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Wednesday, February 8, 2012
New Way of Early Disease Detection!
Breathalyzers, not just for seeing if you are intoxicated anymore! A new way of disease detection has been found by researchers at the University of Wisconsin-Madison! http://www.medicalnewstoday.com/releases/241288.php
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Thursday, September 2, 2010
Disrupted Sleep Patterns Adds to Risk of Obesity, Diabetes
Disrupted sleep patterns seem to contribute to the risk of obesity and diabetes, according to numerous studies. Scientists have theorized that disrupted circadian rhythms throw off various hormonal processes in the body that contribute to disease.
Researchers at UT Southwestern Medical Center in Dallas have found that mice with defective copies of two genes involved in circadian rhythms develop abnormalities in their pancreatic cells that eventually cause problems with the release of insulin.
This theory is looking stronger all the time, and the mounting evidence bolsters the argument that people should care about their sleep habits and these should be discussed while educating every patient with diabetes.
One gene, the CLOCK gene, operates in many parts of the body to control circadian processes. The other gene, BMAL1, works with the CLOCK protein. In the study, scientists engineered some mice to have defective CLOCK genes in the pancreas and some to lack the BMAL1 gene.
They found that mice with the mutant CLOCK gene were defective in releasing insulin. These mice were prone to obesity and other health problems related to liver and metabolic function. The mice lacking the BMAL1 gene in their pancreas had normal body weight and normal circadian patterns but had abnormal blood sugar levels.
The study shows that disruption of these genes only in the pancreas causes early signs of diabetes.
"These results indicate that disruption of the daily clock may contribute to diabetes by impairing the pancreas' ability to deliver insulin," Dr. Joseph Takahashi, a co-author of the paper, stated in a news release.
journal Nature, July 09, 2010
Click Here to Read More..
Researchers at UT Southwestern Medical Center in Dallas have found that mice with defective copies of two genes involved in circadian rhythms develop abnormalities in their pancreatic cells that eventually cause problems with the release of insulin.
This theory is looking stronger all the time, and the mounting evidence bolsters the argument that people should care about their sleep habits and these should be discussed while educating every patient with diabetes.
One gene, the CLOCK gene, operates in many parts of the body to control circadian processes. The other gene, BMAL1, works with the CLOCK protein. In the study, scientists engineered some mice to have defective CLOCK genes in the pancreas and some to lack the BMAL1 gene.
They found that mice with the mutant CLOCK gene were defective in releasing insulin. These mice were prone to obesity and other health problems related to liver and metabolic function. The mice lacking the BMAL1 gene in their pancreas had normal body weight and normal circadian patterns but had abnormal blood sugar levels.
The study shows that disruption of these genes only in the pancreas causes early signs of diabetes.
"These results indicate that disruption of the daily clock may contribute to diabetes by impairing the pancreas' ability to deliver insulin," Dr. Joseph Takahashi, a co-author of the paper, stated in a news release.
journal Nature, July 09, 2010
Click Here to Read More..
Wednesday, August 25, 2010
Implanted Wireless Glucose Sensor Lasts 520 Days
American bioengineers have demonstrated that an implanted glucose sensor with potential to transform the management of diabetes has passed a crucial test: the device they developed worked continuously for over a year, without showing signs of "tissue encapsulation" seen in trials with other similar devices.
Researchers from the Department of Bioengineering at the University of California San Diego (UCSD), and GlySens Incorporated, showed how an implantable sensor, "capable of long-term monitoring of tissue glucose concentrations by wireless telemetry," ran successfully for a total of 222 and 520 days respectively.
One of the challenges of developing an effective glucose sensor that sits in tissue just below the surface of the skin is how to overcome the problem of "tissue encapsulation" which causes unpredictable fluctuations in the readings.
Dr. David Gough, first author and bioengineering professor at UCSD told the press that the most important aspect of their paper is how they overcame this problem so their sensor remained insensitive to tissue encapsulation for over 500 days.
"That's a big step from a scientific point of view, and it's due to the sensor's unique oxygen detection scheme," said Gough.
He and his team hope that after human trials and FDA approval, their device may help people with diabetes manage their condition more effectively than methods currently in use such as finger-sticking and short-term, needle-like glucose sensors that have to be replaced every three to seven days.
"If all goes well with the human clinical trials, we anticipate that, in several years, this device could be purchased under prescription from a physician," said Gough.
