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Research led by the University of Adelaide is paving the way for safer and more effective drugs to treat type 2 diabetes, reducing side effects and the need for insulin injections.

Two studies, published in the Journal of Medicinal Chemistry and BBA-General Subjects, have shown for the first time how new potential anti-diabetic drugs interact with their target in the body at the molecular level.

These new potential drugs have a completely different action than the most commonly prescribed anti-diabetic, Metformin, which acts on the liver to reduce glucose production, and are potentially more efficient at reducing blood sugar. They target a protein receptor known as PPARgamma found in fat tissue throughout the body, either fully or partially activating it in order to lower blood sugar by increasing sensitivity to insulin and changing the metabolism of fat and sugar.

"Type two diabetes is characterised by resistance to insulin with subsequent high blood sugar which leads to serious disease. It is usually associated with poor lifestyle factors such as diet and lack of exercise," says lead researcher Dr John Bruning, with the University's School of Biological Sciences and Institute for Photonics and Advanced Sensing.

"Prevalence of type 2 diabetes in Australia alone has more than tripled since 1990, with an estimated cost of $6 billion a year. The development of safe and more efficient therapeutics is therefore becoming increasingly important.

"People with severe diabetes need to take insulin but having to inject this can be problematic, and it's difficult to get insulin levels just right. It's highly desirable for people to come off insulin injections and instead use oral therapeutics."

The first study, in collaboration with The Scripps Research Institute in Florida, US, describes an honours research project by Rebecca Frkic, where 14 different versions of a drug which partially activates PPARgamma were produced. Partial activation can have the benefit of fewer side-effects than full activation.

The original drug, INT131, is currently being tested in clinical trials in the US but some of the versions produced at the University of Adelaide have increased potency compared to the original, with the potential to further improve the treatment of type 2 diabetes.

"A major finding of this study was being able to show which regions of the drug are most important for interacting with the PPARgamma receptor," says Dr Bruning. "This means we now have the information to design modified drugs which will work even more efficiently."

The second study, in collaboration with Flinders University, used X-ray crystallography to demonstrate for the first time exactly how a potential new drug, rivoglitazone, binds with the PPARgamma receptor. Rivoglitazone fully activates PPARgamma but has less side effects than others with this mode of action.

"Showing how this compound interacts with its target is a key step towards being able to design new therapeutics with higher efficiencies and less side-effects," says lead author Dr Rajapaksha, from Flinders University School of Medicine (now at La Trobe University). "Lack of structural information was hampering determination of the precise mechanisms involved."

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Materials provided by University of Adelaide. Note: Content may be edited for style and length.

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Designing better drugs to treat type 2 diabetes - Science Daily

A colleague recently told me that eye doctors should stay within the lines of traditional eye care because we barely have enough time as it is to do our jobs. My response was that today more than half of our adult patients have either diabetes or prediabetes,1 so our job now requires we go outside the lines to avoid the leading cause of preventable blindness.2

The incidence of severe vision loss caused by proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) appear to have declined significantly over the last 40 years due to improvements in blood glucose control, improved surveillance of diabetes patients, and widespread use of effective interventional therapies like photocoagulation and anti-VEGF injections.3

Nonetheless, diabetic retinopathy (DR) and DME remain hugely important causes of vision impairment and blindness and remain the leading causes of vision loss in Americans of working age.2

Previously from Dr. Chous:How diabetes is linked to gut bacteria

Increased prevalence of DR and DME is linked to increasing prevalence of diabetes and reduction in macrovascular mortality achieved with better treatment regimens. Ironically, improved longevity allows patients with diabetes to live long enough for development of vision-threatening complications.4

With recent estimates showing more than 12 percent of all U.S. adults having diabetes, it is becoming increasingly important to identify and remediate patients at highest risk for progression to clinical diagnosis of diabetes and all of its attendant complications, including vision loss.5

Additionally, identifying diabetes patients at highest risk for developing sight-threatening retinopathy (STR) and attempting earlier intervention will play an increasingly important role as we strive to improve public health outcomes and reduce medical expenditures.

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New strategies to assess the risk of diabetes-related vision loss - ModernMedicine

Photo: Carol Kaliff / Carol Kaliff

File photo of Huckleberry Hill Elementary School in Brookfields JDRF Kids Walk for Diabetes in April 2014.

File photo of Huckleberry Hill Elementary School in Brookfields JDRF Kids Walk for Diabetes in April 2014.

Bethel kids to walk to cure diabetes

BETHEL Students will walk to raise awareness for diabetes this Saturday.

Bethel High School is hosting its first JDRF Kids Walk to Cure Diabetes to help kids and families affected by type 1 diabetes. Registration begins at 10:30 a.m., with the walk and activities running from 11 a.m. to noon at the high school track.

The Juvenile Diabetes Research Foundation (JDRF) is the leading global organization funding type 1 diabetes research. More than 15,000 children in the United States are diagnosed with type 1 diabetes each year, according to the organization.

As of Thursday afternoon, the school had raised $480, just under half of its $1,000 goal. To donate or participate, visit the teams website at http://www2.jdrf.org/site/TR?team_id=234353&fr_id=6580&pg=team. Donations can also be brought to the walk.

For questions, contact Amy Gusitsch at agusitsch@gmail.com

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Bethel kids to walk to cure diabetes - NewsTimes - Danbury News Times

Eric Fenar is a Type 1 diabetic whoexercises regularly,rigorously measures his blood sugar levels and takes othersteps to stayhealthy.

Still, he says,"In life, it's tough to eat tofu and salad and grilled chicken every day."

He likes Asian food, pizza and beer too much for that.

