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Saturday, November 29, 2008

Galvus and Metformin 4X More Effective Than Metformin Alone

The finding in the aforementioned title was presented at the 43rd annual conference of the European Study of Diabetes. The meeting was held in Amsterdam, in the Netherlands. Type 2 diabetes patients who did not achieve their glycemic targets even though they were taking high doses of metformin were given galvus in addition to their metformin treatment. They were found to be four more times liable to reach the recommended goal.

At that time, this drug was projected to receive approval in Europe for marketing purposes. For awhile I wondered whatever happened to it. This is what I found: EU approved Novartis combo drug eucreas as reported in February 2008. The regulators had given the green light to the new combination diabetes drug called eucreas. This contains the inhibitor galvus that was recently approved.
The approval came after Novartis proposed changes to the label. It recommended that liver monitoring should be in place at the beginning of the treatment, and should be conducted every three months for the first year and every so often after this period
The approval was given the go-ahead after the European approval of the galvus that was updated. It will be designated for use with metformin or any of the sulphonylureas. The new European Guidelines for Diabetes says that polypharmacy is the best development in the cure of diabetes.

The combination of drugs is meant to make the treatment more efficient and at the same time lessen the side effects. The European guideline recommends an HbA1c goal of 6.5% while the American Diabetes Association suggests a target of 7%. This is the goal of many approaches on how is diabetes treated.

A principal medical officer at Novartis, USA, Dr. Sylvia Dejager and her colleagues examined the effects of galvus as a monotheraphy and in combination with metformin. They presented their findings at the meeting in the Netherlands saying that when combined with metformin four times more patients achieved the A1c level of 7%.

Saturday, November 22, 2008

Whatever Happened to the Study That Was Granted $10.8 Million

The Columbia University Medical Center received $10.8 million from National Institute of Health last year to study the link between heart disease and diabetes. This multidisciplinary team will find out why those who have type 2 diabetes are vulnerable to heart disease, which is the top cause of death for people who have diabetes.

This will be a five-year program. This all started when Dr. Elizabeth Nabel, director of the National Heart Lung and Blood Institute and Dr. Allen Spiegel, then director of The National Institute of Diabetes and Digestive and Kidney Diseases asked researchers of other fields to get together to study diabetes and heart disease.

Dr. Ira Tabas, professor and vice-chairman of research at Columbia's College of Physicians and Surgeons, Dr. Alan Tall, a professor at Division of Molecular Medicine and Dr. Domenico a co-director of research at Naomi Berrie Diabetes Center agreed to accept the challenge.

Dr. Tabas said that if they could understand better the function of insulin resistance in the development of atherosclerosis, they would be able to develop the appropriate therapies to prevent the terrible effects from these two diseases. Heart disease is the cause of diabetic deaths by 65%, so did the NIDDK report. The risk for heart disease for diabetics is two to four times higher than those without diabetes. The same is true for stroke.

My research did not show any of the aforementioned study but revealed among other studies from the same university the following:

  • Columbia University Medical Center along with the Joslin Diabetes Center and the State University of New York conducted a Telemedicine Research Study.

  • Naomi Berrie of the Columbia University Medical Center will have a study on Telemedicine Research.

  • Columbia University Medical Center reveals that diabetes can result in gum disease in children much younger than previously observed.

As you can tell, there is no mention of the $10 million dollar study on the
link between heart disease and diabetes. With much anticipation, I await the report on the result of this study. It can only advance the knowledge we have on this important issue.

Saturday, November 15, 2008

What Triples the Risk of Developing Diabetes

A major pan-European study reported a while ago that a damaged beta cell in the pancreas that secrete insulin will have a triple risk of developing diabetes even among healthy people. In addition, they also double their risk for developing obese abdomen over a three year period.

These data are arrived at when compared to those whose beta cells are working normally. This RISC (Relationship between Insulin Sensitivity and Cardiovascular risk) study was undertaken to look at the role of insulin resistance in the worsening diabetes and cardiovascular risk factors.

The study observed 1500 middle-aged healthy people from fourteen European countries who are going through regular monitoring for insulin resistance and other risk factors for cardiovascular disease, blood pressure, obesity, lipid levels and physical activity.

After three years, the follow-up data of 784 subjects revealed that insulin resistance was not the only reason for cardiometabolic risk. In addition to insulin resistance, central obesity and obesity contributed to the Insulin Resistance Syndrome with 1% who developed diabetes, 3% having impaired fasting glucose and 12% were observed to have impaired glucose tolerance.

These findings just confirmed the importance of physical activity for this has been found related to better insulin sensitivity . This was found true even in people who have abdominal obesity. And here's another important finding of this study. It also lowered the stiffening of the arterial wall which is age-related.

Mark Walker, professor of molecular diabetes at the University of Castle-Upon-Tyne reported the findings and recommended that the doctors have to persuade all patients whether they are healthy or not to be active physically
as this will lessen the triple risk to develop diabetes.

Do you want to know if you are at risk to develop diabetes? Here's a checklist for you to determine once and for all if you are at risk. The more "yes" responses you have, the more at risk you are. When you find you are at risk, please get tested so you can fight it better:

  • Is there someone in your immediate family with diabetes, like your parents or brothers and sisters?

  • Did you ever have gestational diabetes or have you ever given birth to a baby who weighs more than nine pounds?

  • Is your cholesterol level not normal, that is your HDL cholesterol (good type) below 35 mg/dL, or is your triglyceride level above 250 mg/dL?

