Tag Archives: Insulin

Diabetics

Definition:
Diabetes mellitus, or simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced.  This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst), and polyphagia (increased hunger).

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There are three main types of diabetes mellitus (DM).

*Type 1 DM results from the body’s failure to produce insulin, and currently requires the person to inject insulin or wear an insulin pump. This form was previously referred to as “insulin-dependent diabetes mellitus” (IDDM) or “juvenile diabetes”.

*Type 2 DM results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. This form was previously referred to as non insulin-dependent diabetes mellitus (NIDDM) or “adult-onset diabetes”.

*The third main form, gestational diabetes, occurs when pregnant women without a previous diagnosis of diabetes develop a high blood glucose level. It may precede development of type 2 DM.

Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.
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Diabetes has no age bar. It can appear in a newborn, children, young adults, during pregnancy or in older people. If there are suspicious symptoms, tests should be done.

Some families have a tendency to develop diabetes, with many members being affected. This is because it is a genetic disease that an be inherited from both parents. Type 1 and 2 diabetes are inherited from multiple genes. In type 2 diabetes particularly, the environment and family’s dietary and exercise habits also influence these genes. Families that eat “well” and are sedentary with snacking and excessive TV viewing are more likely to develop type 2 diabetes. Sometimes type 1 diabetes can develop in persons without a family history or genetic predisposition. It may follow viral infections, especially with the mumps and coxsackie group of viruses. The virus attacks and destroys the cells in the pancreas responsible for manufacturing insulin.

There is now a third type of diabetes, where the mutation occurs in a single gene. This gene is dominant, so that if either parent carries it, then half the children (male and female) will be affected. It was called MODY (maturity onset diabetes of youth). The diabetes affecting newborn children is of this type.

Initially, MODY was called type 1.5 diabetes and it was presumed that it was caused by only one type of genetic defect. Recent research has shown that there are 13 defects that lead to MODY.

*It is likely to be present in people who have been diagnosed with diabetes before the age of 30.

*It is present in every generation of the family.

*It can be managed with diet, exercise and tablets. Insulin is usually not required (even in children).

*MODY (depending on the type) can result in the affected woman having small or large babies.

* There may be cysts in the kidney.

* Malabsorption can occur.

* Patients may be infertile.

The incidence of MODY is higher in areas where there is a great deal of consanguinity (marrying a close relative) and when people marry generation after generation from the same community.

It is now possible to test for MODY genes in many centres and identify high-risk individuals and families.

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Symptoms:
The classic symptoms of untreated diabetes are loss of weight, polyuria (frequent urination), polydipsia (increased thirst), and polyphagia (increased hunger). Symptoms may develop rapidly (weeks or months) in type 1 diabetes, while they usually develop much more slowly and may be subtle or absent in type 2 diabetes.

Prolonged high blood glucose can cause glucose absorption in the lens of the eye, which leads to changes in its shape, resulting in vision changes. Blurred vision is a common complaint leading to a diabetes diagnosis. A number of skin rashes that can occur in diabetes are collectively known as diabetic dermadromes.

Causes:
The cause of diabetes depends on the type.

Type 1

Type 1 diabetes is partly inherited, and then triggered by certain infections, with some evidence pointing at Coxsackie B4 virus. A genetic element in individual susceptibility to some of these triggers has been traced to particular HLA genotypes (i.e., the genetic “self” identifiers relied upon by the immune system). However, even in those who have inherited the susceptibility, type 1 DM seems to require an environmental trigger. The onset of type 1 diabetes is unrelated to lifestyle.

Type 2

Type 2 diabetes is due primarily to lifestyle factors and genetics.[16] A number of lifestyle factors are known to be important to the development of type 2 diabetes, including obesity (defined by a body mass index of greater than thirty), lack of physical activity, poor diet, stress, and urbanization.[4] Excess body fat is associated with 30% of cases in those of Chinese and Japanese descent, 60-80% of cases in those of European and African descent, and 100% of Pima Indians and Pacific Islanders. Those who are not obese often have a high waist–hip ratio.

Dietary factors also influence the risk of developing type 2 diabetes. Consumption of sugar-sweetened drinks in excess is associated with an increased risk.  The type of fats in the diet is also important, with saturated fats and trans fatty acids increasing the risk and polyunsaturated and monounsaturated fat decreasing the risk.  Eating lots of white rice appears to also play a role in increasing risk.  A lack of exercise is believed to cause 7% of cases.