This is why Fenar has become one of the biggest volunteer pitchmen in the country for an inhalable insulin drug called Afrezza a drug that has helped the 34-year-old Buffalo public school teacher reach the most stable blood glucose levels he's had since he was diagnosed at age 10.

"There is a little bit of a learning curve," he said, "but now I have the power to fight those high blood sugars. Life is much more flexible."

Fenar discovered Afrezza during one of his routine online searches about better diabetes management. He testified at a 2014 federal Food and Drug Administration hearing to tout the promise of Afrezza for those like himself before he'd even tried the drug. He met Al Mann, the creator, before the billionaire businessman died in February 2016.

Fenar grew up in Lancaster. He remembers the weekend he was diagnosed with Type 1 diabetes, because he watched on a hospital television set on Oct. 23, 1993 as Joe Carter hit a home run to help the Toronto Blue Jays win the World Series.

His diagnosis meant that his body produced no insulin to help him break down food. It also meant a lifetime of insulin injections and great sacrifices as he kept vigilant watch on his blood sugar levels or so it seemed at the time.

"I want people to be aware of this option," Eric Fenar says. "This is what I needed: a faster insulin."

"My family has always been up to date on the latest technologies," he said. "I was up to date on the shots for two years and mom read about the insulin pump. Back then it was only for people 18 and over. At this point, I was about 12."

His mother, Susan, a nurse, convinced doctors and health insurers that Fenar was capable of using a pump to monitor his glucose levels and give himself insulin without dispensing a potentially fatal overdose.

Years later, he started to use a Dexcom, a bluetooth-compatible device that reads blood sugar without the need to do a finger-prick blood test. This allowed him to use his pump, or an injection, to push the correct amount of insulin into his bloodstream.

The challenge, Fenar said, is the lag time that comes with injectable insulin. It can take 45 minutes to an hour for the effect to take hold causing damage from high blood sugar and running the risk of an insulin crash or overflow, particularly an hour or so before or after meals.

"The thing that got me is Afrezza starts to work in 12 to 15 minutes," he said.

Dr. Howard Lippes, a Williamsville endocrinologist, assistant clinical professor with the University at Buffalo medical school and owner of R&B Medical Group, prescribes the inhalable drug to about 15 to 20 percent of his Type 1 adult diabetic patients.

Some use it regularly, others intermittently "to correct high glucose," he said. "There are pros and cons. It's not better. It's different."

Lippes doesn't count Afrezza's inhalability as a big advantage, "given the ease of today's insulin pen devices, which are simple and painless," he said. But he and patients who use it appreciate the speed in which it can control blood sugar levels.

For example, those like Fenar who enjoy pizza. When someone without diabetes eats pizza, or other food or drink loaded with carbs, the pancreas starts making insulin right away to compensate for the spike in blood sugar, which can cause inflammation and damage the cardiovascular system.

"If you're diabetic and eat a meal, you've got to give the insulin a running start if you want to catch the blood sugar before it goes up," Lippes said. "The timing of the meal can be a bit daunting. The Afrezza works really quickly, so that is an advantage for some patients."

It also has a shorter "tail" than injectable insulins, leaving the bloodstream faster so the danger of a lingering low blood sugar reaction diminishes, the doctor said.

Lippes prescribes Afrezza almost exclusively for those with Type 1 diabetes. It costs about the same as injectable insulin and is covered by most health insurance plans, he said.

Those with a cough or cold may not want to use it, Lippes said, and it is not recommended for those with asthma or chronic lung diseases like COPD. Its use is discouraged by those who smoke, "not that any diabetic should do that," Lippes said.

A small percentage of patients who try Afrezza get a throat irritation or cough, though the majority of patients tolerate it well.

Despite its advantages, the inhalable drug has yet to reach a critical mass in the diabetes drug industry.

Mann ran 17 companies that helped improve pacemakers, cochlear implantsand insulin pumps. He put $1 billion of his own money into Afrezza before he died, at age 90, and also was at work on developing an artificial retina.

Lippes blamed lagging Afrezza sales on the relative small size of the drug-making company, MannKind, as well as the first inhalable drug, Exubera, which Pfizer introduced more than a decade ago, then pulled from the market in 2007. In that case, the inhalation device was so big, it couldn't fit into a purse and looked like something you'd use to smoke illegal drugs. It proved too cumbersome for most who tried it, Lippes said.

He described the Afrezza inhaler as "a little whistle device," which dispenses powdered insulin in 4-, 8- and 12-unit doses.

The Afrezza inhaler is a whistle-like device, which dispenses powdered insulin in 4-, 8- and 12-unit doses.

Fenar needs a basal insulin injection once a day, to keep his sugar levels stable while he sleeps. Otherwise, he has found reliability in the drug and delivery method he advocates.

"With Afrezza, I was able to get off my insulin pump," he said. "I used to carry what I called a diabetic man purse," with extra pump supplies and extra insulin. "Now, when I leave the house, I have a tenth of what I used to carry.I'm not connected to anything. And for my insulin needs, I take Afrezza.

"I want people to be aware of this option. This is what I needed: a faster insulin."

For Lippes, the drug represents one of several exciting new changes in diabetes treatment.

The next, he said, is the sensor augmented insulin pump. Medtronics Corp. which recently hit the market with its variety, the 670G Pump refers to it as "the artificial pancreas."

"It's not quite there yet," Lippes said, "but we're on the threshold of big changes with these new glucose sensor devices that can tell the insulin pump what to do in real time. I have patients lined up to get it."

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Buffalo teacher a key advocate in breakthrough diabetes drug - Buffalo News

All signs seem to suggest Apple is gearing up to release a special blood sugar trackerfor the Apple Watch.