The problem with many current methods, for example the so-called finger-sticking system where the patient pricks his or her finger to get some blood to test in a portable reader (usually done about four times a day), is that they do not monitor the level of glucose continuously, leaving open the risk of dangerous ups and downs of glucose levels, known as "glucose excursions." The more "glucose excursions" a patient has, the higher the risk of developing long term problems of diabetes, affecting the eyes, kidneys, heart, brain, feet and nerves.
The device that Gough and his team developed and tested in the pigs is about 1.5 inches (3.8 cm) in diameter and about 5/8 ins thick (1.6 cm). It is implanted under the skin and continuously monitors tissue glucose and transmits the information without wires to an external receiver.
The device worked effectively, they said, because of its unique way of producing a reliable reading without being affected by the problem of tissue encapsulation.
It does this by taking in glucose and oxygen from surrounding tissue and using the enzyme glucose oxidase to catalyze a reaction where oxygen is consumed in proportion to the amount of glucose present.
Any oxygen left over is measured and compared to the baseline oxygen recorded by a reference sensor, so the difference indicates how much glucose is present.
The authors said that the effect of exercise and changes in local blood flow to the tissues are also in the main subtracted out in this differential oxygen sensing system, where the two sensors sit side by side in the same device.
The sensors used in the animal trials sent the glucose information to a data recorder the size of a cell phone. Gough said the data could be made useful in many ways, for example it could be sent to cell phones or displayed in other ways.
"There are parents with diabetic children who spend their nights worrying that their child in a nearby bedroom may go into nocturnal hypoglycemia," he said, explaining that a continuous glucose sensor could trigger an alert if the level dropped too low in the night.
A long term implanted monitor would keep measuring glucose day and night.
"Others wouldn't even know if someone is using a glucose sensor. Our goal is to get people off the finger-stick cycle," he added. He said if the device passes human trials, it could be implanted in patients in a simple outpatient procedure.
"Function of an Implanted Tissue Glucose Sensor for More than 1 Year in Animals." David A. Gough, Lucas S. Kumosa, Timothy L. Routh, Joe T. Lin, and Joseph Y. Lucisano. Sci Transl Med Vol. 2, Issue 42, p. 42ra53, published online 28 July 2010
DOI: 10.1126/scitranslmed.3001148
Click Here to Read More..
Researchers from the Department of Bioengineering at the University of California San Diego (UCSD), and GlySens Incorporated, showed how an implantable sensor, "capable of long-term monitoring of tissue glucose concentrations by wireless telemetry," ran successfully for a total of 222 and 520 days respectively.
One of the challenges of developing an effective glucose sensor that sits in tissue just below the surface of the skin is how to overcome the problem of "tissue encapsulation" which causes unpredictable fluctuations in the readings.
Dr. David Gough, first author and bioengineering professor at UCSD told the press that the most important aspect of their paper is how they overcame this problem so their sensor remained insensitive to tissue encapsulation for over 500 days.
"That's a big step from a scientific point of view, and it's due to the sensor's unique oxygen detection scheme," said Gough.
He and his team hope that after human trials and FDA approval, their device may help people with diabetes manage their condition more effectively than methods currently in use such as finger-sticking and short-term, needle-like glucose sensors that have to be replaced every three to seven days.
"If all goes well with the human clinical trials, we anticipate that, in several years, this device could be purchased under prescription from a physician," said Gough.
The problem with many current methods, for example the so-called finger-sticking system where the patient pricks his or her finger to get some blood to test in a portable reader (usually done about four times a day), is that they do not monitor the level of glucose continuously, leaving open the risk of dangerous ups and downs of glucose levels, known as "glucose excursions." The more "glucose excursions" a patient has, the higher the risk of developing long term problems of diabetes, affecting the eyes, kidneys, heart, brain, feet and nerves.
The device that Gough and his team developed and tested in the pigs is about 1.5 inches (3.8 cm) in diameter and about 5/8 ins thick (1.6 cm). It is implanted under the skin and continuously monitors tissue glucose and transmits the information without wires to an external receiver.
The device worked effectively, they said, because of its unique way of producing a reliable reading without being affected by the problem of tissue encapsulation.
It does this by taking in glucose and oxygen from surrounding tissue and using the enzyme glucose oxidase to catalyze a reaction where oxygen is consumed in proportion to the amount of glucose present.
Any oxygen left over is measured and compared to the baseline oxygen recorded by a reference sensor, so the difference indicates how much glucose is present.
The authors said that the effect of exercise and changes in local blood flow to the tissues are also in the main subtracted out in this differential oxygen sensing system, where the two sensors sit side by side in the same device.
The sensors used in the animal trials sent the glucose information to a data recorder the size of a cell phone. Gough said the data could be made useful in many ways, for example it could be sent to cell phones or displayed in other ways.