The following is a comprehensive list of other causes of diabetes:

*Genetic defects of ?-cell function
*Maturity onset diabetes of the young
*Mitochondrial DNA mutations

*Genetic defects in insulin processing or insulin action
*Defects in proinsulin conversion
*Insulin gene mutations
*Insulin receptor mutations

*Exocrine pancreatic defects
*Chronic pancreatitis
*Pancreatectomy
*Pancreatic neoplasia
*Cystic fibrosis
*Hemochromatosis
*Fibrocalculous pancreatopathy

Diabetes has no age bar. It can appear in a newborn, children, young adults, during pregnancy or in older people. If there are suspicious symptoms, tests should be done.

Some families have a tendency to develop diabetes, with many members being affected. This is because it is a genetic disease that an be inherited from both parents. Type 1 and 2 diabetes are inherited from multiple genes. In type 2 diabetes particularly, the environment and family’s dietary and exercise habits also influence these genes. Families that eat “well” and are sedentary with snacking and excessive TV viewing are more likely to develop type 2 diabetes. Sometimes type 1 diabetes can develop in persons without a family history or genetic predisposition. It may follow viral infections, especially with the mumps and coxsackie group of viruses. The virus attacks and destroys the cells in the pancreas responsible for manufacturing insulin.

Diagnosis:
Diabetes is diagnosed with blood tests. Blood sugar count after a 12 hour fast should be less than 100mg/dl and two hours after a full meal less than 140 mg/. Glycosolated haemoglobin (HbA1 c) should be 5.6.

A GTT (glucose tolerance test) can be done in suspect cases. In this the fasting blood glucose level is checked and 75gm glucose given. The blood is checked every 30 to 60 minutes after that. One hour later the blood glucose level should be lower than 180 mg/dL, two hours later less than 155 mg/dL, and three hours later lower than 140 mg/dL.

Complications:
Uncontrolled, untreated, neglected diabetes of all types causes complications with the nervous system, heart, kidneys, eyes and muscles affected.

All forms of diabetes increase the risk of long-term complications. These typically develop after many years (10–20), but may be the first symptom in those who have otherwise not received a diagnosis before that time. The major long-term complications relate to damage to blood vessels. Diabetes doubles the risk of cardiovascular disease. The main “macrovascular” diseases (related to atherosclerosis of larger arteries) are ischemic heart disease (angina and myocardial infarction), stroke, and peripheral vascular disease.

Diabetes also damages the capillaries (causes microangiopathy). Diabetic retinopathy, which affects blood vessel formation in the retina of the eye, can lead to visual symptoms including reduced vision and potentially blindness. Diabetic nephropathy, the impact of diabetes on the kidneys, can lead to scarring changes in the kidney tissue, loss of small or progressively larger amounts of protein in the urine, and eventually chronic kidney disease requiring dialysis.

Another risk is diabetic neuropathy, the impact of diabetes on the nervous system — most commonly causing numbness, tingling, and pain in the feet, and also increasing the risk of skin damage due to altered sensation. Together with vascular disease in the legs, neuropathy contributes to the risk of diabetes-related foot problems (such as diabetic foot ulcers) that can be difficult to treat and occasionally require amputation. Additionally, proximal diabetic neuropathy causes painful muscle wasting and weakness.

Several studies suggest a link between cognitive deficit and diabetes. Compared to those without diabetes, the research showed that those with the disease have a 1.2 to 1.5-fold greater rate of decline in cognitive function, and are at greater risk.

Treatment:
The major goal in treating diabetes is to minimize any elevation of blood sugar (glucose) without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with insulin, exercise, and a diabetic diet. Type 2 diabetes is treated first with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugars, oral medications are used. If oral medications are still insufficient, treatment with insulin is considered.

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A change in lifestyle goes a long way in preventing the onset of diabetes and controlling it after it sets in. These guidelines are particularly important if you have MODY or feel that you or your family members are in danger of developing it.

Prevention:
To prevent development of the disease as an adult, it is our children who need to be targeted for intervention. Lifestyle changes — a healthy diet and regular exercise — should be implemented at the school level.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Diabetes_mellitus
http://www.medicinenet.com/diabetes_treatment/article.htm
http://www.telegraphindia.com/1131118/jsp/knowhow/story_17579340.jsp#.UolfgL4o52Y

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Diabetes Stem Cell Therapy Patients Show Remarkable Improvement

Cellonis, a Beijing and HK-based biotech company, with its new personalized diabetes treatment concept has demonstrated an amazing improvement in their treated patients’ conditions. The ongoing clinical study shows the treatment’s best case could reconstruct a patient’s natural insulin production and even reverse later complications like kidney failure. Treated patients may have the chance to return to the normal activities non-diabetes sufferers take for granted.