As it turns out, none other than CEO Tim Cook has been spotted wearing what appeared to be an Apple Watch-connected glucose tracker in the vicinity of the company campus, CNBC reports.

Unfortunately, details remain pretty scarce as of now with the exception that the new wearable module is directly connected to the Watch.

Assuming the Big A manages to fine-tune the rumored blood sugar tracker, the technology could become a must-have for millions of people suffering from or at risk of getting diabetes.

Apple was first rumored to be working on a dedicated diabetes wearable back in April, when CNBC reported the company has assembled a secret super-team of bioengineers to craft a solution for tracking blood sugar levels with the Watch.

Speaking at the University of Glasgow earlier in February, Cook said he had been wearing a continuous glucose monitor for a few weeks but stopped short of making any significant revelation about the gadget.

One thing the Apple chief clarified though is that the device would also make it easier for people to responsibly monitor their blood sugar levels and avoid health complications.

Its mentally anguishing to stick yourself many times a day to check your blood sugar, he commented. There is lots of hope out there that if someone has constant knowledge of what theyre eating, they can instantly know what causes the response and that they can adjust well before they become diabetic.

on CNBC

Read next: Microsoft's new Surface Pro just leaked, but it's not a 'Pro 5'

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Tim Cook is reportedly testing Apple Watch-connected diabetes tracker - TNW

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DAVIS COUNTY, Utah -- The growth rate of Type 1 diabetes among Utah students in grades K-12 is rapid.

The Utah Health Department said the most recent data shows in the 2015 to 2016 school year, there were 2,000 Type 1 diabetic students statewide.

The Davis County School District recognized the rapid increase in newly diagnosed students more than five years ago, and at that time they developed a Diabetes Education Program.

They collaborated with The Juvenile Diabetes Research Foundation, the American Diabetes Association, and the Primary Childrens Hospital diabetes clinic to develop their program.

We've had 56 graduates in this program the past five years, said Adam King, one of the program coordinators. Our number of diabetics has gone up exponentially over the years. There are new ones being diagnosed every day. We had three new ones diagnosed this week."

King said the program provides a valuable service, especially to children who may feel afraid after a diagnosis.

"And being able to have this program helps parents, helps educators, helps students have some confidence because its scary to be diagnosed with diabetes; it's life-threatening," he said. "When they are so young it can cause a lot of fear and apprehension.

Type 1 diabetes is an auto-immune disease and means the pancreas organ has stopped doing its job, which is to produce insulin to break down the food youre eating and turn it into nutrients and energy for your body to use. If the disease is not controlled, it can cause major complications and even become deadly.

When a student is more worried about being able to survive day-to-day, whether they are hungry, whether their blood sugar is going to be up or down, how it's impacting them, they don't have the brain power to think about learning their math or their science or English, King said. A program like this takes all the students as they come, with disabilities, with diabetes, and gives them a safe, appropriate education.

The program is catered to individual diabetics. Some students are older or have a better grasp of their condition early on.

Diabetes can be diagnosed at any age. The program is step-based and starts with the essentials, then progresses to counting carbohydrates and calculating how many insulin units a diabetic would need to inject or dial on their insulin pump.

It starts with basics such as washing hands or starting to recognize how they're feeling, and it develops up through five levels of getting to the point where they are counting their own carbs, doing their own blood sugar checks, and giving their own insulin doses," King said. "At the end they have a one-month trial where they are doing things without having a [Teacher's Assistant] standing there giving that support.

Recently at Knowlton Elementary School, 8-year-old Emerie Gelter, graduated from the program earlier than most diabetic students her age. Emerie is still in second grade.

We are very proud of Emerie, said King as he handed her a certificate of graduation from the program. She has gone through a lot of stuff. She has great family support, but she also does a good job with advocating for herself. She is very precocious. She is very excited and that helps her being a self-advocate.

The program is critical for most diabetic students because they learn to take care of themselves at school as they move on to higher levels of learning.

A lot of times we have students who focus on safety so much that they learn a helplessness to where they expect someone to do everything for them, King said. And while we want them to be safe, we also want them to develop those skills.

The Davis County School District is aware other districts do not use the same diabetes program and have talked with parents who have diabetic children who attend other districts. Those parents have seen what Davis is doing and are encouraged by the results.

Davis County would like to see all Utah schools implement a Diabetes Education Program similar to this one.

I don't know why it's not at other schools; this is something we developed on our own about five years ago because we recognized that while we were trying to achieve our goal with the students self-managing, there wasn't a good way to show their progress," King said."This isn't a one-size fits-all program; this is something that we take standardization and framework and cater to what a student needs and the pace they want to move at.

If you want to explore the program at Davis County School District, click here.

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Young Utahn recognized for early graduation from Diabetes Education Program - fox13now.com

By Robert Preidt

HealthDay Reporter

WEDNESDAY, May 17, 2017 (HealthDay News) -- The type 2 diabetes prescription drug canagliflozin (brand names Invokana, Invokamet, Invokamet XR) appears to increase the risk of leg and foot amputations, the U.S. Food and Drug Administration says.

The FDA is requiring the medications to carry new warnings about the risk. The required warnings on the drug's labeling include the most serious and prominent boxed warning.

The agency's decision is based on data from two large clinical trials showing that leg and foot amputations occurred about twice as often in patients taking canagliflozin as among those taking a placebo.

Amputations of the toe and middle of the foot were the most common, but leg amputations below and above the knee also occurred. Some patients had more than one amputation, some had amputations involving both limbs, according to the FDA.

Type 2 diabetes occurs when the body becomes resistant to insulin. Insulin is a hormone that helps to usher sugar from foods into the body's cells. When this process doesn't work correctly, blood sugar levels rise. Left untreated, high blood sugar levels can cause a number of possible complications, including heart disease, kidney problems and amputations, according to the American Diabetes Association.

