StemCell Therapy

By Serena Gordon

HealthDay Reporter

THURSDAY, Feb. 23, 2017 (HealthDay News) -- You'd probably be surprised if your dentist said you might have type 2 diabetes. But new research finds that severe gum disease may be a sign the illness is present and undiagnosed.

The study found that nearly one in five people with severe gum disease (periodontitis) had type 2 diabetes and didn't know it. The researchers said these findings suggest that the dentist's office may be a good place for a prediabetes or type 2 diabetes screening.

"Be aware that worsened oral health -- in particular, periodontitis -- can be a sign of an underlying [condition], such as diabetes," said study author Dr. Wijnand Teeuw. He's the chief of the periodontology clinic at the Academic Center for Dentistry Amsterdam in the Netherlands.

"Early diagnosis and treatment of both periodontitis and diabetes will benefit the patient by preventing further complications," Teeuw added.

Diabetes is a worldwide epidemic. In 2010, it was estimated that 285 million adults worldwide had diabetes. By 2030, that number is expected to rise to 552 million, according to the study authors. It's suspected that as many as one-third of people who have diabetes are unaware they have the disease.

Untreated, diabetes can lead to a number of serious complications, such as vision problems, serious kidney disease, heart trouble and infections that take a long time to heal, according to the American Diabetes Association.

Periodontitis -- an infection that causes inflammation of the gums and destruction of the bones that support the teeth -- is often considered a complication of diabetes, Teeuw said.

The current study included more than 300 people from a dental clinic in Amsterdam with varying levels of periodontitis or healthy gums. Approximately 125 had mild to moderate periodontitis and almost 80 had severe periodontitis. The rest had healthy gums.

The researchers tested blood sugar levels in all of the study participants using a test called hemoglobin A1c. This test provides an average of blood sugar levels over two to three months.

In people who had never been diagnosed with diabetes, the researchers found that 50 percent of the group with severe gum troubles had prediabetes, and 18 percent had type 2 diabetes. In the mild to moderate group, 48 percent were found to have prediabetes and 10 percent learned they had type 2 diabetes.

There were even significant numbers of people in the healthy gums group that had prediabetes -- 37 percent had prediabetes and 8.5 percent had type 2 diabetes, the study revealed.

Dr. Sally Cram, a periodontist and a spokeswoman for the American Dental Association, said she sees what the study found in her practice every day.

"I see quite a few patients who don't know they have diabetes, and when they don't respond normally to periodontal therapy, I have to say, 'Go to your doctor and get tested for diabetes,'" she said.

And, on the other side, she explained that people with uncontrolled diabetes often see improvement when their gum disease is under control.

"People with diabetes aren't as able to fight inflammation and infection," Cram explained.

Diabetes specialist Dr. Joel Zonszein said frequent or slow-to-heal infections are important signs of diabetes.

"People often come in with severe infections in the skin, and I think it's probably the same for infections in the mouth. People have been living for years with high blood sugar, and even if they go to the dentist, they don't get their blood sugar checked," Zonszein said.

"The relationship between diabetes and gum infections goes two ways. When you improve one, you also improve the other," he added. But it's not clear which comes first, and this study didn't prove a cause-and-effect relationship, only an association, Zonszein noted.

But the findings do show the importance of collaboration between health care providers, according to Zonszein, who is the director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

Cram noted that basic prevention goes a long way toward preventing gum disease.

"Ninety-nine percent of dental problems and disease are preventable. Brush your teeth twice a day and floss once, and see your dentist periodically," she recommended.

Warning signs of gum disease include bleeding gums, receding gums, sensitive teeth, loose teeth, bad breath or a bad taste in the mouth.

The study was published online Feb. 22 in BMJ Open Diabetes Research & Care.

WebMD News from HealthDay

SOURCES: Wijnand Teeuw, D.D.S., M.Sc., chief, periodontology clinic, Academic Center for Dentistry Amsterdam, The Netherlands; Sally Cram, D.D.S., P.C., periodontist, Washington D.C., and spokeswoman, American Dental Association; Joel Zonszein, M.D., director, Clinical Diabetes Center, Montefiore Medical Center, New York City; Feb. 22, 2017, BMJ Open Diabetes Research & Care, online

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Dentists at the Front Line in Diabetes Epidemic - WebMD

DUARTE, Calif.--(BUSINESS WIRE)--An international team of researchers led by City of Hopes Bart Roep, Ph.D., the Chan Soon-Shiong Shapiro Distinguished Chair in Diabetes and professor/founding chair of the Department of Diabetes Immunology, has been able to justify an alternative theory about the cause of type 1 diabetes (T1D) through experimental work. The study results were published online today in the journal, Nature Medicine.

T1D, previously known as juvenile diabetes, affects an estimated 1.5 million Americans and is the result of the loss of insulin-producing cells in the pancreas. The prevailing belief was that the root cause of T1D was the immune system mistakenly identifying those insulin-secreting beta cells as a potential danger and, in turn, destroying them.

Now Roep, along with researchers from the Leiden University Medical Center in the Netherlands, have found a mechanism in which stressed beta cells are actually causing the immune response that leads to T1D.

Our findings show that type 1 diabetes results from a mistake of the beta cell, not a mistake of the immune system, said Roep, who is director of the Wanek Family Project for Type 1 Diabetes, which was recently created with gifts from the Wanek family and anonymous donors to support the institutions goal of curing T1D in six years. The immune system does what it is supposed to do, which is respond to distressed or unhappy tissue, as it would in infection or cancer.