"There are parents with diabetic children who spend their nights worrying that their child in a nearby bedroom may go into nocturnal hypoglycemia," he said, explaining that a continuous glucose sensor could trigger an alert if the level dropped too low in the night.
A long term implanted monitor would keep measuring glucose day and night.
"Others wouldn't even know if someone is using a glucose sensor. Our goal is to get people off the finger-stick cycle," he added. He said if the device passes human trials, it could be implanted in patients in a simple outpatient procedure.
"Function of an Implanted Tissue Glucose Sensor for More than 1 Year in Animals." David A. Gough, Lucas S. Kumosa, Timothy L. Routh, Joe T. Lin, and Joseph Y. Lucisano. Sci Transl Med Vol. 2, Issue 42, p. 42ra53, published online 28 July 2010
DOI: 10.1126/scitranslmed.3001148
Click Here to Read More..
Wednesday, August 18, 2010
Possible Groundbreaking Treatment for Diabetes
A London company may be on the verge of a groundbreaking treatment for diabetes. A mini pancreas pouch could begin human clinical trials within a year.
In the last few years a procedure kn����������������;Edmonton Protocol" has been used to treat diabetes by transplanting human islet cells from organ donors into patients. Although the procedure is quite successful it faces two major issues:
The critical lack of organ donors means only a handful of people with diabetes can be treated in any given year. In the United States, there are approximately 6,000 cadaveric organ donors and only a fraction of the available pancreatic tissue is suitable for transplantation. For each patient receiving the transplant there must be at least two donors.
Patients receiving the transplants must stay on anti-rejection drugs for the rest of their lives to keep their immune systems from destroying the transplanted cells. The serious side effects of perpetually compromising a person's immune system means that generally only those people experiencing serious complications receive the transplants. Younger, healthier diabetics who have the most to gain from preventing any more damage by the disease also have the most to lose by living the rest of their lives with suppressed immune systems.
The Cell Pouch System™ has shown long-term efficacy in small animal models, and is currently being tested in the product designed for patients in a large animal model of diabetes supported by a $465,000 in-kind contribution from the National Research Council of Canada. With reduced cost of implantation, increased safety and improved efficacy relative to other cell therapy treatments, this therapy could reduce or eliminate the need for insulin injections in an ever increasing number of patients. The timeline to FDA approval of a medical device is shorter than pharmaceuticals with a higher success rate. Using the device regulatory pathway, Sernova has the potential to have products on the market in a shorter period of time than competing pharmaceutical technologies.
The first clinical indication for the Cell Pouch System™ is anticipated to be for patients with pancreatitis. Patients with severe pancreatitis who have their pancreas removed will become diabetic. These patients could benefit by having their islets removed from the pancreas and placed into the Cell Pouch System™ with the hope of restoring glucose control. Product expansion may then occur through treatment of diabetic patients with the Cell Pouch System™ with immunosuppressant agents or with Sertolin™ cells that provide an immune-protected environment for the islets.
Sertolin is based on the Sertoli cells' natural ability to locally modulate the immune system. Sertoli cells, which are normally found in the testes, synthesize cytokines and growth factors necessary to protect and mature developing spermatozoa. It has been known for more than 60 years that it is possible to transplant cells from different species into the testes without them being rejected. Dr. Helena Selawry discovered that the presence of Sertoli cells is the principal reason for this long-recognized immunologically privileged environment of the testes and that became the basis for the Sertoli patents.
Using the patented Sertoli cells and a medical device inserted under the skin of the patient's abdomen, an immunoprivileged environment is created, in which a second cell type (e.g. insulin producing islets) can be co-transplanted without the need for immunosuppression. Therefore diabetic patients are treated with a minimally invasive day surgery, resulting in a reduced need for insulin or even total insulin independence. The procedure may also prove to have many other cellular co-transplantation or gene therapy applications.
How the Sernova Corporation's pouch works for diabetes treatment:
1.) A "cell pouch" is implanted under the skin in the belly of the patient.
2.) Islets planted in the pouch produce insulin naturally, in response to the blood sugar levels in the patient.
3.) Islets are cells from the pancreas, extracted from a donor, creating a mini pancreas.
4.) The pouch is not visible on the patient.
5.) Animal tests have seen the device work well for six months.
6.) Human clinical trials may begin in about one year.
Sernovacorp.com
Click Here to Read More..