Canagliflozin is meant to be used with diet and exercise to lower blood sugar in adults with type 2 diabetes. It belongs to a class of drugs called sodium-glucose cotransporter-2 (SGLT2) inhibitors. These drugs lower blood sugar levels by causing the kidneys to remove sugar from the body through the urine.

It is available as a single-ingredient product under the brand name Invokana and also in combination with the diabetes medicine metformin under the brand name Invokamet.

Patients taking canagliflozin should immediately notify their health care providers if they develop new pain or tenderness, sores or ulcers, or infections in the legs or feet, the FDA said in a news release. Patients should not stop taking their medication without first talking to their health care provider.

Before prescribing canagliflozin to patients, doctors should consider factors that may predispose patients to the need for amputations, including a history of prior amputation, peripheral vascular disease, neuropathy, and diabetic foot ulcers, the FDA said.

In addition, doctors should monitor patients taking canagliflozin for the above signs and symptoms, and discontinue canagliflozin if these complications occur.

In a statement, Janssen Pharmaceuticals, the maker of canagliflozin, said the company had already shared the findings on amputation risk with medical professionals prior to this warning.

"While the incidence was low, the highest incidence of amputations across all treatments was seen in patients with prior amputation," Janssen said. "At Janssen, patient safety is our highest priority. We are working with FDA to include this information in the prescribing information for canagliflozin."

WebMD News from HealthDay

SOURCES: U.S. Food and Drug Administration, news release, May 16, 2017; statement, Janssen Pharmaceuticals

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Diabetes Drug Gets FDA Warning Due to Amputation Risk - WebMD

by: Darrell Greene Updated: May 17, 2017 - 10:40 PM

MEMPHIS, Tenn. - Diabetes is attacking younger Americans more often than ever before.

According to new research released by the New England Journal of Medicine, cases of both type 1 and type 2 diabetes rose dramatically between 2002 and 2012.

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Those new diagnoses crossed all racial boundaries in young people through age 20.

While a cure is still distant on the horizon according to researchers, new treatments are helping diabetics live longer and better lives.

Emily Fonville is your average 15-year-old learning to drive, playing high school sports, and of course dressing up for the prom.

What you can't see in her pictures, is her daily fight against type 1 diabetes.

"It's like the hidden disease," Emily said.

But that fight is becoming more and more winnable.

Just three weeks ago, Emily became the first person in the Mid-South and one of the first in the nation to begin wearing the artificial pancreas.

It's true name, Medtronic is the hybrid closed loop system.

It's comprised of an insulin pump which attaches to the patient's skin, and a sensor which monitors in real time the patient's blood sugar.

The sensor sends those readings to the pump and when the patient's blood sugar is high, the pump gives the patient a precisely measured dose of insulin.

If the patient's blood sugar is too low, it has the ability to suspend delivery of insulin automatically.

"It is a game changer," Emily exclaimed when asked about the new tool.

Dr. Kashif Latif is Emily's doctor. He's one of the leading endocrinologists in the nation.

"There's a lot of technology going on, but this breakthrough has been the best thing ever for people with type 1 diabetes," said Latif who operates the first insulin pump center in nation out of his practice in Bartlett.

And while he admits this is not a cure, he said it's the next best thing to come along to date.

"It kind of matches what our body or our pancreas does for us. It's a more physiologic delivery of insulin for high glucose or low glucose," said Latif.

That means a lot less worry about diabetes for Emily.

"I think it is life changing. Being on this pump I feel like a normal person. I don't have to pull out a shot and give it in the middle of a restaurant.

I can just look down, press a button, and it's done."

FOX13 spoke to representatives of Medtronic who said the company was somewhat taken off guard.

They applied to the FDA for approval of the system in 2015, understanding that the approval process can take years.

But the human trials of the system went so well, the hybrid closed loop system was approved late last year.

Medtronic is making the systems as quickly as they can to fill the need.

2017 Cox Media Group.

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Artificial pancreas helping people with diabetes - FOX13 Memphis

The FDA has approved a new drug that could reverse the effects of diabetic macular edema, which is what causes blindness in people with diabetes.

Jeremy Baker, KENS 1:34 PM. CDT May 17, 2017

A new medication could help reverse diabetes vision loss. (Photo: KENS)

Diabetes is reportedly the number one cause of blindness in the United States. Until recently, there was no way to reverse it. However, a fairly new drug recently approved by the FDA is changing that.

"It was one of those things that's hard to believe," said Sonny Groves, a portrait photographer. He found out he had diabetes 20 years ago. "As the disease progressed, I had problems like neuropathy in the hands and feet, that sort of thing," Groves said.

His vision also started to go. That's when he was referred to the Medical Center Ophthalmology Associates.

"Better control of your blood sugar will give us better control of the back of your eye," said Dr. Michael Singer as he examined Groves' vision. Singer is the director of clinical trials at MCOA.

"Dr. Singer was the first one to notice I had any problems because he noticed tiny bleeders in my retina," Groves said.

"When tissues are deprived of oxygen, they scream for help. They send out a signal called VEGF," said Singer.

The VEGF sends new blood vessels to help the tissues, but that's not a good thing.

"Instead of being helpful, they are actually harmful. They cause swelling in the central part of your vision," Singer said.

In comes a drug called Lucentis.

"This is the first time the FDA has approved a drug like this to reverse the disease," Singer said. The usage is for diabetic retinopathy in patients either with or without diabetic macular edema. This latest approval broadens the diabetic retinopathy indication to include patients both with and without diabetic macular edema.

