Diabetic Live

Tom Martinez, Facebook And A Donor: Back in June of 2011, famous quarterback coach Tom Martinez announced on his Facebook page that his complications stemming from diabetes and other ailments gave him only one month remaining to live because he needed a simultaneous heart and kidney transplant. Martinez, a very well-respected coach who has worked with many, many quarterbacks over the years, is probably most well known for working so closely with Tom Brady, the winner of three Super Bowl titles while he’s been with the New England Patriots.

In June when Martinez gave his dire prognosis for his imminent death on Facebook, it was a blow for the football world that was difficult to absorb. The football world mourned. Martinez at that time stated, “My medical test numbers say I’m basically gone. My blood pressure is too low for me to continue with dialysis, and without dialysis poisons build up in my body. Doctors say without dialysis I have a week to go. We’re looking into transplants. I would need both heart and kidney transplants done simultaneously.”

Coach Martinez retired in 2005 from coaching at the College of San Mateo, California, because of his health issues, but he still worked with quarterbacks at camps and on an individual basis. Martinez will always be one of the best coaches from the junior college ranks and is a member of the College of San Mateo’s Hall of Fame.

Facebook can do wonders. Since those announcements by Martinez back in June, he was contacted by eight people who offered Martinez a kidney. Through testing, a suitable donor was found that matched Martinez’s blood type. The heart situation seems to have been corrected through a pacemaker that was adjusted just last week. Now, it seems that Martinez just needs that kidney to keep on going.

After Martinez finishes up with the camp that he’s now visiting, he will return to UCLA for more internal tests to see if he is well enough to undergo the kidney transplant and stated that, “They might try to do a double transplant if everything works.”

This is great news for the football world, his family and those who love him. Most importantly, it’s great news for Coach Martinez. There might be a new young kid out there somewhere with a great throwing arm that needs Martinez’s guidance, and catches Martinez’s eye. Coach Martinez has never walked away from a good challenge, particularly when it comes to quarterbacking, but especially when it comes to his diabetes.

New Discoveries Made in Conquering Kidney Disease in Diabetic Patients: Diabetes and kidney failure go hand in hand. The kidneys do not fail simply because one has either Type 1 or Type 2 diabetes, but the kidneys fail because increased blood sugar levels over time damage blood vessels and the internal organs. Researchers worldwide are seeking to find the answers to why a person develops diabetes, how to stop the complications that arise from having these elevated blood sugar levels caused by diabetes and how to protect the organs. The kidneys, along with the eyes, are at times the main targets of these complications. With the eyes, there is vision loss. With the kidneys, there is kidney failure, which could lead to kidney dialysis. Many people live with the help of kidney dialysis, waiting for a transplant to become available.

According to the latest issue of the Journal of Clinical Investigation, Professor Dr. Tobias Huber, a kidney expert at the Nephrology Division of the University Medical Center Freiburg, Germany (a teaching hospital and medical research unit of the University of Freiburg and well known for its advanced research), along with the help of the Cluster of Excellence BIOSS (Center for Biological Signaling Studies), and his team have been able to make new discoveries as to why the kidneys fail as a result of diabetes.

This new research data was able to identify a signaling path that affects the progression of kidney disease in diabetic patients. mTOR (which belongs to the phosphatidylinositol 3-kinase-related kinase protein family) is a metabolic enzyme that controls the growth and reproduction of cells. Through research, it has been shown that diabetes, either Type 1 or Type 2, causes the mTOR signaling path to become overactive. When the signaling path becomes overactive, it causes damage to the kidney cells which in turn leads to kidney failure.

Basal activation of mTOR may be proven to be vital for the regular function of renal corpuscles during human development, but the overactive mTOR can result in breakdown of kidney filtering in diabetic patients, which eventually leads to the total shutdown of the kidneys.

Using animals for testing, the researchers were able to stop the signaling path and able to stop the kidney disease in its tracks. If applied to diabetic patients with kidney failure in the future, this is a chance for the end of kidney failure in those suffering from any form of diabetes.

Kidney failure affects approximately 288,000 American citizens who are currently undergoing kidney dialysis. Kidney dialysis involves removing waste and excess water from the blood. Like artificial insulin being placed into the body to replace insulin no longer produced by the body, dialysis takes away the excess waste products for people with lost kidney function. Kidney failure can develop over months or years. Acute kidney failure is not reversible and kidney dialysis is required in order for the patient to live. Many consider kidney dialysis as the waiting period until a kidney transplant can be performed.

