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The Hottest Diabetes Research
The Hottest Diabetes Research -- Posted by Gumbo on 10-24-04 12:39
The Hottest Diabetes Research
Originally Published:20041001.
The Latest On Islet Transplants
Type 1
When researchers in Edmonton, Alberta, introduced their protocol for islet
transplantation to the world in 2000, they began writing a book of hope for
people with type 1 diabetes. Since then, research centers around the world
have been adding to the story, with centers in the United States, Canada,
and Europe using the protocol to transplant human islet cells into people
who have an unstable form of type 1. The islets are injected into the portal
vein to the liver, where they function as the islets in a healthy pancreas
would by producing insulin as needed.
The latest chapter is a happy one: Nineteen of 36 trial participants in the
Immune Tolerance Network have remained free of insulin shots for as long as
a year after their transplants. Five of them required only one infusion of
islets, seven required two infusions, and seven required three infusions.
Seven of the remaining participants who are still taking insulin are taking
it at lower doses, on average, than before their transplants. Four more
participants withdrew from the trial before the protocol could be completed,
leaving only six participants whose islet transplants failed entirely.
Although recipients of islet transplants must take powerful
immunosuppressive drugs for the rest of their lives, the researchers who
developed the Edmonton Protocol regard the latest results as a sign of
progress.
"In the years ahead, as we enroll further patients, we look forward to
exciting new approaches that will prevent rejection without the need for
immunosuppressive drugs and to increasing [the procedure's] efficiency so
that we can routinely have success with one infusion," says James Shapiro,
MD, PhD, Director of the Clinical Islet Transplant Program at the University
of Alberta, Edmonton, and principal investigator of the study.
Kids, Snacks, and Nighttime Lows
Type 1
If your child has been experiencing nighttime lows or morning highs, you
might want to change his or her bedtime snack, say researchers in Quebec
City, Quebec, Canada.
In a study of 29 children between the ages of 6 and 10, researchers found
that adjusting the nutrient content in a child's bedtime snack based on the
child's blood glucose level at bedtime can affect the risk of nighttime lows
and morning highs.
The children were divided into two groups, a control group and a treatment
group. In the control group, the bedtime snack was comprised of 200 calories
(30 grams of carbs, 6.5 grams of protein, and 6 grams of fat) regardless of
the child's bedtime blood glucose level.
In the treatment group, bedtime snacks were adjusted according to bedtime
blood glucose levels. If a child's bedtime blood glucose was less than 126
mg/dl, his or her bedtime snack was 200 calories (18 grams of carbs, 18
grams of protein, and 6 grams of fat). If bedtime blood glucose was between
127 mg/dl and 216 mg/dl, the bedtime snack was the same as the control
group: 200 calories (30 grams of carbs, 6.5 grams of protein, and 6 grams of
fat). If bedtime blood glucose was higher than 216 mg/dl, the snack was half
of that in the control group, at 100 calories (15 grams of carbs, 3 grams of
protein, and 3 grams of fat). The insulin dose for each child remained the
same throughout the study.
Each child was studied for two to five nights, and his or her blood glucose
was checked at bedtime, 11:00 p. m., 2:00 a.m., and in the morning.
Over the course of the study, there were 15 instances of night lows in the
control group, compared with only eight in the treatment group.
Morning blood glucose differed as well. There were 17 instances of high
blood glucose in the control group and 13 in the treatment group. What's
more, children in the control group whose bedtime blood glucose was higher
than 216 mg/dl and who ate the standard snack had more morning highs than
their counterparts in the treatment group who ate the smaller snack.
In a nutshell, the higher the blood glucose at bedtime, the smaller the
snack. If you think adjusting your child's bedtime snack may help him or her
avoid nighttime lows and morning highs, ask your family health care provider
about it.
Blood Glucose And Your Bones
Type 2
High blood glucose can accelerate bone loss in older women with type 2, say
researchers from several centers across the United States who analyzed data
from the Health, Aging, and Body Composition Study. When reviewing the
histories of 461 men and women between the ages of 70 and 79 with diabetes,
they found that those with A1Cs higher than 8 percent lost more bone density
over the course of four years than those whose A1Cs were lower than 8
percent.
At the beginning of the study, those with A1Cs higher than 8 percent had
greater bone mineral density in their hips as shown by bone scans. They
weighed more than their counter-parts with lower A1Cs, as well.
Bone scans of the participants' hips four years later revealed that bone
loss was greatest among women with A1Cs higher than 8 percent. (Men with
A1Cs higher than 8 percent lost bone mineral density faster than their
counterparts with lower A1Cs, but the researchers felt the difference was
negligible.) Among all participants, those with higher A1Cs were less likely
to take calcium supplements and more likely to take diabetes medications.
Among the women, those with higher A1Cs were less likely to take estrogen.
(Estrogen therapy is generally not recommended solely for the treatment or
prevention of osteoporosis as the potential side effects may outweigh the
benefits.) The researchers conclude that "among women with diabetes, poor
glycemic control is a risk factor for bone loss."
Hoofing It To Prevent Neuropathy
Type 2
If you want to cut your risk of painful diabetes-related nerve damage
(neuropathy), start walking.
In a four-year study of 78 men and women with type 2 in Rome, Italy,
researchers divided the participants into two groups. Thirty-one
participants (the exercise group) walked briskly for not less than four
hours a week. The remaining 47 (the control group) remained sedentary. None
of the participants had signs of neuropathy at the beginning of the study.
Among those in the control group, over four years almost 30 percent
developed sensory neuropathy, which causes symptoms ranging from burning and
tingling to numbness; 21 percent experienced changes in their ability to
perceive vibration; and 17 percent developed motor neuropathy, which causes
weakness and loss of dexterity.
However, in the exercise group, only 6.5 percent developed sensory
neuropathy, about 13 percent experienced changes in their ability to
perceive vibration, and not one developed motor neuropathy.
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