In the last few years a procedure kn����������������;Edmonton Protocol" has been used to treat diabetes by transplanting human islet cells from organ donors into patients. Although the procedure is quite successful it faces two major issues:
The critical lack of organ donors means only a handful of people with diabetes can be treated in any given year. In the United States, there are approximately 6,000 cadaveric organ donors and only a fraction of the available pancreatic tissue is suitable for transplantation. For each patient receiving the transplant there must be at least two donors.
Patients receiving the transplants must stay on anti-rejection drugs for the rest of their lives to keep their immune systems from destroying the transplanted cells. The serious side effects of perpetually compromising a person's immune system means that generally only those people experiencing serious complications receive the transplants. Younger, healthier diabetics who have the most to gain from preventing any more damage by the disease also have the most to lose by living the rest of their lives with suppressed immune systems.
The Cell Pouch System™ has shown long-term efficacy in small animal models, and is currently being tested in the product designed for patients in a large animal model of diabetes supported by a $465,000 in-kind contribution from the National Research Council of Canada. With reduced cost of implantation, increased safety and improved efficacy relative to other cell therapy treatments, this therapy could reduce or eliminate the need for insulin injections in an ever increasing number of patients. The timeline to FDA approval of a medical device is shorter than pharmaceuticals with a higher success rate. Using the device regulatory pathway, Sernova has the potential to have products on the market in a shorter period of time than competing pharmaceutical technologies.
The first clinical indication for the Cell Pouch System™ is anticipated to be for patients with pancreatitis. Patients with severe pancreatitis who have their pancreas removed will become diabetic. These patients could benefit by having their islets removed from the pancreas and placed into the Cell Pouch System™ with the hope of restoring glucose control. Product expansion may then occur through treatment of diabetic patients with the Cell Pouch System™ with immunosuppressant agents or with Sertolin™ cells that provide an immune-protected environment for the islets.
Sertolin is based on the Sertoli cells' natural ability to locally modulate the immune system. Sertoli cells, which are normally found in the testes, synthesize cytokines and growth factors necessary to protect and mature developing spermatozoa. It has been known for more than 60 years that it is possible to transplant cells from different species into the testes without them being rejected. Dr. Helena Selawry discovered that the presence of Sertoli cells is the principal reason for this long-recognized immunologically privileged environment of the testes and that became the basis for the Sertoli patents.
Using the patented Sertoli cells and a medical device inserted under the skin of the patient's abdomen, an immunoprivileged environment is created, in which a second cell type (e.g. insulin producing islets) can be co-transplanted without the need for immunosuppression. Therefore diabetic patients are treated with a minimally invasive day surgery, resulting in a reduced need for insulin or even total insulin independence. The procedure may also prove to have many other cellular co-transplantation or gene therapy applications.
How the Sernova Corporation's pouch works for diabetes treatment:
1.) A "cell pouch" is implanted under the skin in the belly of the patient.
2.) Islets planted in the pouch produce insulin naturally, in response to the blood sugar levels in the patient.
3.) Islets are cells from the pancreas, extracted from a donor, creating a mini pancreas.
4.) The pouch is not visible on the patient.
5.) Animal tests have seen the device work well for six months.
6.) Human clinical trials may begin in about one year.
Sernovacorp.com
Click Here to Read More..
Tuesday, August 10, 2010
Lifestyle Change Wins Over Weight Loss Programs
Obese adults prefer noncommercial, nonstigmatizing interventions designed to help them improve their lifestyles over programs that just promote weight loss, according to a new study.
Samantha L. Thomas, MD, from Monash University, Notting Hill, Australia, and colleagues write, "Consumer involvement, perceptions and engagement are well recognized as cornerstones for developing effective interventions within communities and in improving the translated outcomes of intervention programs.... Yet, there has been very limited research seeking to understand the perspectives, attitudes and opinions of obese adults about current approaches to obesity."
The aim of this study was to explore the opinions and attitudes of obese individuals toward population and individual interventions for obesity.
The researchers conducted telephone interviews with a community sample of 142 obese adults aged 19 to 75 years who had a body mass index of at least 30 kg/m2. The interviews lasted from 60 to 90 minutes. The participants were asked about their attitudes to 6 interventions:
The researchers found that about two-thirds of participants thought that regulation was one of the most effective solutions for the obesity epidemic in Australia. Public health interventions and initiatives were favored by 60 participants (42%). One third of the participants thought that media campaigns were effective, especially ones based on positive messages and incentives, rather than scare tactics.
The researchers also report that most participants were somewhat skeptical about the long-term success of obesity surgery, voicing concerns about the commercial marketing of the surgery and also about the associated short- and long-term risks.