In order to gain a better understanding of why the immune system attacks the bodys own source of insulin the pancreatic beta cells in the islets of Langerhans the team took some clues from cancer molecules that are targeted by the immune system after successful treatment of the cancer with immunotherapy.

One of these cancer targets is a so-called nonsense protein, resulting from a misreading of a DNA sequence that makes a nonfunctional protein. It turns out that the same type of protein error is also produced by the beta cells in T1D. Therefore, Roep and the other researchers believe it is a wrong read of the insulin gene itself that proves to be a major target of the immune system. This error product of the insulin gene is made when beta cells are stressed, Roep said.

Our study links anti-tumor immunity to islet autoimmunity, and may explain why some cancer patients develop type 1 diabetes after successful immunotherapy, he added. This is an incredible step forward in our commitment to cure this disease.

According to the paper titled, Autoimmunity against a defective ribosomal insulin gene product in type 1 diabetes, the findings further support the emerging concept that beta cells are destroyed in T1D by a mechanism comparable to classical antitumor responses where the immune system has been trained to survey dysfunctional cells in which errors have accumulated.

The results of the study give Roep new insight, he said, for his work in developing new vaccines to desensitize the immune system so that it will tolerate islets again, as well as for research into combining immunotherapy with more traditional diabetes treatments to reinvigorate islets.

Our goal is to keep beta cells happy, Roep said. So we will work on new forms of therapy to correct the autoimmune response against islets and hopefully also prevent development of type 1 diabetes during anti-cancer therapy.

The work described in the Nature Medicine paper was supported by the Dutch Diabetes Research Foundation, the DON Foundation and the JDRF.

About City of Hope

City of Hope is an independent research and treatment center for cancer, diabetes and other life-threatening diseases. Designated as one of only 47 comprehensive cancer centers, the highest recognition bestowed by the National Cancer Institute, City of Hope is also a founding member of the National Comprehensive Cancer Network, with research and treatment protocols that advance care throughout the world. City of Hope is located in Duarte, California, just northeast of Los Angeles, with communityclinics throughout Southern California. It is ranked as one of Americas Best Hospitals in cancer by U.S. News & World Report. Founded in 1913, City of Hope is a pioneer in the fields of bonemarrowtransplantation, diabetes and numerous breakthrough cancer drugs based on technology developed at the institution. For more information about City of Hope, follow us on Facebook, Twitter, YouTube or Instagram.

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City of Hope Researchers Discover New Potential Cause of Type 1 Diabetes - Business Wire (press release)

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An effective pan-India diabetic policy is imperative to address the growing burden of diabetes in the country.

An effective pan-India diabetic policy is imperative to address the growing burden of diabetes in the country, experts at the 7th World Congress of Diabetes said here on Friday.Effective policy actions as early as possible is an urgent need to address the growing burden of diabetes in our country, Banshi Saboo, Diabetes India Chairman said in a statement.The government has made pioneering efforts towards diabetes care in India However, there is need for further strengthening of the programmes and implementation in all states and union territories, added Ashok Kumar Das, Professor at Pondicherry Institute of Medical Sciences.The four-day Diabetes India 2017 conference, that began on Thursday, has brought together stakeholders from diverse fields to endorse the philosophy of the Berlin Declaration.It also urged the policy makers to take early action across four primary areas prevention, detection, control and access for the right intervention to prevent the growing menace of the disease.

The Berlin Declaration signed by India in December 2016 is a manifesto establishing foundational principles as well as specific targets and policy recommendations to help countries formulate and implement policies to improve health outcomes for people living with, or at risk of diabetes.More than 3,000 doctors and eminent national and international faculties are taking part in the conference that would continue till February 26.There are more than 69.1 million people in India affected with Type 2 diabetes alone.Poorly controlled Type 2 diabetes can increase the risk of cardiovascular disease, blindness, kidney failure, amputation and premature death.It is estimated that 1 million deaths per year in India are attributable to the Type 2 diabetes.Here are 8 facts about diabetes you didnt know.

Source: IANS

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Published: February 27, 2017 9:59 am

Disclaimer: TheHealthSite.com does not guarantee any specific results as a result of the procedures mentioned here and the results may vary from person to person. The topics in these pages including text, graphics, videos and other material contained on this website are for informational purposes only and not to be substituted for professional medical advice.

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With the speedy rise of diabetes in the country, pan-India diabetic policy urgently required - TheHealthSite

PIKEVILLE SOAR is set to host an obesity and diabetes roundtable at Union College in Barbourville on March 16. The goal of the roundtable will be to identify specific strategies that can be implemented throughout the region through innovation, collaboration and the support of SOAR.network.

This Roundtable event is about next steps, Dr. William Hacker, Chair of the SOAR Community Health and Wellness Advisory Council, said. We refuse to get caught up in the continual loop of negative data and poor outlooks. We know the rates, we know that there is work to be done in our communities and we are bringing together the people, the organizations and the leaders that are ready to work together to reduce obesity and diabetes in our region.

The roundtable will feature bright spot presentations from successful programs and attendees will have the opportunity to participate in one of two separate roundtable discussions: Education, Prevention, and Innovation and Disease Detection and Management. Each discussion will be led by a panel of experts.

Our region continues to struggle with the effects of obesity and diabetes in our daily lives, in our families and in building and maintaining a strong, healthy workforce, Jared Arnett, Executive Director of SOAR, said. We are ready to turn the conversation to identifying strategies that communities can implement to reduce the impact of these conditions and meet the goals of the SOAR Regional Blueprint. We are excited to bring together those with an interest and a desire to be a part of the solution and provide the link for continued conversation and action through the SOAR.Network.