That disease is called diabetic macular edema. Lucentis is a shot given in the white of the eye after it is numbed. The typical Lucentis dose for diabetic retinopathy is 0.3 mg, which is slightly lower than the 0.5 mg dose used for other eye diseases.

"The process takes literally about two seconds and the results can be seen as early as three days," Singer said.

Groves said the results were amazing.

"When I started taking the Lucentis, it got better. The swelling that causes all of that stopped," Groves said.

"They go from a situation where they are not seeing as well to actually improving their vision and increasing activities they are able to do in their daily life," Singer said.

Now, thanks to Lucentis, Groves said he doesn't have to stop being a photographer.

Some of the side effects of Lucentis could be eye irritation, eye pain, dry eyes or some potentially serious side effects.

Uncommon side effects could reportedly include changes in vision and eye infections.

2017 KENS-TV

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'Breakthrough' drug could reverse vision loss caused by diabetes ... - KENS 5 TV

Science Daily

Improving drugs for type 2 diabetes Science Daily Type 2 diabetes, a prolific killer, is on a steep ascent. According to the World Health Organization, the incidence of the condition has grown dramatically from 108 million cases in 1980 to well over 400 million today. The complex disease occurs when ... and more »

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Improving drugs for type 2 diabetes - Science Daily

Outdoor air temperature may influence a pregnant woman's risk of developing gestational diabetes, a new study suggests.

Mothers-to-be in very cold climes are less likely to develop diabetes during pregnancy than women exposed to hotter temperatures, researchers say.

If borne out in other studies, these findings could have important implications for the prevention and management of gestational diabetes, said study lead author Dr. Gillian Booth.

Changes in temperature may only lead to a small increase in the risk of gestational diabetes, but the number of women affected may be substantial, said Booth. She is a scientist at the Li Ka Shing Knowledge Institute at St. Michael's Hospital in Toronto.

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Also, areas that are getting hotter because of climate change could see more cases of gestational diabetes, the study authors theorized.

Others are less certain of this link, however.

"Temperature and risk of diabetes is a hot topic," said Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City.

However, the study doesn't show a direct cause-and-effect relationship, and Zonszein cautioned that it's too soon to consider the findings definitive.

"Pregnant women or those wanting to become pregnant should not pay attention to this finding at this time, as more studies are needed to show a true causal effect," said Zonszein, who wasn't involved in the study.

Moreover, "the findings of this study do not support that climate change, a rise in global temperatures, increases the incidence of diabetes in Canada or worldwide," he said.

Booth explained that gestational diabetes in women develops in the second trimester of pregnancy and is usually temporary. Women are screened for it at 24 to 28 weeks of pregnancy.

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If there is a connection between temperature and gestational diabetes risk, cells called brown fat might help explain it.

According to Zonszein, "Brown fat cells are cells that -- instead of storing energy -- burn energy."

Booth speculated that extreme cold triggers activity of brown fat, thus controlling weight gain. It might even lead to weight loss, improving blood-sugar levels, she noted.

However, Zonszein said that many environmental factors -- such as excessive food intake, sugary drinks, inactivity, stress and lack of sleep -- can cause gestational diabetes in women genetically susceptible to the disease.

"Genetic factors are very important," he said, "and they are affected by many environmental factors, probably temperature is one more."

For this study, the researchers analyzed about 500,000 births in the Toronto area over 12 years. The researchers also looked at the average temperature for 30 days before diabetes testing, then compared temperature readings with results of the diabetes testing.

In women exposed to extreme cold -- 14 degrees Fahrenheit or lower -- in the month before the test, gestational diabetes was less than 5 percent. But it was about 8 percent for women when temperatures averaged 75 degrees Fahrenheit or higher, the findings showed.

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Not just heat stroke, but kidney stones, salmonella and other health issues may become far more prevalent as our planet gets warmer

Moreover, the odds of developing gestational diabetes rose slightly with every 18-degree rise in temperature, Booth said.

The association held up whether women were born in hot climates or colder regions, she added.

"Furthermore, the same association was seen when we looked at consecutive pregnancies in the same woman," Booth said.

Besides a healthy diet and physical activity to avoid excess weight, controlling temperature might be something women can do for a healthier pregnancy, Booth suggested.

"For example, turning down the thermostat and getting outside in the winter, or using air conditioning in summer, and avoiding excess layers in hot weather may help to lower the risk of gestational diabetes," she said.

An association between temperature and gestational diabetes was also reported last September in a Swedish study. In that paper, researchers found that gestational diabetes was more common in the summer than in other seasons.

Booth said the findings of the new study might also pertain to developing type 2 diabetes.

"The risk factors for gestational diabetes and type 2 diabetes are virtually the same," she said.

The report was published online May 15 in the CMAJ (Canadian Medical Association Journal).

Read more:
Could warmer temperatures raise diabetes risk in pregnancy? - CBS News

Johnson & Johnson (JNJ.N) is required to add new warnings to its diabetes drug, Invokana, about the risk of foot and leg amputations, the U.S. Food and Drug Administration said on Tuesday.

Final results from two clinical trials showed leg and foot amputations occurred about twice as often in patients with type 2 diabetes treated with Invokana, known also as canagliflozin, as those given a placebo, the FDA said in an announcement posted on its website.

The warnings include a boxed warning, reserved for the most serious possible adverse events, the FDA said.

Invokana belongs to a relatively new class of type 2 diabetes drugs called SGLT-2 inhibitors, which help remove excess blood sugar through urine. Others in the class include Eli Lilly and Co's (LLY.N) Jardiance and AstraZeneca Plc's (AZN.L) Farxiga.