  • Are you fairly physically inactive, that is you exercise less than three times a week?

  • Is your ethnic background American Indian, Hispanic American, African American, Alaskan Native or Pacific Islander?

  • Is your blood pressure 140/90 mm Hg or higher or have you ever been told you have high blood pressure?

  • Do you have a history of cardiovascular disease?

  • Have you ever had impaired glucose tolerance or impaired fasting glucose on your previous test?

  • Are you over 45 years old?

  • Are you overweight?

Now you know if you are at risk to develop diabetes. What is the next step? Make an appointment to get tested for diabetes. If they find you have pre-diabetes, get going with a strategy to beat the condition and you will have a better chance at stopping this or delaying its coming. This is how to prevent diabetes.

Saturday, November 8, 2008

Sleep Apnea Improved After Obesity Surgery?

November 8, 2008

Sleep apnea was the topic at the annual Congress of the European Respiratory Society in Stockholm. Two studies were presented that revealed a benefit from obesity surgery over and above the weight loss. It can considerably lessen or stop apnea during sleep. This breathing disruption in sleep can result in snoring and is a known risk factor for cardiovascular disease.

Since obesity is now recognized as a major problem and contribute to such diseases as diabetes, this finding is of importance. With obese people, the fatty tissue around the neck narrows the airway so when the throat muscles relax when sleeping, the airway is narrowed even more. So it is good to lose weight with exercise and a diet that is low in calories. Obviously, this will also help prevent diabetes and delay or stop the complications.

Here's the other side of the equation. It has been found that obesity surgery may not put sleep apnea to rest. They say that sleep apnea oftentimes continues after obesity surgery. What is sleep apnea? In the obstructive type, breathing stops for a short time several times each night. This happens more often to those who are obese but it can also occur to those who are not overweight.

This shows that if the obstructive sleep apnea continues on after the bariatric surgery, then these people are taking a health risk because often they do not know that the condition is still there and I will tell you why in a while. You see this study included 24 adults who were severely obese who spent a night at the Walter Reed Medical Center's sleep lab in Washington, D.C. before surgery and then a year later.

They all lost weight after the surgery although they were still obese but not as much as before the operation. After a year, only one of the participants reported that he did not have the obstructive sleep apnea. The condition was not really changed except that the symptoms improved in different extent. Scroll down to see Sleep Apnea.

All of the participants still needed the machine for help so they can breathe better at night. However, only six of them were using the machine. So here's the answer to why some do not know if they still have the sleep apnea. It's because they snored less after they stopped using the machine.

Sunday, November 2, 2008

November is Declared American Diabetes Month

November 1, 2008

To increase awareness to the millions of Americans who have diabetes or at risk for getting the disease, November has been declared American Diabetes Month. Diabetes is now considered an epidemic so each week in November, the American Diabetes Association will focus on one aspect of the disease. This is what the Vanderbilt Diabetes Center wants to do to spread the news about diabetes awareness, prevention and control.

November 1, 2008
"Dream Big" - Diabetes Family Day
An event for pediatric diabetes patients & their families and friends

November 5, 2008
Brown Bag Lecture
“Diabetes: Who gets it and Why?”
Mike Fowler, M.D.
11:30 am – 12:30 pm
Room 419A Light Hall

November 12, 2008
Brown Bag Lecture
"Diabetes: Basic Information for You & Your Family”
Alvin Powers, M.D.
11:30 am – 12:30 pm
Room C-2209 Medical Center North

November 14, 2008
World Diabetes Day
Wear BLUE with Vanderbilt Diabetes 
Staff & Faculty to show your support!

November 17, 2008
Blood Sugar Screening with Health Plus
10:00 a.m. – 2:00 p.m.
North Lobby of Light Hall

November 19, 2008
Blood Sugar Screening with Health Plus
10:00 am – 2:00 pm
VU Law School, Ray Room #151

Last year the American Diabetes Association had all these activities:

November 1-3 was devoted to the caregivers. These are the main supporters of loved ones who suffer from diabetes and so are faced with so many challenges. Let's hope they will be given the support they need themselves.

The employees was the focus on November 4-10. Encouraging the adoption of healthy lifestyle in the workplace will be the key component of this week. This will not only prevent type 2 diabetes and the complications, but it will also help the companies improve their bottom line each year.

Considering the diabetes around the world was the topic for November 11-17. Over 246 million people are afflicted by diabetes and this number is expected to grow to 350 million by 2020. It is not too late to do something about it. Let us all help stop this trend. The power is in our hands to prevent diabetes.

November 18-24 dealt with the population that is at risk. The statistics now stands at one in two members of minority groups born after 2000 will develop diabetes if the present trend keeps going on. Let's accept the challenge and stop this trend by encouraging others to adopt a healthy lifestyle.

The ones who need the most vital care are the youth and Type 1 diabetes. ADA made the resources available for these youth and their families. I didn't see this released. Had I found it, you would have been the first to know. I know they worked hard assembling all the materials and networking facilities for this group.

ADA supports the United Nations' resolution on diabetes which invites everybody to fight this epidemic by making people aware of this. Let's do our share and accept this invitation. Let us let people know of this epidemic by making themselves aware of things they can do now to prevent diabetes and its complications.

Let us spread the word far and wide and reach as many people as we can not only on the United Nations' World Diabetes Day on November 14. In other words, let's make every day a Diabetes Day by contributing in our small way to spread the word to all we know. Our small ways put together equals one giant step to beat diabetes.