The roundtable will be held at Union College through collaboration with Union College and the Appalachian Regional Commission. The roundtable will take place from 10am-2pm with lunch sponsored by WellCare of Kentucky. Informational booths and posters with evidence based best practice recommendations will be displayed. Registration is free but space is limited. All are encouraged to attend.

All interested in attending can register at http://www.soar-ky.org/healthroundtable.

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SOAR to host obesity and diabetes roundtable - The Floyd County Times

Diabetes Psychosocial Care Addressed by ADA in First Published Recommendations Endocrinology Advisor The American Diabetes Association (ADA) has released a position statement focused on aspects of psychosocial care in type 1 and type 2 diabetes, published in Diabetes Care.1 Based on current diabetes research and recommendations from mental and ...

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Diabetes Psychosocial Care Addressed by ADA in First Published Recommendations - Endocrinology Advisor

Insulin-producing cells (yellow) produce the hormone insulin (green spheres) and are surrounded by other cells in the pancreas.

Carol and Mike Werner/Science Source

By Jennifer Couzin-FrankelFeb. 22, 2017 , 2:00 PM

Type 1 diabetes is one of the most common serious diseases to strike young children, but how does it start? Its a question that has bedeviled scientists for years. Now, a new study pinpoints a warning sign in healthy babies as young as 6 months old. The work could advance prevention efforts and might help explain the genesis of the autoimmune disease.

Type 1 diabetes hits when the body destroys insulin-producing cells in the pancreas. By the time peoplemany of them childrenare diagnosed, most of those cells are gone. Forty thousand new type 1 diabetes cases are recorded each year in the United States, and the disease is on the rise for reasons not well understood. A dream for diabetes researchers is to treat kids earlier, when they are headed down the diabetes road but arent yet there.

About 3 decades ago, scientists discovered a collection of signposts: antibodies directed at certain proteins in the body, including insulin. As they studied these children more intensively, they learned that those with two or more different kinds of these autoantibodies will eventually develop diabetes, though sometimes not for many years. Many clinical trials have since focused on trying to slow disease onset in these individuals.

But what happens before these autoantibodies arise? Ezio Bonifacio, a biologist at the Technische Universitt Dresden in Germany, had the means to tackle this question. He and his colleagues had for years been following children since birth whose genetics and family history put them at increased risk. Beginning in 2000, the researchers began to collect and store blood cells from a subset of these children. Recently, technology had advanced to the point that scientists could analyze single cells in those samples.

We decided that it was time to start to see if there was something happening at the level of the T cells, Bonifacio says. Commonly referred to as the sentries of our immune system, T cells are the villains in diabetes. They for some reason go rogue, leading the attack on insulin-producing cells in the pancreas.

Bonifacio and his colleagues performed sophisticated analysis on T cells from 12 babies who didnt develop autoantibodies latersuggesting they were in the clearand 16 babies who did. Probing the T cells in the lab, they saw that cells from the children who continued down the path toward type 1 diabetes were not normal. Essentially, when the T cells were exposed to a substance called an antigen, which in this case could trigger a response against insulin-producing cells, some of those T cells got activated. This is a faint echo of what happens inside the body of someone developing diabetes: Their T cells are activated against cells in the pancreas much as they would be against a foreign invader, like a virus.

These T cells have somehow already learnt to get halfway toward becoming autoreactive cells, says Bonifacio, whose team reports its findings today in Science Translational Medicine.

Bonifacio cautions that the findings are still preliminary. For one, samples like these from infancy are rare, and thus the number of children whose T cells were studied is modest. For another, although the unusual T cell behavior was entirely absent in kids who didnt get autoantibodies later on, it was recorded in only about half who did.

Still, the work breaks ground by identifying likely signs of type 1 diabetes studies earlier than ever, says Kevan Herold, an endocrinologist at Yale University, who studies ways to prevent the condition. The value of this paper is that theres stuff that can be measured even before the autoantibodies, agrees Gerald Nepom, director of the Immune Tolerance Network and former director of the Benaroya Research Institute in Seattle, Washington.

One central mystery is whats causing the changes in these cells so early in life. Bonifacio and others have looked exhaustively for environmental drivers of type 1 diabetes; although there have been hints of various influences, like certain infections, the punch line here is that the datas inconsistent across all the studies, says Carla Greenbaum, who chairs Type 1 Diabetes TrialNet, which oversees type 1 diabetes treatment and prevention trials, and directs the diabetes program at the Benaroya Research Institute.

So diabetes experts like Greenbaum have their eyes on prevention. Bonifacio is co-leading a study called Pre-POINT-Early, which offers oral insulin to children between 6 months and 2 years old; results are expected sometime next year. An oral insulin prevention study by TrialNet, in people with autoantibodies, will be reported in June. Herold hopes to report data in the near future on a study of an antibody called anti-CD3; he has tested it in newly diagnosed patients and is now trying it as a preventive.

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An early signpost for type 1 diabetes? - Science Magazine

white yogurtGetty Images

Not all saturated fats are created equal, it appears. A pair of new studies suggests that certain sources of saturated fat may be worse than othersespecially when it comes to raising risk for type 2 diabetes.

In one study , published in the American Journal of Clinical Nutrition, researchers from Harvard University and the Universitat Rovira i Virgili in Spain tracked 3,349 Spanish adults for about 4.5 years. Overall, they found that people who consumed higher amounts of saturated fats and animal fats were twice as likely to develop diabetes than those who consumed a lower amount.

When the researchers broke down the results by specific food type, the consumption of butter (at 12 grams a day) and cheese (at 30 grams a day) were both linked to an increased risk of diabetes. On the other hand, people who ate whole-fat yogurt actually had a lower risk than those who didn't.