Through the new research results from Dr. Huber and his team there might be hope on the horizon for those new patients in the future who suffer from kidney failure. This new research information might lead the way for the discoveries necessary to eliminate the need for kidney dialysis. There may be hope that those with diabetes may never have to face the possibility of kidney failure and dialysis.

High-Fat Diet Pregnancy Could Lead to Diabetes in Children: A study created by the University of Illinois suggests that a high-fat diet throughout one’s pregnancy could lead to diabetes in the child even if the mother herself is not a diabetic or even obese.

A University of Illinois professor of nutrition, Yuan-Xiang said, “We found that exposure to a high-fat diet before birth modifies gene expression in the livers of offspring so they are more likely to overproduce glucose, which can cause early insulin resistance and diabetes. He also noted, “The high-fat diet that caused these changes was a typical Western diet that contained 45 percent fat, which is not at all unusual. In recent years, the American diet has shifted to include many high-energy, high-fat, cafeteria-type, and fast foods.”

Based off of the study, researchers hope that doctors will be able to screen newborns through a diagnostic tool in which cam help keep children’s blood sugar in the normal range, which in the end will give them a better chance at lessening the risk of diabetes.

During the study, doctoral student Rita Strakovsky was able to feed obesity-resistant rats with a high-fat or a controlled diet from the first day of their gestation period. The rats were not obese at all, which means they were able to see that the diet alone was very helpful in slowing the risk of diabetes.

Strakovsky said, “At birth, offspring in the high-fat group had blood sugar levels that were twice as high as those in the control group, even though their mothers had normal levels. The high-fat offspring also had epigenetic modifications to genes that regulate glucose metabolism. One of these modifications, the acetylation of histones, acts by loosening the DNA, making it easier for the gene to be transcribed.”

Through the study it was quickly understood that diabetes cannot be stopped but the chances can be lessened with a low-fat diet.

Pan said, “We’d like to see if diet after birth could alleviate this problem that was programmed before birth,” During the study epigenetics was used as the diagnostic tool but Strakovsky states “The importance of making dietary recommendations for pregnant women more available so they are able to prevent this health problem.

She also stated, “Obstetrics patients rarely see a dietitian unless they’re having medical problems like gestational diabetes or pre-eclampsia. Doctors now tend to focus on how much weight a woman should gain in a healthy pregnancy. Although healthy weight gain is extremely important, nutritional guidance could be invaluable for all pregnant women and their babies.”

A pregnant woman’s diet should consist of foods that are low in saturated fats such as fish, walnuts, whole grain bread, poultry, sunflower seeds and eggs. Fast foods, pastries and fattier cuts of meat are all bad, high-fat foods that are leading to more diabetic patients.

Oil Refining Helping Researchers With New Tools For Type 1 Diabetes: In order to control blood sugar, engineering researchers from the Rensselaer Polytechnic Institute are merging automation techniques from oil refining in order to create a closed-loop artificial pancreas.

The reason for this device is so that blood sugar levels can be automatically monitored and insulin can be administered to patients suffering from Type 1 diabetes. After six years of research and studies, Professor B. Wayne Bequette, a member of the Department of Chemical and Biological Engineering at Rensselaer had progressively created more highly advanced control systems for the closed-loop artificial pancreas. Through Professor Bequette work, he hopes to benefit 15,000 children and 15,000 adults who are diagnosed with Type 1 diabetes every single year.

Bequette states: “Every single person with Type 1 diabetes has a different response to insulin and a different response to meals. These responses also vary with the time of day, type of meal, stress level, and exercise. A successful automated system must be safe and reliable in spite of these widely varying responses.”

Like most people, Bequettes fight against type 1 diabetes is very personal to him, given that his little sister developed the disease very early in life. Unfortunately, at that time diabetes wellness was not as advanced as it is today.

A person who had Type 1 diabetes will find themselves with little or no insulin in their pancreas. Due to this, they will have to take insulin injections on a daily basis. Some people who have Type 1 diabetes prefer to use an insulin pump instead. The insulin will help to maintain the blood sugars, for if they do not stay balanced serious life-threatening health problems could occur through hyperglycemic, which means blood sugar is too high and through hypoglycemic, which means blood sugar is too low.

Bequette says, “A key challenge for people living with Type 1 diabetes is the constant monitoring of their blood sugar level. Blood glucose levels are generally measured from a tiny blood sample captured from a finger stick test, prior to eating or sleeping. Another critical challenge is accurately estimating how many carbohydrates they eat. These blood sugar readings, along with the amount of carbs eaten, must be interpreted to decide how much insulin the individual needs to inject. Exercise and fitness also impact the amount of insulin required. Continuous blood glucose monitors are available on the market, but are not yet as accurate as finger sticks tests. There are many judgment calls and best guesses being made on a daily basis by individuals with Type 1 diabetes. And though medical technology for diabetes is very advanced and reliable, he is working on an artificial pancreas that would remove the need for most of this guesswork.”