Only 26 participants (18%) thought that commercial dieting programs were effective interventions for weight loss, and only a small number thought that diets were effective for weight loss. Weight Watchers was deemed to be better than other commercial programs, with participants calling the program's approach "genuine," "sensible," and "[health-]promoting," according to the study authors.
The authors also found that participants distrusted the commercial marketing techniques of the diet industry and wanted the industry regulated. Some participants also described commercial diets as unsafe -- particularly those that provide pre-prepared meals. They used terms such as "greedy," "a scam," and "a rip-off" to describe the dieting industry. Despite these attitudes, many participants said they would still turn to commercial dieting to lose weight because they had very little other support available to them, the authors stated.
The reserchers noted limitations of their study, including the high education level of the participants and the preponderance of women participants over men.
Dr. Thomas and her colleagues conclude that their study provides a unique assessment of the perspectives, attitudes, and opinions of obese adults toward 6 different interventions currently used in Australia to address obesity. The results highlight the need for interventions that support and empower individuals to improve their lifestyle.
"At the individual level, personalized care planning and long term support systems must be developed to assist obese individuals," they write. "At the population level, anti-stigma campaigns and regulation should both be explored."
BMC Public Health. Published online July 15, 2010.
Click Here to Read More..
Samantha L. Thomas, MD, from Monash University, Notting Hill, Australia, and colleagues write, "Consumer involvement, perceptions and engagement are well recognized as cornerstones for developing effective interventions within communities and in improving the translated outcomes of intervention programs.... Yet, there has been very limited research seeking to understand the perspectives, attitudes and opinions of obese adults about current approaches to obesity."
The aim of this study was to explore the opinions and attitudes of obese individuals toward population and individual interventions for obesity.
The researchers conducted telephone interviews with a community sample of 142 obese adults aged 19 to 75 years who had a body mass index of at least 30 kg/m2. The interviews lasted from 60 to 90 minutes. The participants were asked about their attitudes to 6 interventions:
- media-based social marketing campaigns
- public health interventions and initiatives
- regulation (e.g., banning junk food advertising aimed at children)
- obesity surgery
- commercial diets (specifically Weight Watchers and Jenny Craig)
- specialized fitness programs (e.g., women-only gyms such as Curves and public funding for personal trainers)
The researchers found that about two-thirds of participants thought that regulation was one of the most effective solutions for the obesity epidemic in Australia. Public health interventions and initiatives were favored by 60 participants (42%). One third of the participants thought that media campaigns were effective, especially ones based on positive messages and incentives, rather than scare tactics.
The researchers also report that most participants were somewhat skeptical about the long-term success of obesity surgery, voicing concerns about the commercial marketing of the surgery and also about the associated short- and long-term risks.
Only 26 participants (18%) thought that commercial dieting programs were effective interventions for weight loss, and only a small number thought that diets were effective for weight loss. Weight Watchers was deemed to be better than other commercial programs, with participants calling the program's approach "genuine," "sensible," and "[health-]promoting," according to the study authors.
The authors also found that participants distrusted the commercial marketing techniques of the diet industry and wanted the industry regulated. Some participants also described commercial diets as unsafe -- particularly those that provide pre-prepared meals. They used terms such as "greedy," "a scam," and "a rip-off" to describe the dieting industry. Despite these attitudes, many participants said they would still turn to commercial dieting to lose weight because they had very little other support available to them, the authors stated.
The reserchers noted limitations of their study, including the high education level of the participants and the preponderance of women participants over men.
Dr. Thomas and her colleagues conclude that their study provides a unique assessment of the perspectives, attitudes, and opinions of obese adults toward 6 different interventions currently used in Australia to address obesity. The results highlight the need for interventions that support and empower individuals to improve their lifestyle.
"At the individual level, personalized care planning and long term support systems must be developed to assist obese individuals," they write. "At the population level, anti-stigma campaigns and regulation should both be explored."
BMC Public Health. Published online July 15, 2010.
Click Here to Read More..
Thursday, August 5, 2010
Daily Insulin Shots May Be a Thing of the Past
That daily shot of insulin may soon be a thing of the past. Scientists at the National Immunology Institute in New Delhi, India, have developed a new form of insulin which could maintain normal blood sugar levels for over 120 days.
Dr. Avadhesha Surolia, Director of the National Institute of Immunology and Professor of Biophysics, Molecular Biophysics Unit, Indian Institute of Science, stated that the insulin currently available can work for a maximum of 18 hours, forcing diabetes patients to take at least one injection daily to sustain their sugar levels. With this new product, they can now restrict their shots to once every four months.