The researchers have several explanations for these findings. Yogurt contains healthful ingredients, like probiotics and protein, that may have protective effects when it comes to diabetes risk, says lead author Marta Guasch-Ferre, a nutrition research fellow at the Harvard T.H. Chan School of Public Health. Even though the results were adjusted to account for other food intake, unhealthy eating patterns may have influenced them. Butter and cheese often come with carbohydrates, like toast or crackers, Guasch-Ferre says. Plus, people who eat more yogurt tend to have better diets than those who dont, she adds.

The study did not find any significant links between diabetes risk and consumption of red meat, processed meat, eggs or whole-fat milk. That was a surprise to the researchers, who suspect that other factors may have diluted these results. They point out that dietary patterns in Spain are different than those in the United States, and that many of the study participants were following a Mediterranean diet, so these findings may not apply to someone following a typical American diet.

Its safe to say, based on the findings of other studies, that processed meat and red meat are associated with cardiovascular disease and other chronic disease risks, says Guasch-Ferre. We know its beneficial to reduce the intake of these meats and to replace them with healthy fats from plant sources like nuts and olive oil.

However, just because a fat may come from a plant doesn't make it healthy. Palm oil, used in a lot of processed foods, is very high in saturated fat. In another recent study, scientists demonstrate how even one dose of palm oil can affect metabolism and reduce the bodys sensitivity to insulin.

For this research, published in the Journal of Clinical Investigation, German scientists asked 14 healthy men to drink either a glass of plain water or a drink made with palm oil that contained as much saturated fat as a cheeseburger and French fries. When the participants drank one of these beverages, they experienced a reduction in insulin sensitivity, an increase in fat deposits in the liver and changes in their metabolism similar to those experienced by people with diabetes.

For healthy people, the authors say, the occasional fatty meal likely wont cause any permanent damage. But people who regularly eat foods high in palm oil or other saturated fats may face bigger long-term consequences, like chronic insulin resistance and fatty liver disease. Both are risk factors for diabetes.

The American Heart Association recommends that no more than 10% of total calories come from saturated fat and encourages consumption of unsaturated fats and carbohydrates from vegetables, fruits, whole grains, nuts and legumes. Based on recent research, says Guasch-Ferre, these recommendations seem to be just as important for diabetes risk as they are for heart healthand not just because fatty foods can cause weight gain.

I think its probably more that saturated fats have harmful effects on insulin resistance and other markers of inflammation, more than weight gain, she says. More research is needed, she adds, to fully understand the connection or to make clear recommendations about specific foods.

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This Kind of Fat Lowers Your Risk For Diabetes - TIME

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Researchers implicate suspect in heart disease linked to diabetes ... Science Daily Scientists have struggled to trace the specific biology behind diabetes-associated heart disease risk or find ways to intervene. Now, researchers have hunted ... and more »

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Older adults are at a higher risk for diabetes and pre-diabetes than younger Americans. In fact, according to the Centers for Disease Control and Prevention (CDC), more than one in every four Americans over the age of 60 has diabetes, and with age comes greater risks for complications.

Diabetes can lead to heart attacks, strokes, blindness, kidney disease, amputations and even death.

However, studies show it is never too late to make changes to improve a persons health. Motivated adults ready to make lifestyle changes can slow the progression of diabetes and avoid or delay complications.

To help adults who want to get better control of their diabetes, Mountain-Pacific Quality Health, the Medicare quality innovative network-quality improvement organization (QIN-QIO) for Montana, Montana State University Teton County Extension and the Montana Geriatric Education Center are partnering together to offer a series of six, free diabetes classes.

These classes provide fun, informative and interactive ways to help people with diabetes or pre-diabetes (high blood sugar).

Understand diabetes and how it affects the entire body;

Manage diabetes in a way that makes sense for them and their individual health goals;

Become more informed members of their health care teams, as they continue to work with their doctors, diabetes educators and other health care providers to improve their health.

The classes support, not replace, professional self-management diabetes education. While the classes are designed for people with Medicare, anyone with diabetes or pre-diabetes is welcome to attend.

The series kicks off March 7, from 6:45 to 7:45 p.m., in the Alice Gleason room at the Choteau/Teton Public Library at 17 Main Ave. N. Classes will then meet every Tuesday through April 18, excluding March 21. Anyone interested in attending these classes can register by calling 466-2492 or emailing to teton@montana.edu.

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Diabetes series begins on March 7 - Choteau Acantha

Makayla Mattei, 15, went missing from her Virginia home on Friday morning. Her mom is worried that a stranger online lured her daughter to Georgia. Makayla is diabetic.

Ellison Barber and 11Alive , WUSA 12:54 PM. EST February 21, 2017

DUMFRIES, VA (WUSA9) - The family of a missing 15-year-old is afraid their daughter is with a stranger she met on the internet.They are originally from Atlanta and the mom said it is possible the teen may try to make her way toward Georgia.

"We haven't seen her. We haven't heard from her," said Chermene Shaw. "It feels like someone just ripped my heart out of my chest and there's a hole."

Shaws daughter, Makayla "Kayla" Phyllis Mattei, was last seen on Friday morning when she left to attend school at Forest Park High School in Dumfires, Virginia. Shaw says Makayla did not show up for school and hasn't been seen or heard from since.

This is the first time Makayla has ever left home, Shaw told WUSA9, and she's afraid the teen did it because of someone she met on the internet.

A few months ago, Shaw said she noticed her daughter talking to someone through social media.

"We believe she was talking to someone that she believed to be her age We think that this may be an adult, Shaw explained. "They don't live around here. They don't go to school anywhere."