HbA1C Results Prove Inaccurate For Dialysis Patients: According to a new study at Wake Forest Baptist Medical Center, a test known as the golden standard long-term glucose monitoring test proved to be less valuable in patients who are on dialysis.

The hemoglobin A1C (HbA1c) is administrated to patients over a 3-month period to check blood sugar levels and has become a trusted test in terms of the medical field. It had even been identified as an applicable tool in diagnosing diabetes, according to the American Diabetes Association. However, recently professionals have found that the HbA1c test is not helpful for patients who have been diagnosed with diabetes and are in the advanced stages of kidney failure. Alternatively, the GA assay, aka glycated albumin does appear to be more helpful in that area.

Diabetes is the most common cause of kidney failure worldwide and is associated with high mortality rates — more than 20 percent of dialysis patients die each year. As such, there is an urgent need for accurate blood sugar testing in diabetic dialysis patients.

Barry I. Freedman, M.D., lead investigator of the study and Professor at John H. Felts III said, “Many organs don’t function properly in severe kidney failure. For example, most dialysis patients have anemia with fewer red blood cells than they should, which has a dramatic impact on the accuracy of the HbA1c reading.”

Freedman goes on to say, “Doctors long thought the HbA1c predicted outcomes in diabetes. This test is not predictive of outcomes in diabetes patients with kidney disease on dialysis. Dialysis patients and physicians get a false sense of security because their lower HbA1c actually relates to shorter red cell survival, yet suggests diabetes control is better than it really is.”

This is the way it works. Hemoglobin takes red blood cells through the body, carrying oxygen. Blood sugar will interact with the hemoglobin and come up with HbA1c, which are only accurate when red cells have a regular lifespan. However, dialysis patients have a shorter red cell lifespan, which means the time that sugar is in the blood stream to interact with hemoglobin is reduced and cause less HbA1c values.

During this study, 444 patients suffering from diabetes who also have to undergo dialysis were tested on. While patients continued their normal treatments and were monitored in the amount of HbA1c they also agreed to the GA test every three months for 2.3 years.

Freedman responds the results of the test. “This is the first study showing that a blood sugar test predicts risk of death in diabetic dialysis patients, as well as risk of hospitalization. This test provides the missing link that will allow dialysis patients and physicians to accurately gauge risk. The association is clear: high GA readings predict higher risk.”

More than 24 million Americans suffer from diabetes and being able to monitor blood sugar is one way to manage diabetes. More than 500,000 people are on dialysis in United States alone and diabetes is the cause of almost 50 percent of those with kidney failure. More than 20 percent of patients who suffer from kidney failure die each year.

Master Gene Found To Cause Obesity And Diabetes: According to a study led by a team of King’s College London and the University of Oxford researchers, a “master regulator” gene is being named the culprit of high cholesterol levels and type 2 diabetes in the body.

The regulatory gene has become a lead target in helping to fight off metabolic diseases such as diabetes, obesity and even heart disease. Fat alone is the biggest cause of these diseases.

Through years of continuous study, it had already come to light that the KLF14 gene was linked to type 2 diabetes and cholesterol levels. However, researchers did not know about the role that was being played in which could control other genes positioned further away on the genome.

Over 20,000 genes within subcutaneous fat biopsies in 800 UK female twin volunteers were examined. A connection was found between the KLF14 gene and the expression levels of multiple distant genes that were found in fat tissue. This means that the gene acts as a master switch to control these genes. Six hundred subcutaneous fat biopsies were then confirmed in Icelandic subjects.

These other genes that are controlled by the KLF14 gene are found to be linked to certain metabolic traits like cholesterol, insulin, glucose levels, and BMX (body-mass index).

There are a set of genes that are inherited by the mother and the father, but the KLF14 gene is inherited from the mother. In this instance, the father’s side of the KLF14 for lack of a better world “switched off.” This means that the mother’s gene is the one that is ready and active. This is actually referred to as a process known as imprinting. The KLF14’s ability to control other genes is completely dependent on the mother, as the father’s copy showed nothing.

A professor by the name of Tim Spector who led the MuTHER project to find out what the master gene was capable of had this to say. “This is the first major study that shows how small changes in one master regulator gene can cause a cascade of other metabolic effects in other genes. This has great therapeutic potential particularly as by studying large detailed populations such as the twins we hope to find more of these regulators.”