Dr. Surolia said the new product, which has been tested successfully in animals, was based on the principles of "protein folding," and could release insulin molecules in a controlled and sustained manner for over 120 days.
"The just above basal level of human insulin released in a sustained manner has been found to be effective in not only controlling the upsurge in the level of blood glucose after meals, but also in preventing the dreaded early morning hypoglycemia, which is caused by low glucose levels," he said.
The team has already patented the technology and transferred it to a US-based company for fine-tuning and clinical trials, and the product is likely to be in the market in about six years.
Proceedings of the National Academy of Sciences
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Dr. Avadhesha Surolia, Director of the National Institute of Immunology and Professor of Biophysics, Molecular Biophysics Unit, Indian Institute of Science, stated that the insulin currently available can work for a maximum of 18 hours, forcing diabetes patients to take at least one injection daily to sustain their sugar levels. With this new product, they can now restrict their shots to once every four months.
Dr. Surolia said the new product, which has been tested successfully in animals, was based on the principles of "protein folding," and could release insulin molecules in a controlled and sustained manner for over 120 days.
"The just above basal level of human insulin released in a sustained manner has been found to be effective in not only controlling the upsurge in the level of blood glucose after meals, but also in preventing the dreaded early morning hypoglycemia, which is caused by low glucose levels," he said.
The team has already patented the technology and transferred it to a US-based company for fine-tuning and clinical trials, and the product is likely to be in the market in about six years.
Proceedings of the National Academy of Sciences
Click Here to Read More..
Tuesday, July 27, 2010
Family Meals Keep Kids Trim
A new study finds that, children who regularly sit down to family meals and get plenty of vegetables in their diet tend to be thinner than their peers without such eating habits.
The published results may not sound surprising. However, few studies have looked at the relationship between children's weight and their diet patterns. And while it is generally believed that sitting down to family dinner is good for kids, there has been little research evidence it keeps them slim.
For the new study, Greek researchers interviewed 1,138 children ages 9 to 13 about their diets and physical activities, and used that information to identify five general diet-and-lifestyle patterns across the group.
One was what they dubbed the "dinner, cooked meals and vegetables" pattern. Children with this pattern had a high intake of vegetables, regularly sat down to family dinner and typically had traditional "cooked" meals (hot or cold) for lunch and dinner, rather than sandwiches, snack foods or "breakfast-like" meals.
Kids who fell into that pattern generally had a lower body mass index (BMI), smaller waistlines and less body fat than their peers who did not fit the diet pattern.
None of the other four diet-and-lifestyle patterns the researchers identified were associated with children's weight or body-fat levels.
Those patterns included an "unstructured eating, fast food/sugary foods and sedentary lifestyle" pattern, and "high fiber," "breakfast," and "exercise, fruits and vegetables" patterns.
According to the researchers, who were led by Dr. Mary Yannakoulia of Harokopio University in Athens, it is not clear why those four categories failed to show a link to children's weight, while the family meal/vegetable pattern did.
But, they write, the habits of sitting down to family dinner and having cooked meals could signify children who are closely sticking to the traditional Mediterranean diet -- one rich in vegetables, olive oil, whole grains and fish.
A key limitation of the study is that it assessed children at one time point. However, Yannakoulia and her colleagues write, the findings suggest that such an eating pattern stands as a "potential preventive approach" to combating childhood obesity. They note that it is also a "non-restrictive" way of eating that most children can live with.
J Pediatr, June 18, 2010
Click Here to Read More..
The published results may not sound surprising. However, few studies have looked at the relationship between children's weight and their diet patterns. And while it is generally believed that sitting down to family dinner is good for kids, there has been little research evidence it keeps them slim.
For the new study, Greek researchers interviewed 1,138 children ages 9 to 13 about their diets and physical activities, and used that information to identify five general diet-and-lifestyle patterns across the group.
One was what they dubbed the "dinner, cooked meals and vegetables" pattern. Children with this pattern had a high intake of vegetables, regularly sat down to family dinner and typically had traditional "cooked" meals (hot or cold) for lunch and dinner, rather than sandwiches, snack foods or "breakfast-like" meals.
Kids who fell into that pattern generally had a lower body mass index (BMI), smaller waistlines and less body fat than their peers who did not fit the diet pattern.
None of the other four diet-and-lifestyle patterns the researchers identified were associated with children's weight or body-fat levels.
Those patterns included an "unstructured eating, fast food/sugary foods and sedentary lifestyle" pattern, and "high fiber," "breakfast," and "exercise, fruits and vegetables" patterns.