Makayla has diabetes and needs insulin injections. Shaw said when her daughter left home she had medication with her, but she might not use it properly and she does not have a phone.

The mom took her phone away when she noticed her daughter talking to the stranger, and she had started to look through it.

"I had already taken it from her to look into. Even to hand off to the police initially, because my concern already was that there was possibly an adult trying to maybe even lure my child. It seemed so farfetched at the time, she said.

"You know your great fear, you think is to not have your child near to you but to not have them near to you and have them near to someone that possibly means them harm - I feel paralyzed."

Shaw says she and her family have spent days handing out missing flyers to as many people as they can.

"I want Makayla to know that we love her. Everyone is looking for her. Your family. We miss you, Shaw said. "We just want you to come home. If anyone has my daughter - we will find you. I will never stop looking until I get my baby back."

Makaylawas last seen wearing jeans, a pink hoodie, and carrying a dark book bag with the words Georgia State University on the front pocket.

Shaw said the family moved to Dumfries about a year ago. They are originally from Atlanta and Shaw said it is possible Makayla may try to make her way toward Georgia.

If you have any information about Makayla's whereabouts, please contact the Dumfries Police Department at (703)-792-6500.

( 2017 WUSA)

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Missing teen with diabetes believed to be headed to Georgia - 11alive.com

Older adults are at a higher risk for diabetes and pre-diabetes than younger Americans. In fact, according to the Centers for Disease Control and Prevention (CDC), more than one in every four Americans over the age of 60 has diabetes, and with age comes greater risks for complications. Diabetes can lead to heart attacks, strokes, blindness, kidney disease, amputations and even death.

However, studies show it is never too late to make changes to improve a persons health. Motivated adults ready to make lifestyle changes can slow the progression of diabetes and avoid or delay complications.

To help adults who want to get better control of their diabetes, Mountain-Pacific Quality Health, the Medicare quality innovative network-quality improvement organization (QIN-QIO) for Montana, Montana State University Teton County Extension and the Montana Geriatric Education Center are partnering together to offer a series of six, free diabetes classes. These classes provide fun, informative and interactive ways to help people with diabetes or pre-diabetes (high blood sugar)

understand diabetes and how it affects the entire body;

manage diabetes in a way that makes sense for them and their individual health goals;

become more informed members of their health care teams, as they continue to work with their doctors, diabetes educators and other health care providers to improve their health.

The classes support, not replace, professional self-management diabetes education. While the classes are designed for people with Medicare, anyone with diabetes or pre-diabetes is welcome to attend.

The series kicks off Tuesday, March 7, from 6:45 to 7:45 PM, in the Alice Gleason Room at the Choteau/Teton Public Library at 17 Main Ave. N. Classes then meet every Tuesday through April 18, excluding Tuesday, March 21. Anyone interested in attending these classes can register by calling (406) 466-2492 or emailing teton@montana.edu

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Live Healthy with Diabetes: Free Diabetes Classes - Fairfield Sun Times

February 21, 2017 by Mark Derewicz Top Row: Heart arteries in normal mice, diabetic mice, and normal mice with deleted IRS-1 gene. Bottom row: when artery is wounded, diabetic mice with less IRS-1 and normal mice with deleted IRS-1 gene show much greater blockage due to over-proliferation of smooth muscle cells. Credit: Clemmons Lab, UNC School of Medicine

People with diabetes are at high risk of developing heart disease. Despite knowing this, scientists have struggled to trace the specific biology behind that risk or find ways to intervene. Now, UNC School of Medicine researchers have hunted down a possible culprit - a protein called IRS-1, which is crucial for the smooth muscle cells that make up veins and arteries.

According to a study published in the Journal of Biological Chemistry, too little of IRS-1 causes cells to revert to a "dedifferentiated" or stem-cell like state, and this may contribute to the buildup of plaque in the heart's arteries, a condition known as atherosclerosis, which increases the risk of heart attack, stroke, and other forms of heart disease.

"When diabetes is poorly managed, your blood sugar goes up and the amount of this protein goes down, so the cells become subject to abnormal proliferation," said senior author David R. Clemmons, MD, Sarah Graham Kenan Professor of Medicine at the UNC School of Medicine. "We need to conduct more studies, but we think this cell pathway may have significant implications for how high blood glucose leads to atherosclerosis in humans."

The research could bring scientists one step closer to finding drugs to help stave off heart disease in people with diabetes, who are twice as likely to have heart disease or experience a stroke, as compared to people without diabetes. People with diabetes also tend to experience major cardiac events at a younger age.

The study focused on the cells that form the walls of veins and arteries, known as vascular smooth muscle cells. The main function of these cells is to contract whenever the heart beats, helping to push oxygen-rich blood to the body's tissues. When plaque builds up along the arterial walls, these cells gradually lose their ability to contract.

In their previous work, Clemmons and colleagues discovered that diabetes can trigger an abnormal cell signaling pathway that causes vascular smooth muscle cells to proliferate, which contributes to atherosclerosis. But their attempts to correct the abnormal signaling pathway didn't seem to completely solve the problem, leading them to suspect another factor.

In the new study, the team found that IRS-1 acts as an inhibitor of the abnormal signaling pathway thereby keeping the vascular smooth muscle cells differentiated, or specialized. In the absence of IRS-1, the cells revert to a stem-cell like state, which in turn activates the abnormal signaling pathway and promotes cell proliferation.

In people with diabetes, the presence of IRS-1 is strongly influenced by how well - or how poorly - blood sugar is kept in check. Previous studies have shown that patients who frequently or consistently have high blood sugar show dramatic reductions in IRS-1. The new study is the first to link this reduction with a predisposition for heart disease.