The FDA noted that results of one clinical trial showed that over the course of a year the risk of amputation in patients treated with Invokana was equivalent to 5.9 out of 1,000, compared with 2.8 out of 1,000 for patients given a placebo.

A second trial showed the risk of amputation was equivalent to 7.5 out of every 1,000 patients treated with Invokana compared with 4.2 out of every 1,000 patients given a placebo.

The agency said amputations of the toe and middle of the foot were the most common but that amputations involving the leg, below and above the knee, also occurred.

Untreated type 2 diabetes can cause blindness, nerve and kidney damage and heart disease.

(Reporting by Toni Clarke in Washington and Bill Berkrot in New York; Editing by Lisa Shumaker)

DUBAI/CAIRO Spilling into the hallways of crowded Yemeni hospitals, children writhe in pain from cholera. Displaced villagers roam baking hot plains and barren mountains to evade warring militias.

The U.S. Justice Department for the second time in a month sued UnitedHealth Group Inc on Tuesday, accusing the nation's largest health insurer of obtaining over $1 billion from Medicare to which it was not entitled.

Merck & Co Inc and Upsher-Smith Laboratories Inc have agreed to pay $60.2 million to resolve a lawsuit that said they entered into a deal to unlawfully delay the availability of generic versions of potassium supplement K-Dur.

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FDA warns of foot, leg amputations with J&J diabetes drug - Reuters

In Brief A year after receiving a new type of islet cell transplant to treat her severe diabetes, a patient continues to do well and no longer needs insulin injections to manage her disease. A Happy Anniversary

Even the most exciting breakthrough medical treatment can be rendered obsolete by a particularly insurmountable obstacle: time. If a treatment only works temporarily, it has little chance of making a significant difference in the lives of patients, which is why the latest news from the University of Miamis Diabetes Research Institute is so exciting.

A year after transplanting insulin-producing islet cells into the omentum of a woman with a particularly unwieldy form of type 1 diabetes, the cells continue to operate as hoped. She no longer needs to receive insulin via injections or an insulin pump and is in good health.

By using the omentum, a fatty membrane in the belly, as the transplant site, the researchers were able to avoid complications associated with the traditionally used site, the liver. The longterm goal of the research is to identify a suitable location for a pancreas-mimicking mini-organ called the BioHub. Based on this patients response, the omentum is looking like it just may be the ideal spot.

Prior to this transplant, the patients entire life revolved around her diabetes. Her quality of life was severely impacted. She had to move in with her parents. And, if she traveled, she had to travel with her father, the studys lead author, Dr. David Baidal, told HealthDay.

Unfortunately, shes not alone in having diabetes control her life. According to the Centers for Disease Control, 9.3 percent of the United States population has diabetes, and 28.7 percent of those people have to inject insulin to manage their disease. If improperly treated, diabetes can lead to a range of ailments, from blindness and high blood pressure to nerve damage or even death.

This patients positive reaction to her islet cells transplant could be the first step to helping those millions of people live normal, healthy lives free from the burden of constantly managing their disease. Were exploring a way to optimize islet cell therapy to a larger population, said Baidal. This study gives us hope for a different transplant approach.

See the article here:
A Patient With Diabetes No Longer Needs Insulin After Receiving A Bioengineered Pancreas - Futurism

Gestational diabetes is a birth complication affecting millions of women worldwide. New research examines the link between air temperature and the risk of developing this condition.

Gestational diabetes (GD) is a temporary form of diabetes that affects some women during pregnancy. These future mothers often have no history of diabetes prior to getting pregnant, but their blood sugar increases by the time they are halfway through their pregnancy.

In 2014, the Centers for Disease Control and Prevention (CDC) reported that in the United States, as many as 9.2 percent of pregnant women may be affected by GD. Worldwide, around 1 in 7 births are affected by this complication.

GD occurs when the hormones in the placenta trigger insulin resistance, meaning that healthy blood sugar levels cannot be maintained.

Sensitivity to insulin is known to be improved by exposure to cold temperatures, during which the body produces more heat to keep itself warm. However, could it be that outside air temperatures have a larger impact on the risk of developing GD?

Researchers from St. Michael's Hospital, the Institute for Clinical Evaluative Sciences (ICES), Mount Sinai Hospital, and the University of Toronto - all in Ontario, in Canada - set out to explore the connection between outdoor air temperature and the risk of GD.

The findings were published in CMAJ.

The study examined 555,911 births from 396,828 women over a period of 12 years, from 2002 to 2014.

The women were 31 years old on average, and lived in the Greater Toronto Area. Approximately half of the mothers were not born in Canada.

Extremely cold outdoor temperatures were defined as an average of 10C or less, and hot temperatures as 24C on average.

The women were exposed to these different temperatures for 30 days before being screened for GD.

GD occurred in 4.6 percent of the women that had been exposed to extremely cold temperatures, but this number jumped to 7.7 percent for the women who had been exposed to hot temperatures.

Furthermore, each 10C increase in temperature correlated with a 1.06 times higher risk of GD. A similar trend was found when the temperature increased between two pregnancies in the same mother.

"By further limiting our analysis to pregnancies within the same woman, we controlled for a whole number of factors," says co-lead author Dr. Joel Ray, a researcher at St. Michael's and ICES. "Doing so allowed us to eliminate factors like ethnicity, income, activity, and eating habits that would differ between two different women."

Lead author Dr. Gillian Booth, a researcher at St. Michael's and ICES, reports on the findings:

"We observed a direct relation between outdoor temperature and the risk of gestational diabetes among nearly 400,000 women residing in a single urban area in Canada.

After adjusting for influential risk factors, each 10C increase in [...] temperature was associated with a 6-9 percent relative increase in the risk of gestational diabetes mellitus."