According to the researchers, who were led by Dr. Mary Yannakoulia of Harokopio University in Athens, it is not clear why those four categories failed to show a link to children's weight, while the family meal/vegetable pattern did.
But, they write, the habits of sitting down to family dinner and having cooked meals could signify children who are closely sticking to the traditional Mediterranean diet -- one rich in vegetables, olive oil, whole grains and fish.
A key limitation of the study is that it assessed children at one time point. However, Yannakoulia and her colleagues write, the findings suggest that such an eating pattern stands as a "potential preventive approach" to combating childhood obesity. They note that it is also a "non-restrictive" way of eating that most children can live with.
J Pediatr, June 18, 2010
Click Here to Read More..
Monday, July 19, 2010
Lifestyle Counseling Reduces Medications and Costs in Diabetes
Effect of the Look AHEAD Study intervention on medication use and related cost to treat cardiovascular disease risk factors in individuals with Type 2 diabetes....
Look AHEAD (Action for Health and Diabetes) is a multisite clinical trial of 5,145 overweight or obese individuals with Type 2 diabetes, age 45-76 years. Participants were randomly assigned to either intensive lifestyle intervention (ILI), which involved group and individual meetings to achieve and maintain weight loss through decreased caloric intake and increased physical activity, or to general diabetes support and education (DSE).
The goal is to study the effects on cardiovascular morbidity and mortality. In the current analysis, use of medications prescribed to treat diabetes, hypertension, and hyperlipidemia and the costs of those medications were compared at baseline and 1 year. All participants were required to have a primary care clinician who was responsible for any necessary changes in medications. Costs were conservatively estimated through the use of generic drug costs (when available) and the assumption that patients were using about 50% of the maximum dose. In addition to analyses of all participants, a subanalysis of participants who met optimal care goals for diabetes, blood pressure, and lipid control, was also conducted.
The mean age of the participants was 59 years, and 59% of the participants were women. At baseline, participants in both groups averaged 3.3 prescriptions per month at a mean cost of about $156. After 1 year, medication use for intensive lifestyle intervention was significantly lower than for DSE (3.1 vs. 3.6; P < .001), as were monthly medication costs ($143 vs. $173; P < .001). Thus, medication costs declined by almost 10% in the lifestyle group and increased by 10% in the DSE group. The differences were greatest for diabetes medications: medication costs declined by 17% in the lifestyle group and increased by 11% in the DSE group. Furthermore, the intervention more than doubled the percentage of participants who achieved optimal care goals (from 11% to 24%) and at the same time reduced medication use and cost. A greater proportion in the DSE group also achieved optimal care goals at 1 year (increasing from 10% to 16%), but doing so required an increase in medication use and costs.
The Look AHEAD investigators recently reported beneficial effects of 1 year of intensive lifestyle intervention on weight loss, glycemic control, and cardiovascular risk factors. This, of course, has important implications for long-term morbidity and mortality. In the short term, however, the current study demonstrates that intensive lifestyle intervention can reduce medication use and costs, both of which could be a far stronger motivation for individual patients to undertake lifestyle changes than a small decrease in A1c levels. Furthermore, because lifestyle interventions reduce diabetes incidence among at-risk patients well after the active interventions have ceased, the current findings could be extrapolated to suggest that glycemic control among patients with diagnosed diabetes may also endure beyond active intervention. Even if it doesn't, long-term follow-up of the United Kingdom Prospective Diabetes Study showed a reduction in microvascular complications, myocardial infarction, and all-cause mortality risk even though glycemic control differences between intensive and standard control groups later equalized.
Thus, if possible reductions in medication use and cost can indeed motivate patients to make lifestyle changes, the long-term goals of better health and quality of life can still be achieved. Furthermore, the current results have important implications for the cost-benefit ratio of providing lifestyle interventions; medication cost reductions must be factored in as an offset to the cost of the programs themselves. Perhaps lifestyle interventions can help bend the cost curve.
The study showed that, at 1 year, ILI significantly improved CVD risk factors, while at the same time reduced medication use and cost. Continued intervention and follow-up will determine whether these changes are maintained and reduce cardiovascular risk.
1.) Pi-Sunyer X, Blackburn G, Brancati FL, et al. Reduction in weight and cardiovascular disease risk factors in individuals with Type 2 diabetes: one-year results of the Look AHEAD trial. Diabetes Care. 2007;30:1374-1383. Abstract
2.) Lindstrom J, Ilanne-Parikka P, Peltonen M, et al. Sustained reduction in the incidence of Type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet. 2006;368:1673-1679. Abstract
3.) Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374:1167-1186.