"The study suggests that you can't just inhibit the abnormal signaling, which we've already figured out how to do," Clemmons said. "Our work suggests you probably have to restore the normal signaling pathway, at least to some extent, in order to completely restore the cells to normal cell health, differentiation, and functioning."

As a next step, the Clemmons lab will look for things that might stimulate the synthesis of this protein even in the presence of high blood glucose.

To prove that IRS-1 acts as a brake on the abnormal signaling pathway that leads to cell proliferation, the team conducted experiments in three different types of mice: healthy mice, diabetic mice, and nondiabetic mice that were genetically engineered to produce no IRS-1. The scientists made a small incision in the blood vessels of the animals and then watched to see how the vascular smooth muscle cells reacted. In healthy mice, the incision stimulated wound healing but little cellular proliferation. In both the diabetic animals and the nondiabetic IRS-1 deficient animals, the researchers observed a marked increase in abnormal cellular proliferation.

The findings suggest that it may be possible to counteract the deleterious effects of high blood sugar on atherosclerosis by developing drugs that boost IRS-1.

Clemmons said the activities of IRS-1 might also play a role in other diabetes complications, such as eye and kidney disease. The researchers plan to study those potential links.

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Why do some people get Type 2 diabetes, while others who live the same lifestyle never do?

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I was diagnosed with type 2 Diabetes and put on Metformin on June 26th, 2016. I started the ADA diet and followed it 100% for a few weeks and could not get my blood sugar to go below 140. Finally i began to panic and called my doctor, he told me to get used to it. He said I would be on metformin my whole life and eventually insulin. At that point i knew something wasn't right and began to do a lot of research. On August 13th I found Lisa's diabetes story (google " HOW EVER I FREED MYSELF FROM THE DIABETES " ) I read that article from end to end because everything the writer was saying made absolute sense. I started the diet that day and the next morning my blood sugar was down to 100 and now i have a fasting blood sugar between Mid 70's and the 80's. My doctor took me off the metformin after just three week of being on this lifestyle change. I have lost over 30 pounds and 6+ inches around my waist in a month

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Researchers implicate suspect in heart disease linked to diabetes - Medical Xpress

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How treating diabetes is helping to prevent falls and injuries on Coast Live wtkr.com HAMPTON ROADS, Va. - A recent EVMS study in Virginia Beach showed that diabetes is among the top causes of senior falls. We spoke with researchers from the EVMS Strelitz Diabetes Center about ways they are treating and studying diabetes and ...

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Live Well, Be Well diabetes program set in Union County Annanews A free, six-week diabetes self-management course is scheduled to begin on Feb. 28 at the Union County Courthouse in Jonesboro. The Live Well, Be Well with Diabetes course is scheduled from 1 p.m. to 3:30 p.m. each Tuesday in the community room at the ...

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Live Well, Be Well diabetes program set in Union County - Annanews

The proportion of deaths attributable to diabetes in the US is as high as 12 percentthree times higher than estimates based on death certificates suggesta new analysis shows.

For a new study, published inPLOS ONE, researchers used two large datasets that included more than 300,000 people to estimate the fraction of deaths attributable to diabetes among people ages 30 to 84 between 1997 and 2011. To come up with the estimates, researchers calculated the prevalence of diabetes in the population, as well as excess mortality risk among people with diabetes over five years of follow up.

The proportion of deaths attributable to diabetes was estimated to be 11.5 percent using one datasetthe National Health Interview Study (NHIS)and 11.7 percent using the otherthe National Health and Nutrition Examination Survey (NHANES). Among the subgroups examined, the attributable fraction was highest among individuals with obesity (19.4 percent).

The proportion of deaths overall was significantly higher than the 3.3 to 3.7 percent of deaths in which diabetes is identified on death certificates as the underlying cause.

The frequency with which diabetes is listed as the underlying cause of death is not a reliable indicator of its actual contribution to the national mortality profile, writes Andrew Stokes, assistant professor of global health at Boston University School of Public Health, and Samuel Preston, professor of sociology and a researcher with the Population Studies Center at the University of Pennsylvania.

They say their analysis indicates that diabetes was the third leading cause of death in the US in 2010, after diseases of the heart and malignant neoplasms.

Diabetes is associated with a number of diseases and disabilities, including ischemic heart disease, renal disease, and visual impairment. Its prevalence has risen rapidly in the US and worldwide in the last 20 years.

Our results demonstrate that diabetes is a major feature on the landscape of American mortality, and they reinforce the need for robust population-level interventions aimed at diabetes prevention and care, Stokes says.

The study notes that the sensitivity and specificity of death certificate assignments of diabetes as an underlying cause of death are lowfar below those of administrative records or surveys.

When both diabetes and heart disease are mentioned on a death certificate, the researchers add, the decision about whether diabetes is listed as the underlying cause is highly variable.

The NHIS dataset is based on self-reports of diabetes diagnoses, while the NHANES data contains both self-reports and HbA1c levels, a preferred biomarker for the presence of diabetes. Individuals in both datasets were linked to the National Death Index through December 2011 to calculate mortality over five years.

The National Institute on Aging and the National Center for Health Statistics funded the work.

Source: Boston University

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Investigations after boy missing without diabetes medication dies BBC News Two investigations have been launched after a 13-year-old boy who went missing in Edinburgh without his diabetes medication fell ill and died. Blake Ross, who was in care, was reported missing from Howdenhall at 15:15 on Saturday. He was found unwell ... and more »

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Investigations after boy missing without diabetes medication dies - BBC News

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s oncologists race forward with new treatments verging on science fiction and biotech companies press onwith drugs for once-hopeless rare disorders, one of the worlds most pervasive diseases looks like its been left behind.