Another professor, Mark McCarthy also commented. “KLF14 seems to act as a master switch controlling processes that connect changes in the behavior of subcutaneous fat to disturbances in muscle and liver that contribute to diabetes and other conditions. We are working hard right now to understand these processes and how we can use this information to improve treatment of these conditions.”

New System Could Convert Cells Into Making Insulin: Diabetes is a disease of the body that incurs when a person does not have enough pancreatic beta cells, to produce the necessary insulin which is used to regulate their blood sugar levels.

As it stands right now, there is one standard treatment for diabetic patients and that’s insulin therapy. Insulin therapy works by supplying the patient with insulin so that blood sugar levels can be maintained, thereby reducing the risk of high blood sugar levels that cause a number of various diabetic complications such as neuropathy.

With advancements being made all the time in scientific medicine, researchers began to wonder what would happen if they tried to persuade other cells within the body to become pancreatic beta cells. The answer became quite clear when researchers from UCLA’s Larry L. Hillblom Islet Research Center took the scope from asking the question to making it a reality. The researchers found an underlying mechanism that can transform other cells into pancreatic beta cells.

While insulin therapy does work as an effective treatment, pancreatic beta cells are a potential cure for diabetes.

“Our work shows that beta cells and related endocrine cells can easily be converted into each other,” notes study co-author Dr. Anil Bhushan, an associate professor of medicine in the endocrinology division at the David Geffen School of Medicine at UCLA and in the UCLA Department of Molecular, Cell and Developmental Biology.

Throughout history, cells have been construed as being set in place and unable to change or switched to other cells. However, recent studies have proved something much different. This has launched further understanding into what mechanism allows this to happen.

Chemical tags named “methyl groups” are connected to DNA; these chemical tags can turn up and down the activity of different, particular genes. Methyl groups are very important when it comes to understanding how cells can be transformed into pancreatic beta cells. Methyl groups keep a gene called ARX, which triggers the formation of glucagon-secreting alpha cells in the embryonic pancreas, which cannot be seen in beta cells. By deleting an enzyme called Dnmt1 from the insulin-producing beta cells, they can be transformed into alpha cells.

“We show that the basis for this conversion depends not on genetic sequences but on modifications to the DNA that dictates how the DNA is wrapped within the cell,” Bhushan notes. “We think this is crucial to understanding how to convert a variety of cell types, including stem cells, into functional beta cells.”

Artificial Pancreas May Improve Overnight Control of Diabetes in Adults: New trial studies show suggest that an artificial pancreas, also known as closed loop insulin delivery could advance overnight blood glucose control. The studies also show a reduction in nocturnal hypoglycemia, which is a sudden drop of blood glucose levels in the night for patients who have Type 1 diabetes.

Diabetes is a very common illness among the population. Just alone, the United States has more than 26 million diabetic patients. Patients range from women to men, to small children. Diabetes does not pick and choose, it affects everyone. In today’s world, genetics has very little to do with whether or not a person becomes a diabetic. Although the risk factors are greater, with diabetes in an individual’s family history. Diabetes increases yearly and right now the illness stands at a rate of 3 percent of people developing diabetes yearly.

Those who have Type 1 diabetes know that it is no secret that, in order to control diabetes, insulin must be administered. It is a life-long process and while medical science has made some pretty amazing diabetic breakthroughs, it is a pattern that must completed on a daily basis. In order for blood glucose levels to be controlled, a person must use insulin. While this is a common annoyance to those with type 1 diabetes, it is not uncommon for patients to make the best of it and take their insulin. However, when it comes to the night, patients are sleeping. A common problem occurs during the night with many patients, a drop in glucose levels known as hypoglycemia.

Due to the growing issues, researchers have made advances to try and keep those glucose levels maintained. The development of a closed loop insulin delivery, also known as an artificial pancreas has become the answer to so many health issues that result from low blood glucose levels. A closed loop insulin delivery system automatically records insulin dose judging by glucose levels, which are detected by a sensor. Through studies, the system has proven effective on teens and children alike. However, the effect the system has on adults remains unknown.

This trial study was led by Roman Hovorka of the University of Cambridge, who instructed a team of researchers. It consisted of two studies, so that comparison and efficiency of the overnight closed loop insulin delivery with conventional insulin pump therapy in adults with type 1 diabetes could be completed.

Within this trial 24 adults (10 men and 14 women) between the ages of 18 and 65 were studied upon. Every patient has used insulin pump therapy for the previous three months.

Glucose levels increased by 28 percent, with overnight patients who were using the closed loop insulin delivery.

Through this study, evidence was provided that help to prove that an overnight closed loop delivery can work both safely and effectively to help patients sleep better without have their glucose levels drop in the night.