4.) Li G, Zhang P, Wang J, et al. The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabets Prevention Study: a 20-year follow-up study. Lancet. 2008;371:1783-1789. Abstract
5.) Holman RR, Paul SK, Bethel MA, et al. 10-year follow-up of intensive glucose control in Type 2 diabetes. N Engl J Med. 2008;359:1577-1589. Abstract
Diabetes Care. 2010;33:1153-1158
Click Here to Read More..
Look AHEAD (Action for Health and Diabetes) is a multisite clinical trial of 5,145 overweight or obese individuals with Type 2 diabetes, age 45-76 years. Participants were randomly assigned to either intensive lifestyle intervention (ILI), which involved group and individual meetings to achieve and maintain weight loss through decreased caloric intake and increased physical activity, or to general diabetes support and education (DSE).
The goal is to study the effects on cardiovascular morbidity and mortality. In the current analysis, use of medications prescribed to treat diabetes, hypertension, and hyperlipidemia and the costs of those medications were compared at baseline and 1 year. All participants were required to have a primary care clinician who was responsible for any necessary changes in medications. Costs were conservatively estimated through the use of generic drug costs (when available) and the assumption that patients were using about 50% of the maximum dose. In addition to analyses of all participants, a subanalysis of participants who met optimal care goals for diabetes, blood pressure, and lipid control, was also conducted.
The mean age of the participants was 59 years, and 59% of the participants were women. At baseline, participants in both groups averaged 3.3 prescriptions per month at a mean cost of about $156. After 1 year, medication use for intensive lifestyle intervention was significantly lower than for DSE (3.1 vs. 3.6; P < .001), as were monthly medication costs ($143 vs. $173; P < .001). Thus, medication costs declined by almost 10% in the lifestyle group and increased by 10% in the DSE group. The differences were greatest for diabetes medications: medication costs declined by 17% in the lifestyle group and increased by 11% in the DSE group. Furthermore, the intervention more than doubled the percentage of participants who achieved optimal care goals (from 11% to 24%) and at the same time reduced medication use and cost. A greater proportion in the DSE group also achieved optimal care goals at 1 year (increasing from 10% to 16%), but doing so required an increase in medication use and costs.
The Look AHEAD investigators recently reported beneficial effects of 1 year of intensive lifestyle intervention on weight loss, glycemic control, and cardiovascular risk factors. This, of course, has important implications for long-term morbidity and mortality. In the short term, however, the current study demonstrates that intensive lifestyle intervention can reduce medication use and costs, both of which could be a far stronger motivation for individual patients to undertake lifestyle changes than a small decrease in A1c levels. Furthermore, because lifestyle interventions reduce diabetes incidence among at-risk patients well after the active interventions have ceased, the current findings could be extrapolated to suggest that glycemic control among patients with diagnosed diabetes may also endure beyond active intervention. Even if it doesn't, long-term follow-up of the United Kingdom Prospective Diabetes Study showed a reduction in microvascular complications, myocardial infarction, and all-cause mortality risk even though glycemic control differences between intensive and standard control groups later equalized.
Thus, if possible reductions in medication use and cost can indeed motivate patients to make lifestyle changes, the long-term goals of better health and quality of life can still be achieved. Furthermore, the current results have important implications for the cost-benefit ratio of providing lifestyle interventions; medication cost reductions must be factored in as an offset to the cost of the programs themselves. Perhaps lifestyle interventions can help bend the cost curve.
The study showed that, at 1 year, ILI significantly improved CVD risk factors, while at the same time reduced medication use and cost. Continued intervention and follow-up will determine whether these changes are maintained and reduce cardiovascular risk.
1.) Pi-Sunyer X, Blackburn G, Brancati FL, et al. Reduction in weight and cardiovascular disease risk factors in individuals with Type 2 diabetes: one-year results of the Look AHEAD trial. Diabetes Care. 2007;30:1374-1383. Abstract
2.) Lindstrom J, Ilanne-Parikka P, Peltonen M, et al. Sustained reduction in the incidence of Type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet. 2006;368:1673-1679. Abstract
3.) Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374:1167-1186.
4.) Li G, Zhang P, Wang J, et al. The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabets Prevention Study: a 20-year follow-up study. Lancet. 2008;371:1783-1789. Abstract
5.) Holman RR, Paul SK, Bethel MA, et al. 10-year follow-up of intensive glucose control in Type 2 diabetes. N Engl J Med. 2008;359:1577-1589. Abstract
Diabetes Care. 2010;33:1153-1158
Click Here to Read More..
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