There are few new drugs on the horizon for diabetes, which affects about 29 million Americans. Most of the treatments in late-stage development are simply improved versions of whats out there taken weekly versus daily, or orally instead of by injection.

So has pharma run out of ideas in diabetes?

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Not exactly. But whether its ideas will ever get to market is another question. Theres plenty of promising science in the early stages of research. Available drugs, however, work pretty well. Given the cost of development and a high bar for approval, pharma can only afford to advance true-blue breakthroughs, and those are hard to come by.

There are unmet needs, but its going to take a really good drug, said Dr. John Buse, director of the Diabetes Center at the University of North Carolina, Chapel Hill. Its not like 10 years ago where you could market acarbose, a drug you have to take three times a day that makes you fart. Now that profile would never make it into Phase 2.

The risky bet behind the first artificial pancreas for diabetes patients

And the economics can be unforgiving. Oral insulin has long been considered a Holy Grail in diabetes research, potentially freeing patients from routine injections in favor of an easy-to-take pill. But late last year, Danish drug maker Novo Nordisk backed away from such a project not because it failed in clinical trials, but because developing it would be too expensive to get a sure return on investment.

That logic frustrates patients and their advocates.

My wish would be that people thinking like that would spend time with the people who face the challenges of Type 1 diabetes, said Derek Rapp, CEO of JDRF, which funds and advocates for research in the field.

But diabetes has become a tough and crowded market. Industry leaders Sanofi, Novo Nordisk, and Eli Lilly have all issued grim sales forecasts in recent years, as pricing pressure makes their past discoveries less and less lucrative.Novo Nordisks CEO abruptly decided to resign last year amid a surprise dip in projected revenue.

Clearly the bar has gone up, said Dr. Philip Larsen, Sanofis head of diabetes research. The larger companies are now in what you could call a thinking-outside-the box mode.

A Novo Nordisk diabetes drug may save lives, but Wall Street shrugs

That means betting on early-stage efforts that could truly move the needle, albeit withhigh odds of failure.

Scientists at Sanofi, for instance, noted that gastric bypass surgery can have remarkable effects on Type 2 diabetes, even sending some patients into remission. Their question: Can that be replicated with a drug? Theyve got a drug, now in mid-stage development, that seeks to copy the cocktail of endocrine events that happens in the aftermath of surgery, Larsen said. The goal:create an injection that spares the need for a knife.

Drug makers are also at work on so-called smart insulin, which would switch on when blood glucose is too high and then harmlessly switch off once it had normalized, reducing the risk of hypoglycemia. Others are digging into the gut microbiome, a network of trillions of microbes, in hopes of finding a way to ameliorate diabetes.

We dont want to add new classes just to have new classes, said Dr. Ruth Gimeno, vice president of diabetes research at Eli Lilly. We want to really make a difference. Were giving ourselves a little more time rather than saying lets just fill the pipeline with incremental things.

And pharma has gradually widened its aperture to include novel technology, examining how wearable devices, glucose monitors, and advanced insulin pumps can work alongside drugs to improve patients lives.

There are some exciting and promising things that are being looked at, but I think the scope of diabetes management is getting a bit wider to be not strictly pharmaceuticals, said Dr. Robert Gabbay, chief medical officer of Harvard Universitys Joslin Diabetes Center. Devices are becoming increasingly important.

For some doctors, the key isnt more new products. Its education to teach themhow to use whats already on the market

Drugs called GLP-1 agonists, introduced more than a decade ago, have proved both to lower patients blood sugar and cut the risk of long-term cardiovascular problems. The same goes for SGLT2 inhibitors, introduced in 2013, which have been shown to reduce the risk of death by 32 percent for Type 2 diabetics.

And yet theyre not being widely used.

Thats in part because most primary care physicians dont know how to use them, said Dr. Athena Philis-Tsimikas, who leads the Scripps Whittier Diabetes Institute in California. The other issue is paperwork: Doctors have to go through a ridiculous number of steps to get patients health plans to cover those new drugs, Philis-Tsimikas said.

Its not like were desperate for something that is additionally innovative, she said. Were not using what we have.

Damian Garde can be reached at damian.garde@statnews.com Follow Damian on Twitter @damiangarde

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There are a lot of barriers standing between the average youth soccer player and a career as a professional. Theres competition, fitness, skills, bad coaching. Jordan Morris had one more barrier to deal with. He was diagnosed with Type 1 diabetes when he was nine.

You dont see a ton of professional soccer players with diabetes, Morris tells Sounder at Heart. My dad recently told me he didnt even think Id be able to play soccer in college.

Having Type 1 diabetes means that Morris pancreas doesnt produce insulin. After eating, sugar and other nutrients enter the blood stream, and insulin helps the body absorb that sugar and turn it into energy. Morris wears an insulin pump, a cell phone-sized device that gives him a steady stream of insulin throughout the day, and more whenever he eats.

Zach Galifianakis surrounded by math in the Hangover

A lot of being a diabetic is trying to keep the amount of sugar in the blood within a specific range. That requires constantly paying attention to insulin, exercise, and food intake. It can feel a bit like living in that gif of Zach Galifianakis enshrouded in a swirling cloud of calculations. Insulin lowers blood sugars. With some exceptions, exercise also lowers them and food has the opposite effect.

Even for diabetics with the best control, the disease is a major health issue. Low blood sugars can make a diabetic feel lightheaded or blur their vision. Serious low blood sugars, although rare, can cause loss of consciousness. On the other hand, high blood sugars can mean headaches or nausea and, if left untreated, can lead to comas.

