Airway Obstruction During Sleep Causes Death of Pancreatic Beta Cells

January 4, 2008

Researchers found that alternating hypoxia results in death of the pancreatic beta cells and resistance to insulin three more times in animals they studied at the School of Medicine of the University of Louisville in Kentucky. This raises the chance of developing type 2 diabetes.

What is intermittent hypoxia? It is the symptom of OSAS (obstructive sleep apnea syndrome). In this condition, there is a repeated obstruction in the upper airway during sleep. Those who have severe OSAS can have as many as 30 episodes of this in an hour. This affects 2 - 5% of the population.

Conducting this study at the diabetes lab of Professor Paul N. Epstein, Dr. Jianxiang Xu found the connection between the death of beta cells and hypoxia. At the start of the research, he treated mice with intermittent hypoxia continuously for 24 hours.

He found that compared to the control group, these mice showed increased proliferation of the beta cells four times. The death of the beta cell also increased three times. These mice also showed resistance to insulin. Thus it is possible that this could also happen to humans with sleep apnea. More studies on this are indicated.

Diabetes Drug Receives FDA Approval

Depomed received FDA approval for Glumetza. It is metformin hydrochloride tablet. It could be taken alone or in combination with insulin or sulfonylurea for those who are 18 years old and over who have type 2 diabetes.

When taken in addition to diet and exercise it will help improve the glycemic control of type 2 diabetics. I am glad they have not forgotten to include eating healthy and adequate physical activity to help in maintaining glycemic control.

The president and Chief Executive officer of Depomed, Carl Pelzel said that they now have two ways for the diabetics to make their glycemic control better. This company obtained the exclusive rights in the United States to the Glumetza formulation of 1000 mg.

Depomed previously obtained this exclusive right from Biovail in December 2005. Regarding the formulation, they have an agreement with Biovail. So now they have the two ways to improve the glycemic control. One is their Glumetza tablets of 500 mg and now this 1000 mg tablet.

The original Glumetza which is the 500 mg tablet starts out as small. It is easy to swallow and once it reaches the stomach, it expands. With the 1000 mg tablet, it will need less pills to reach the target dose. Carl Pelzel took over the position of Dr. John Fara who retired but will remain as director and consultant of Depomed.

Depomed has also reached an agreement with Watson Pharmaceuticals. It is some kind of agreement that is of the co-promotion kind. It is for ProQuin XR for the treatment of simple and basic urinary tract infections. Both will get some profit from this agreement.

Inadequate Sleep May Increase Risk for Type 2 Diabetes

Ability to regulate blood glucose level is lowered with inadequate deep sleep. University of Chicago Medical Center's researchers report that this raises the type 2 diabetes risk. This report is available online in the Proceedings of the National Academy of Science.

What is deep sleep? It is that stage of sleep that is considered as the most healing. Also known as slow-wave sleep, its benefit has not been studied until this research found out that after three nights of inadequate deep sleep, healthy adults turned out to be less responsive to insulin.

Despite the need for more insulin to get rid of the equal amount of glucose, the study participants' secretion of insulin did not go up to make up for the lowered sensitivity. This led to lower glucose tolerance which raised their risk for type 2 diabetes. The lower sensitivity to insulin is just like the one caused by a 20 to 30 pound increase in weight.

University of Chicago's assistant professor of medicine, Esra Tasali, MD who is the lead author of this research said that their finding showed that deep sleep has a role in regulating glucose control. Inadequate deep sleep had a negative effect on sensitivity to insulin and tolerance to glucose.

The findings show that strategies to improve the quality of sleep should be in place to prevent or at least delay type 2 diabetes to those who are at risk. This is the opinion of the University of Chicago's professor of medicine, Eve Cauter, PhD who is also the study's senior author.

The participants were nine healthy lean men and women who were between the ages 20 and 31. They spent two nights at the sleep laboratory going to bed at 11 pm with undisturbed sleep which was monitored until 8 and a half hours later.

The same participants were also watched for three nights with the same time schedule but when they were going into deep sleep, sounds through speakers that were loud enough to disturb their sleep but did not fully wake them up were administered.

The researchers gave glucose intravenously to the participants after each study and took sample of blood to check the glucose level and insulin. They found that after only three nights of inadequate sleep, the healthy participants became less responsive to insulin by 25%.

What You Need to Lose Weight in 2008

ADA (American Diabetes Association) has released its new recommendations for clinical practice regarding weight loss for this year. If you still don't know what plan to follow in order to lose weight, check out what ADA is recommending.

We know that ADA has revised its stand on low fat and low carb diets. It is now saying that both are effective in losing weight although they specified the duration as short term, meaning for up to one year. Perhaps that's all they have for a track record but it could also be that ADA says it is more crucial for people to stick to it.

Be realistic in setting the weight-loss goal. It is not good to set the goal up high for it may set the stage for failure. Think only of losing 5 to 15 pounds but keep them off instead of having them go up and down like a yoyo. Adhering to the goal is the most important factor for success.

Here are some tips from ADA:

. Monitor the physical activity as to how much and how often do we exercise, honestly.

. Monitor how much, what and when we eat and drink.

. Change eating habits gradually. Eat responsibly.

. Get a support system among family, friends and co-workers.

Monitor your health while trying to lose weight. Low carb diets for example may substitute calories from carbohydrates with protein or fat so check the cholesterol and triglycerides levels. Also, high protein consumption may exacerbate kidney problems, so consult with your doctor.