Researchers of this study admit that the closed loop delivery, “may in the future allow more flexible lifestyles in conjunction with improved glycemic control for people with type 1 diabetes.”

Clinical Trial Finds Weight Loss Through An Experimental Drug: Researchers at Duke University Medical Center have found that an investigational combination of drugs that are used to treat epilepsy, migraine and obesity is producing a 10 percent weight loss in patients who were suffering from obesity during a one-year clinical trial.

The treatment was also helpful in other health areas as well. For example, the controlled-release combination therapy, which consists of topiramate and phentermine were also helpful in decreasing blood pressure and hemoglobin A1C levels. Cholesterol, triglycerides and inflammatory markers were also improved during the clinical trial.

“Patients receiving this combination experienced 8.6 percent greater weight loss, on average, compared to those patients receiving placebo,” stated Kishore M. Gadde, M.D., director of Duke’s obesity clinical trials program. “This kind of weight loss, coupled with significant reductions in cardiometabolic risk factors represents a potentially important advancement in the management of obesity.”

Presently, the only drug available for long-term obesity is Orlistat. Orlistat is available over-the-counter known as Alli, and in a prescription strength known as Xenical. During studies, Orlistat, used at its maximum strength has shown a seven pound weight loss over placebos.

“The combination drug achieves about 19 pounds of weight loss relative to placebo at one year,” Gadde says.

During the 56-week trial, 3 studies were conducted in 93 U.S. Centers with more than 2400 patients who all had a BMI of 27-45 kg/m2 and who also had two or more health issues such as heart disease or diabetes. The patients were randomly drawn to either receive either one/two low-dose drug combinations or a placebo. The drugs used in the trial were phentermine, which has been available for treatment of short-term obesity since 1959, and topirmate, which is also known as Topamax. The patients in this study were also offered advice about exercise and diet.

Vivus funded this clinical trial who is also trying to get Qnexa, the name of the combination therapy to be approved by the FDA.  It was first declined in October 2010 because the FDA ruled that the drug could not be approved in its current form. The FDA needed more safety data about the drug. In March of 2011, a warming was issued by the FDA stating that women who were pregnant and taking topirmate were more at risk for having babies that were born with cleft palate or cleft lip. The drug has also been associated with depression, anxiety, mood changes, and memory problems.

During the Qnexa clinical trials, 34 women became pregnant. Gadde states that, “No birth defects were reported for the babies born.” Gadde also stated, “There is no reason for women to use weight loss drugs while they are pregnant or trying to become pregnant.”

Broken down, the study used once-daily doses of the combined drugs listed below.

Phentermine 7.5mg plus Topiramate CR 46mg achieved 7.8 percent weight loss (p<0.0001 vs. placebo).

Phentermine 15mg plus topiramate CR 92mg achieved 9.8 percent weight loss (p<0.0001 vs. placebo). The placebo group experienced 1.2 percent weight loss.

The highest advance in cardiovascular disease and diabetes were seen in high-risk patients among the groups given placebo, phentermine 7.5mg plus topiramate 40mg, or phentermine 15mg plus topiramate 92mg individually:

• Systolic blood pressure: -4.9mmHg, -6.9mmHg, -9.1mmHg
• Diastolic blood pressure: -3.9mmHg, -5.2mmHg, -5.8mmHg
• Total cholesterol: -4.9%, -5.7%, -7.8%
• LDL: -3.6%, 0.7%, -4.3%
• HDL: 2.8%, 9.5%, 10.7%
• Triglycerides: -8.8%, -24.1%, -25.6%
• Hemoglobin A1C in diabetics: -0.1%, -0.4%, -0.4%
• Fasting insulin in pre-diabetics: 6.0pmol/L, -29.2pmol/L, -31.9pmol/LM

The most common side effects in the groups given placebo, phentermine 7.5mg plus topiramate 40mg, or phentermine 15mg plus topiramate 92mg, individually were:

• Dry mouth (2%, 13% and 21%)
• Parethesia (numbness or tingling), (2%, 14%, 21%)
• Constipation (6%, 15%, 17%)
• Insomnia (5%, 6%, 10%)
• Dizziness (3%, 7%, 10%)
• Dysgeusia (distorted sense of taste) (1%, 7%, 10%)

“Although the overall incidence of these events was relatively small,” Gadde says, “clearly there is a dose-related increase in risk.”

“Two thirds of Americans are overweight or obese. For obese patients who have failed to achieve meaningful weight loss with diet and exercise, we have just one treatment before jumping to bariatric surgery. We need more treatment options.”