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The clinical study, jointly conducted by scientists and doctors of the Cellonis clinical research team, aims to help patients be free from insulin and oral drugs, by reconstructing their natural insulin production damaged by either autoimmune disorder (T1DM) or hyperglycemia and also improve insulin sensitivity (T2DM). Using injections of autologous stem cells from the patient’s bone marrow, the research team believes that this therapy could help patients return to a life without annoying everyday injections and drugs.

“Most of the patients in our clinical study are now taking less synthetic insulin or oral drugs for BG control,” says Dr. Chase Dai, Chief Medical Officer at Cellonis. “We appear to have restored the biological insulin producing function of the body. We are excited to see that some patients have been treatment-free for five months now, and we believe the effect of the stem cell therapy can last much longer. We were also encouraged by some other happy surprises during the clinical study.

“For example, this therapy appears to reverse chronic kidney failure. It was a surprise for all of my team to observe that the kidney function of a 75- year-old patient improved remarkably.”

This patient had suffered from diabetes for years, gradually developing diabetic foot and nephropathy. He can now walk freely after having been confined to bed or a wheelchair for six months, and his quality of life has improved significantly. Moreover, he only needs kidney dialysis one time a week instead of three times. In a follow-up visit he excitedly told us that he was hopeful that in the near future he could be completely rid of diabetes.

Diabetes, an increasingly spreading disease, can lead to life-threatening diseases such as blindness, amputation, strokes, or kidney failure in its natural course. Current treatments, including insulin, cannot change this situation.

“We believe that our stem cell therapy will bring promising hope for patients suffering from diabetes and its complications,” comments Cindy Hao, CEO of Cellonis. “Personalized diabetes therapies for patients of various conditions will be developed by Cellonis in the near future. We believe what we have restored for patients will not only be their natural insulin production, but also a normal life filled with the activities non-diabetes sufferers can enjoy daily.”

Cellonis Biotechnologies focuses on R&D and the clinical application of novel personalized stem cell therapies and immunotherapies for patients with diseases including cancer, diabetes and central nervous system disorders.

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Diabetes Hope – Successful Pilot Study of Immature Adult Stem Cells

RESEARCH FROM 90?S CURES TYPE 1 DIABETES!

Pancreas cells to produce insulin

Source: Elements4Health June 24th. 2010

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A protein, a by-product of natural insulin production, reduces heart complications in diabetics.  Reports on the outcome of a new study :-

Doctors have known for a long time that diabetes is one of the major risk factors for heart disease. If uncontrolled sugar levels persist for long, the blood vessels can become leaky. Such a condition allows cholesterol to seep in. And when cholesterol builds up inside the arterial blood vessels, they thicken from inside, reducing and eventually blocking the blood flow, leading to atherosclerosis.

Thanks to sustained campaigning over the years, most people now know that diabetes is also bad for the heart.

However, what many people do not know is that an inadvertent fallout of certain treatment methods can be detrimental to the heart’s functioning. A case in point is insulin therapy. One of the last resorts in diabetes management, the hormone insulin is administered either through a subcutaneous injection or by using a self-controlling pump attached to the body.

But this externally supplied insulin, for reasons not yet known, causes some cells in the blood vessels to grow more than they should, leading to a narrowing of their passageway to the heart.

A consequence of this, as some studies have shown, is that diabetics on insulin who have undergone bypass surgery are likely to have their newly grafted veins blocked earlier than non-diabetic heart patients.

But now a team of vascular biologists at the University of Leeds in the UK has found that a small protein, which was long thought to have been a useless by-product of natural insulin production in the pancreas, can ameliorate this undesirable side effect of insulin treatment.

Led by Karen Porter of the Leeds Institute of Genetics, Health and Therapeutics (Light), the researchers found that C-peptide, a natural by-product of insulin production, has a role to play in nature’s scheme of things and hence is not as “useless” as it is made out to be.

When C-peptide was given along with insulin, as happens in normal people who are not diabetic, the excessive growth and movement of cells was completely stopped, they report in the latest issue of the journal Diabetologia. “We found that administering insulin with C-peptide — which is released naturally in partnership with insulin in healthy people — appears to protect blood vessels from this damage,” says Porter.