When I was newly diagnosed, it was scary, Morris says. It was tough. There were a lot of questions going through my mind.

Morris profusely credits his parents (his dad is the Sounders team doctor, and his mom was a nurse) for helping him early on. He had to learn to check his blood sugar multiple times a day: when he eats, exercises, wakes up, goes to bed, or just feels off. Before meals he has to count how many carbs hes going to have, so that he knows how much insulin to give himself, because the body converts most carbs into sugar. He carries a backpack around with diabetes supplies he might need in an emergency.

In his journey from high school to college to Major League Soccer, he has gotten better at dealing with the disease, largely because of how well he has gotten to know his body. Things like how sensitive a diabetic is to insulin (in other words, how much insulin they give themselves for how many carbs they eat, or how much their blood sugar is off), can change based on things as simple as the time of day. So knowing your body helps. Morris has a specific food that he knows works well when he has low blood sugar: fruit snacks. Nowadays, most of his diabetes management is up to him.

Its pretty much all me doing it, Morris says. [The Sounders] obviously do normal dietary stuff with athletes, but in terms of my diabetes, its me kind of having to deal with it, because I know my body best.

Even with all the knowledge that he has stored up, with all he knows about how his body reacts to different stimuli, dealing with the diabetes is still difficult. He has to deal with the fact that no matter how much calculation he does, things can still go wrong.

I think the toughest part about diabetes is its so unpredictable, he says. You can eat the same things, do the same work out a couple days in a row and your blood sugar will turn out differently at the end. Its just different days lead to different blood sugars.

And being a professional adds new difficulties too. Adrenaline raises blood sugars, meaning that on gameday, when hes looking up from the turf at a sea of screaming fans, the same thing that energizes him to play his best is also going to cause a spike in his blood sugars if he doesnt counter it with the exact right amount of insulin.

He fine-tuned how he deals with the adrenaline over the 2016 season. During a game against Portland, his blood sugar went low and he had to scramble over to the sidelines to eat some gummies. He said that during the MLS Cup final in Toronto he came into the locker room feeling sick, checked his blood sugar, and found out it was high. That was annoying.

If things arent right with your blood sugar, youre not going to be as efficient on the field, he said. Obviously as a professional athlete everything should be focused on the game, and not on your diabetes.

Dave Tenney, the Sounders High Performance Director, is impressed with Morris diabetes management. Whatever Jordan says, I trust him, because I know what hes been through and that hes learned to listen to his body better than the average (21)-year-old, Tenney told the Seattle Times last October.

Morris says hes proud of how he has dealt with his diabetes, and of course for making it to MLS, too. Now that hes a Sounder, he says hes trying to be a role model for younger kids. Diabetic athletes Jay Cutler and Adam Morrison gave him hope growing up, and he likes giving that same hope to a new generation of young diabetics.

When I was a kid, I told myself I wasnt going to let it hold me back, and now that my dreams become a reality, its pretty special to see that thats happened. I think it taught me how to be responsible at such a young age. I had to deal with this disease that you have to be constantly aware of. I definitely dont think Id be the person I am today without it.

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By Marlene Cimons By Marlene Cimons February 19

Women typically dont develop heart disease or high blood pressure, one of its major risk factors until after menopause. But if you have diabetes, that rule no longer applies, says Christine Maric-Bilkan, a program officer in the vascular biology and hypertension branch of the National Heart, Lung, and Blood Institute.

Diabetes dramatically increases the risk of heart disease at any age overall, people with diabetes are twice as likely to have heart disease or a stroke as are other people and its impact tends to be greater in women than in men, she says. Diabetes, a disease in which the body either doesnt produce enough insulin (Type 1) or cannot use it properly (Type 2), can cause spikes in blood sugar. Over time, these spikes can damage nerves and blood vessels, putting diabetics at elevated risk of heart disease and stroke.

Uncontrolled diabetes also contributes to vision loss, kidney failure and amputations, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

[What you need to know about those new, deadly heart-surgery infections]

People with diabetes are up to four times as likely to develop cardiovascular disease as are people who do not have diabetes, according to the Cleveland Clinic. Women with diabetes are twice as likely to suffer a second heart attack and four times as likely to suffer heart failure as are women who do not have the disease, according to the American Diabetes Association.

The risk of developing hypertension doubles in men and quadruples in women if you have diabetes, Maric-Bilkan says. (Hypertension is a major contributor to heart disease.)

There is something about diabetes that takes away the protective factor against heart disease that premenopausal women seem to have, something probably related to estrogen, she says. Women are not impacted by heart disease as much as men at younger ages, but once they have diabetes, that protection is lost and diabetes has an overall greater impact on women, compared with men, at all ages.

In 2011, Maric-Bilkan tested a small group of premenopausal Finnish women with Type 1 diabetes and found that they all had lower-than-normal estrogen levels.

[Diabetes was once a problem of the rich. Now it belongs to the poor.]

I dont know if they got diabetes because their estrogen levels were reduced, or the reverse, she says. One thought is that its the estrogen that gives protection, but men with diabetes, who also have a greater risk of heart disease, have high estrogen and low testosterone, the opposite of women. So the high estrogen doesnt protect men. Diabetic women have more testosterone than non-diabetic women, so it may have to do with the balance of hormones.

She stresses that the risk of death from heart disease is exceptionally high in women with early-onset [Type 1] diabetes compared with women in the general population, according to a study she authored.

Women with diabetes need to understand that the risk of getting heart disease is significant, and they need to be aware of it, she says.

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Women with diabetes are especially prone to developing heart ... - Washington Post