The Diabetes Prevention Program has a weight-loss plan in sixteen sessions. It works because it follows ADA guidelines. It is not a lose-weight quick program. Head down to Blogging for Diabetes and You
and follow the program.

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Resveratrol Benefit Revealed by a New Study

What is resveratrol? It is an antioxidant that Baywood International said may work against type 2 diabetes. It is found in red wine and a new study reports that it reduces the resistance to insulin in mice. Blood sugar is controlled by insulin and so when the body turns out to be less responsive to this hormone it can lead to type 2 diabetes.

Shanghai's Chinese Academy of Sciences researchers Qiwei Zhai and Cheng Sun said that this finding is an important line of attack for treating type 2 diabetes and insulin resistance. This has been proven in mice and if the same result is found in people, then creating new compounds of resveratrol is a possibility.

For now, people will have to consume a large amount of red wine, about three liters a day to get enough resveratrol which translates to 15 milligrams but Zhai said the scientists do not recommend for people to depend on wine to correct their resistance to insulin.

Sun and team found that mice which were resistant to insulin became more responsive when resveratrol was given to them. Their experiments showed that resveratrol stimulated a gene to become more energetic which helped boost the sensitivity to insulin.

Baywood International Inc. introduced Resveratrol Life Tonic that contains 300 mg of resveratrol extract per one ounce of serving of this tonic. This translates to 1300 glasses of red wine. The launch was made during the third quarter of this year.

Baywood International Inc. distributes its products through chain health food stores, grocery stores and natural food stores. It is a nutraceutical company that develops, markets and distributes its own brands in Canada, Dubai, England and other countries as well.

Annual ADA Clinical Recommendations for 2008 Issued

For the health care teams to treat diabetics with the latest facts available, ADA (acronym for the American Diabetes Association) has released its yearly recommendations for the clinical practitioners. This ensures the best possible treatment for people with diabetes.

This coming year will see a significant change in the section of Medical Nutrition Therapy concerning loss of weight. While previously the American Diabetes Association did not recommend low carb diets due to lack of proof that it is effective and safe, the recommendations for 2008 shows otherwise.

The recommendations for the year 2008 now acknowledges the rising proof that low carb and low fat calorie consumption are effective in the loss of weight. The 2008 document on the Standards for Medical Care in Diabetes reviews the growing proof that either of the two ways to lose weight is effective.

However, ADA adds that the most important factor in weight loss is not the diet itself but rather it is the determination of the people concerned to adhere to it. Some will be able to follow the low carb diet while others will stick to the low fat diet better.

ADA still stresses that maintaining a moderate but sustained loss of weight along with more physical activity is important for overweight or obese people with diabetes or at risk for the condition. ADA's president of Health Care and Education, Ann Albright, PhD, RD, said the risks for obesity and overweight are real.

While there is proof that both diets are effective in losing weigh, ADA is not endorsing either. Rather, they just want the health care team to know the importance of the patients' choice of what works for them, support this and make health monitoring available.

"The Diabetes Educator" Centers on Diabetes Management

Diabetes management is the focus of "The Diabetes Educator". And no wonder because if this is adhered closely, many of the complications can be avoided. It takes time, that's true, but isn't health worth the effort and time placed on this? Just think of all the things that can be avoided: blindness, kidney disease, heart attack, stroke, and amputations. Need we say more?

So let's see what diabetes management entails. Studies are systematically reviewed and assessed critically whether they investigate the patient benefits who follow the seven behaviors which is identified as the AADE7. Researches were thoroughly assessed using the review criteria.

AADE director of communications, Diana Pihos, said that the American Diabetes Association adopted these criteria in reviewing studies to recognize their weaknesses and strengths to see which strategies will help the diabetes educators educate diabetics regarding behaviors of self care.

The shortfalls were identified in the existing data for each of the seven behaviors so that future researches will be able to fill the gap. The studies in the future will then be guided appropriately as to the direction they should take.

We have been concentrating on these seven behaviors in our website, hoping and encouraging self care behavior. We do believe that if these seven behaviors are religiously adhered to, many complications can be avoided. It will be good to keep a checklist and evaluate one's daily activities as to whether these seven behaviors have been adhered to:

. physical activity or move more

. eat healthy

. monitor glucose level

. take medications as prescribed

. solve problems as they come

. cope with health issues

. reduce risk

Uninsured Patients Improved Health After Receiving Medicare Coverage

JAMA (acronym for the Journal Of the American Medical Association) published an article in its December issue saying that those who were not insured before improved their health after getting Medicare coverage. The article said this was especially true for those with cardiovascular disease and diabetes.

It was clear that that those who were 65 and over sought medical help more often than those who were near 65 who did not have medical coverage yet. This near elderly group therefore experienced worst health due to medical coverage they could not afford.

Researchers from Harvard Medical School and Brigham and Women's Hospital studied this issue. They gathered survey data from 1992 and 2004 that composed of 5006 adults who were insured and 2227 who were not always insured from 55 to 65 years old.

J. Michael McWilliams, MD, and team compared the data that covered pain, agility, depression and general health. They found out that the health of those who were not insured before got worse faster than the ones who were insured. And their health improved after they were 65 years old except for depressive symptoms.

What is the implication of this finding? It is clear there should be changes in the provision of insurance health coverage for the near elderly adults especially those with diabetes and cardiovascular disease as improving the health of these people are economically and socially priceless.

There have been proposals introduced in the United States Congress regarding the provision of Medicare health coverage to the near elderly. This proposed extension will improve the health of the near elderly and has received endorsement from the American College of Physicians.

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