Although the study was observational and cannot provide causality, Dr. Booth offers a potential explanation for the seemingly counterintuitive results:

"Many would think that in warmer temperatures, women are outside and more active, which would help limit the weight gain in pregnancy that predisposes a woman to gestational diabetes. However, it fits a pattern we expected from new studies showing that cold exposure can improve your sensitivity to insulin, by turning on a protective type of fat called brown adipose tissue."

"Although we studied a single geographical region, our findings are likely to be generalizable to other regions in North America and worldwide," say the authors.

They also warn that, if their findings are correct, this could potentially mean that the worldwide number of GD cases might continue to increase as a consequence of global warming.

"Although changes in temperature of this size may lead to a small relative increase in the risk of gestational diabetes mellitus, the absolute number of women affected in Canada and elsewhere may be substantial," the authors conclude.

Learn how the link between depression and GD can work two ways.

Originally posted here:
Can outdoor temperatures influence gestational diabetes? - Medical News Today

KJZZ

Diabetes Patients And Tech Companies See Value In Continuous Glucose Monitoring KJZZ Yehuda Friedman is a hockey fanatic. When the 11-year-old isn't on the ice, he's zooming around his house in Phoenix on rollerblades, taking shots on the net in the living room. But two years ago Yehuda started feeling lethargic and lost a bunch of weight.

Excerpt from:
Diabetes Patients And Tech Companies See Value In Continuous Glucose Monitoring - KJZZ

The American Diabetes Association is teaching Mick Mulvaney, who serves as head of the Office of Management and Budget under President Donald Trump, a valuable lesson about human biology.

On Thursday, Mulvaney told an audience at the Light Forum at Stanford University that people who get diabetes may not deserve affordable health insurance.

That doesnt mean we should take care of the person who sits at home, eats poorly and gets diabetes. Is that the same thing as Jimmy Kimmels kid? I dont think that it is, Mulvaney told the audience, according to a report by the Washington Examiner.

Butas the American Diabetes Association pointed out in a public statement on Friday, the notion that the condition is solely caused by poor lifestyle choices is both offensive and inaccurate.

All of the scientific evidence indicates that diabetes develops from a diverse set of risk factors, genetics being a primary cause, the statement said. People with diabetes need access to affordable health care in order to effectively manage their disease and prevent dangerous and costly complications. Nobody should be denied coverage or charged more based on their health status.

This isnt the first time that Mulvaney has made comments which critics perceived as calloused and factually challenged. In March, Mulvaney caught flak for arguing that cutting funds to Meals on Wheels was probably one of the most compassionate things we can do because it allowed the government to guarantee to you that that money is actually being used in a proper function.

Not only was this remark derided for its insensitivity, but it ignored the fact that Meals on Wheels has been demonstrably very effective.

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Mick Mulvaney gets schooled about diabetes after saying it's caused by poor lifestyle choices - Salon

Diabetes during pregnancy has long frustrated doctors trying to discern why some women are more at risk for the disease than others. Though some factors have been associated with increased risk for the condition, including age, family history, excess weight and race, many questions remain.

A new study published today in the Canadian Medical Association Journal looked at 396,828 pregnant women and found another potential factor that could increase the risk for gestational diabetes: rising temperatures.

"There is also growing evidence supporting a link between air temperature, metabolic function and energy expenditure," the authors wrote.

Researchers at the Mount Sinai Hospital, University of Toronto and St. Michael's Hospital in Toronto, studied 555,911 births from women in the Toronto area between 2002 and 2014 to see if certain temperatures were associated with increased risk of gestational diabetes.

They studied the average temperatures for 30 days before a pregnant woman's routine test for gestational diabetes, which occurs at 27 weeks.

They found that the prevalence of women diagnosed with gestational diabetes was higher if there the weather was warmer shortly before they were diagnosed. When the average temperature was above 24 degrees Celsius, or about 75 degrees Fahrenheit, approximately 7.7 percent of women were diagnosed with gestational diabetes. When the average temperature was below -10 degrees Celsius, or about 14 degrees Fahrenheit, just 4.6 percent of pregnant women studied were diagnosed with the condition.

"If the association between air temperature and risk of gestational diabetes mellitus is real, then modifying the thermal environment (e.g., lowering the setting on a home thermostat or spending more time outdoors in cooler weather) may reduce risk of gestational diabetes mellitus," the authors concluded.

Previous studies have found that cold temperature can have major changes on how the body processes fat and adipose tissue. Cold temperatures are associated with an increase of "brown fat" in the body, which can improve glucose levels and metabolism, according to at least one published study by the National Institutes of Health.

Dr. David Hackney, Division Chief, Maternal Fetal Medicine at UH Cleveland Medical Center, said the study was interesting and joins a growing number looking at how temperature can affect effect the body's metabolism.

It's an "area of concern due to issues regarding rising temperatures and global warming," Hackney said. "We're starting to see a rising number of studies across a number of different fields."

This study is a start. He said that far more research would need to be done to correlate simple temperature changes to rates of gestational diabetes. There may be several factors that could create the relationship.

"As the temperature changes, maybe they go outside less or there's impacts on activity levels or changes in particles of the air," Hackney said.

Gestational diabetes is associated with a host of birth complications. Some fetuses can become extremely large in the womb and become injured during the birthing process or an emergency cesarean section may be required to safely deliver the baby.

Newborns with mothers who had gestational diabetes may also suffer from low blood sugar immediately after delivery. Hackney said there are concerns they could be at increased risk for metabolic issues as they grow older.

For women, having gestational diabetes can increases risk for type 2 diabetes even years after giving birth.