Though insulin has been in use as medication since the 1930s, research till very recently failed to ascribe any role to C-peptide, insulin’s natural “partner”.

As a result, it was never incorporated in externally supplied insulin. In the 1970s though, some scientists briefly wondered if diabetics might be suffering from a lack of C-peptide. Subsequent studies, however, didn’t help much as they failed to ascertain any beneficial effect.

For instance, a study in 1993 by Julio Santiago of the Washington University who injected diabetic patients with low levels of the protein — just enough to match normal levels — saw no effect.

“Patients with diabetes are known to have higher cardiovascular risk and some will require coronary artery bypass grafting, using a vein from the leg. Patients donated these veins, left over after their operations, for research and we found that insulin on its own caused the cells lining these veins to go into an overdrive, with increased growth and movement that we know contribute to blockages. We were really surprised as to how powerful C-peptide was — it completely took away this insulin effect,” explains Porter.

“The study shows us a new path, wherein thickening of arteries — which is sometimes induced by insulin itself — could be decreased by giving C-peptide. This has huge relevance for the treatment of heart disease in patients with diabetes,” says Anoop Misra, head of internal medicine at New Delhi’s Fortis Hospital.

However, Nihal Thomas, an endocrinologist at the Christian Medical College, Vellore, says the idea that an additional peptide may augment the action of insulin is not entirely new. Previous studies with peptides such as IGF1 (insulin-like growth factor-1) and GLP-1 (glucagon-like peptide- type 1) have shown similar benefits.

Moreover, the mechanism works at a cellular level in laboratory studies. “It needs to be established over a period of time through extensive human clinical trials to assess its clinical viability,” he adds.

But if the trials were to become successful in the next few years, a large number of diabetics all over the world will benefit from it.

It will be especially welcome in India, which is home to more than 40 million Type 2 diabetic patients.

This more common form of diabetes, associated with obesity and a sedentary lifestyle, results in the pancreas overworking and eventually failing. These patients will require insulin therapy over time. For instance, some 5 per cent of Indian diabetics are on insulin. Those suffering from Type 1 diabetes need insulin therapy at a much earlier stage.

“The number of people affected by diabetes each year indicates the problem is here to stay. Patients can generally learn to manage and live with their diabetes but heart disease is a complication that kills,” says Porter.

As has been shown by the Light researchers, a combination of insulin and C-peptide may provide a more effective treatment than insulin alone in controlling some of the cardiovascular complications associated with diabetes.

Source:
The Telegraph ( Kolkata, India)

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‘Spoonful of Sugar’ Makes The Worms’ Lifespan Go Down

If worms are any indication, all the sugar in your diet could spell much more than obesity and type 2 diabetes. Researchers reporting in the November issue of Cell Metabolism say it might also be taking years off your life.
……………………11_24sugar
By adding just a small amount of glucose to C. elegans’ usual fare of straight bacteria, they found the worms lose about 20 percent of their usual lifespan. They trace the effect to insulin signals, which can block other life-extending molecular players.

Although the findings are in worms, Cynthia Kenyon of the University of California, San Francisco says there are known to be many similarities between worms and people in the insulin signaling pathways department.

As an aside, Kenyon says she read up on low-carb diets and changed her eating habits immediately — cutting out essentially all starches and desserts — after making the initial discovery in worms. The discovery was made several years ago, but had not been reported in a peer-reviewed journal until now.

You may click to see :Avoiding Sweets May Spell A Longer Life, Study In Worms Suggests

Resources:
ScienceDaily November 5, 2009

Cell Metabolism November 2009;10(5):379-91

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Coconut Oil Could Ward Off Type 2 Diabetes.

Diet Rich  Coconut Oil Could Stop Type 2 Diabetes.  A diet rich in coconut oil could ward off Type 2 diabetes.

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The oil, used in foods such as margarine, helps prevent insulin resistance.

This is where muscle and fat cells stop reacting to insulin, the hormone that helps to mop up excess sugar in the blood.
Australian scientists used mice to compare the effects of coconut oil-rich foods with a lard-based diet, consumed by many in the developed world.
The results showed coconut-fed mice were much less likely to develop resistance to insulin. Previously, coconut oil has had a mixed reception because it is high in saturated fat, which is linked to high cholesterol.

But coconut fat is now known to be made up of so-called ‘medium chain’ fatty acids, regarded as healthier than the long-chain fatty acids found in animal products such as butter or lard.

Source: Mail online:23rd. Sept. 2009

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