Cell Memory and Insulin Levels: According to new research, stem cells from early embryos can be persuaded into becoming a various selection of particular cells that can both recover and restore different areas in the body. Researchers have often thought about the use of this process for diabetes but have admitted some medical and ethical downsides.

However, researchers at the Tel Aviv University are taking advantage of this process and are started to use the memory of stem cells to generate from adult cells to bring some new found hope to patients suffering from juvenile and type 1 diabetes. This process could open up a whole new line in new treatments for diabetic patients.

Prof. Shimon Efrat of TAU’s Department of Human Molecular Genetics and Biochemistry at the Sackler Faculty of Medicine states, “these “induced pluripotent stem cells” derived from adult cells, represent an embryonic-like state. To some degree, the cells retain a “memory” of what they once were when created from pancreatic beta cells, the cells responsible for the production of insulin, these pluripotent cells prove more efficient than their embryonic counterparts in creating insulin-producing cells. Prof. Efrat says that this discovery promises to advance the development of cell replacement therapy for diabetics, possibly leading to an effective alternative to organ transplants.”

Embryonic stem cells are chosen over adult dells because they grow easier in the lab and can form any type of cell in the body.

Professor Efrat states, “But turning them into pancreatic beta cells is not an easy task. When generated from human beta cells, pluripotent stem cells maintain a ‘memory’ of their origins, in the proteins bound to their genes. As though receiving a prompt from their past life, the cells already have some understanding of their purpose, making them more efficient in generating beta cells.

While today many diabetic patients can choose an option for an organ transplant to replace damaged pancreatic beta cells, there is a shortage among organ donors.

Professor Efrat states, “The ratio of donors to potential recipients is about one to 1,000. A better option is sorely needed, and stem cells present a viable hope for the future.”