Read more from the original source:
Gestational diabetes may increase with warmer days, study finds - ABC News

Rates of newly diagnosed cases of type 1 and type 2 diabetes are increasing among children and teens in the United States, according to a report published in theNew England Journal of Medicine (NEJM). The fastest rise is among racial/ethnic minority groups.

As reported in Diabetes Care, in the United States in 2009, an estimated 191,986 youth under age 20 had diabetes; 166,984 had type 1 diabetes, 20,262 had type 2 diabetes, and 4,740 had other types.

Here are four things MCOs should know about the study and why diabetes rates are increasing in young populations.

1. The drivers of increased diabetes are very different for type 1 and type 2 diabetes

The NEJM study is the first one to estimate trends in newly diagnosed cases of diabetes types 1 and 2 in youths from the United States five major racial/ethnic groupsnon-Hispanic whites, non-Hispanic blacks, Hispanics, Asian Americans/Pacific Islanders, and Native Americans. The study included 11,244 youth ages 0 to 19 with type 1 diabetes and 2,846 youth ages 10 to 19 with type 2 diabetes.

The reason for increasing incidences of diabetes is most likely very different for types 1 and 2 diabetes, because they are very different in their etiologies, says Elizabeth J. Mayer-Davis, PhD, the lead author of the study and professor and chair, Department of Nutrition, The University of North Carolina, Chapel Hill, North Carolina. Both involve genetic influences, although the specific genes involved are quite different for the two types, and environmental and behavioral factors are likely very different.

For type 1, the specific environmental or behavioral triggers that push the autoimmune process to destroy cells that produce insulin are unknown. For type 2, its believed that childhood obesitywhich has increasedis the main culprit, Mayer-Davis says.

Giuseppina Imperatore, MD, PhD, a study co-author and epidemiologist at the CDCs Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, adds that several reports have also shown that exposure to maternal diabetes in utero has been associated with increased risk of type 2 diabetes in youth. Other factors, yet to be identified, may also contribute to reduced insulin secretion in youth.

2. Rates of newly diagnosed diabetes are higher for type 2 diabetes

The source of data for the NEJM study, TheSEARCH for Diabetes in Youth studyfunded by the CDC and the National Institutes of Health found that from 2002 to 2012, the rate of newly diagnosed cases of type 1 diabetes in youth increased by about 1.8% each year. During the same period, the rate of newly diagnosed cases of type 2 diabetes increased more quickly, at 4.8%.

As our study has shown, there are differences in risk for both diabetes types 1 and 2 across the various racial and ethnic groups, Imperatore says. Understanding these differences is crucial for identifying factors that lead to these diseases.

More:
Rising diabetes rates in children: Four things health execs should know - ModernMedicine

RELATED: Sign up for Lillys track walk

NASCAR fans, get ready to get physical: NASCAR.com is launching a Fit Row series that focuses on the health and fitness aspects of racing and its superstar drivers. Presented by Lilly Diabetes, the exclusive diabetes health partner of NASCAR, the series will feature 10 themed stories and include coverage from Lillys track walk on May 26 from 2-4 p.m. ET at Charlotte Motor Speedway.

With the Fit Row Series, fans will get an inside scoop into how drivers such as Kevin Harvick, Jimmie Johnson and more stay fit, and learn simple tips that focus on areas such as talking to your doctor and making lifestyle changes through healthy eating and exercising that can give you a win when it comes to diseases like diabetes.

In addition to simple healthy tips for consumers, Lilly Diabetes aims to stress an element through the Fit Row series that NASCAR drivers know all too well: Perseverance. Everyone has setbacks and struggles in life, but perseverance is especially important during these times of trials so that you can feel healthy and continue to do the things you love to do.

The goal of Lilly Diabetes driving awareness and education is critical to NASCAR as many of our fans are affected by the disease, NASCAR Vice President of Partnership Marketing Lou Garate said at the time. The rate of Americans developing diabetes continues to rise, and we hope this partnership can help make a positive change in peoples lives.

The Lilly Diabetes #DriveYourHealth Track Walk is the official kick-off event of the Lilly Diabetes and NASCAR health and wellness initiative. The walk aims to encourage NASCAR fans to take action to better manage their diabetes and/or overall health, starting by pledging to walk 1.5 miles around the Charlotte Motor Speedway.

Lilly Diabetes which remains the primary sponsor of XFINITY Series driver and 2017 Daytona winner Ryan Reed increased its relationship with the sanctioning body in March, when it was announced as NASCARs official health partner.

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Lilly Diabetes launches 'Fit Row' on NASCAR.com - Nascar

This isn't the only plan to cure T1D, of course. The FDA approved the first automated system for T1D last September, while other research teams study the possible effects stem cells and 3D printing techniques. This is the first time omentum-implanted islet cells have produced long-term insulin independence in a patient who has T1D, however. The medical team took donor islets and combined them with the patient's own blood plasma. This mixture was then layered onto the patient's omentum via a laproscopic incision.

Islets are clusters of endocrine cells throughout the pancreas; they secrete insulin and glucagon in people without diabetes. These insulin-producing cells have previously been implanted in the liver, but the technique can cause inflammation. The new "tissue-engineered" implant site of the omentum has no such issue and can be accessed with minimally invasive surgery. It also has a similar blood supply and drainage as the pancreas, which is where insulin is typically produced. The result is then a mini-pancreas that supplies insulin more naturally to the patient with diabetes.

"The results thus far have shown that the omentum appears to be a viable site for islet implantation using this new platform technique," said the lead author of the study, David Baidal. "Data from our study and long-term follow up of additional omental islet transplants will determine the safety and feasibility of this strategy of islet transplantation, but we are quite excited about what we are seeing now."

Original post:
Implanting pancreatic cells in your gut could cure diabetes - Engadget