CDC researchers estimate that 28.5% of U.S. diabetes patients over age 40 have diabetic retinopathy, an eye disorder in which the blood vessels of the retina are damaged by diabetes. CDC researchers also reported that 4.4% of the U.S. population is estimated to have vision-threatening retinopathy, which, if left untreated, can lead to blindness.

The findings suggest a need for more comprehensive eye care, particularly among patients with diabetes who are at risk for retinopathy, the researchers report. Their study results are published in the Aug.  11 issue of the Journal of the American Medical Association.

Eight percent of the U.S. population is estimated to have diabetes, but CDC researchers note there have been few studies documenting the prevalence of diabetic retinopathy. “Investigating the prevalence of diabetic retinopathy is important because it is a key indicator of systemic diabetic microvascular complications, and as such, a sentinel indicator of the impact of diabetes,” writes the research team led by Xinzhi Zhang MD, PhD.According to the authors, diabetic retinopathy is the leading cause of new cases of legal blindness in the U.S. among people aged 20 to 74, and treating diabetes-related blindness costs about $500 million per year.

Researchers analyzed data on 1,006 people who participated in the National Health and Nutrition Examination Survey 2005-2008. Participants with gestational diabetes, severe visual impairment, or eye infections were excluded from the analysis.

The Financial Times reports that AZ has agreed to pay out $198 million to settle 17,500 cases filed against the company—about two thirds of the total of cases filed. The settlement amounts to about $11,300 per claimant, the article reported. About 8,600 cases against AZ still remain to be heard. A series of trials against the company will begin in Delaware, Florida and New Jersey in November, the article noted.

In addition, seven US states are seeking fines and compensation from AZ for treatment of side effects of Seroquel and unapproved prescriptions of the drug.  Seroquel continues to generate revenue in excess of $4 billion each year, and it remains the company’s second biggest seller. The FDA has issued warnings against AZ’s Seroquel promotional materials, stating that they are misleading, overpromising, and do not warn against the potential of developing diabetes, an Associated Press article said.

While AZ denies the validity of claims saying that they have known about the dangers of Seroquel, they continue to fight to keep internal documents from the public eye. Thousands of cases still remain to be heard, and the story is far from over.

Diabetes Basics
Diabetes is a condition characterized by faulty sugar metabolism, resulting in high levels of sugar in the bloodstream. In Type 1 diabetes, the pancreas does not make enough insulin to control blood sugar. In Type 2 diabetes, the body becomes resistant to insulin. If not controlled, the disease can lead to long-term complications that include heart and circulatory disease, kidney failure and cataracts. Type 2 diabetes is the preventable kind.

Insulin Resistance
The hallmark of diabetes is insulin resistance, which is the loss of sensitivity of the body’s cells to the effects of insulin. As a result, the pancreas puts out more insulin to drive the sugar in the bloodstream into the cells to be burned or stored. With excess insulin around, cells become immune to its effects, and this further exacerbates insulin resistance. Reversing insulin resistance by re-sensitizing cells to insulin is the key to preventing diabetes. The right foods and nutritional supplements, as well as exercise, help to restore the communication between insulin and the body’s cells.

Low Glycemic Diet
A low glycemic diet is designed to maintain blood sugar levels on an even keel, so as to minimize insulin levels. Small, frequent meals and snacks should include some protein and/or fat to “buffer” the carbohydrate foods, thus slowing their absorption into the bloodstream. Sources of carbohydrates include fruits, vegetables, whole grains and whole, unprocessed starches such as dry beans, yams and sweet potatoes. Nuts, seeds, olives, olive oil, avocados and fish provide monounsaturated fat and omega-3 fatty acids that help to reverse insulin resistance. All beverages are sugar-free. You can eat an occasional sweet after a meal rather than alone as a snack.

Exercise
Most diabetics are aware that exercise helps them to control their blood sugar levels. In contrast with unconditioned muscles, toned and developed muscles are more responsive to blood sugar and insulin. Regular exercise helps lower blood sugar and improve insulin sensitivity. According to Journal of the American Medical Association, people who exercise consistently have a dramatically reduced risk of developing diabetes.

Nutritional Supplementation
Two nutrients that are often lacking in the American diet are chromium and omega-3 fats. Chromium is an essential trace mineral that may play a key role in glucose metabolism. Supplementation with chromium helps to normalize blood sugar levels, as demonstrated in the American Journal of Clinical Nutrition. A deficiency of chromium causes glucose intolerance, which can lead to the development of Type 2 diabetes.

As reported in the Journal of Nutrition, omega-3 fatty acids can also lower the risk of diabetes by reducing insulin resistance. High-quality fish oil is the best source of omega-3 fats. Recommended doses for fish oil are 2g to 4g per day.

Imagine simply shining a light on your skin to determine how much sugar is in your blood. Researchers at MIT are developing a glucose-monitoring device for diabetes patients that may help do away with finger pricks.

By scanning a user’s arm or finger with near-infrared light, the device frees users from the necessity of drawing blood, a daily routine for most type 1 diabetes patients.

The laptop-size machine is the result of 15 years of research at the MIT Spectroscopy Lab. It employs Raman spectroscopy, which can determine chemical compounds based on their molecular vibration.

In a technique described in an Analytical Chemistry paper, the researchers fire near-infrared light into the skin. It only penetrates about half a millimeter, reaching the interstitial fluid surrounding skin cells, but not the blood itself.

While glucose is represented in the interstitial fluid, there’s a delay of up to 10 minutes between the time it spikes in the bloodstream (after someone consumes sugary food, for example) and the time it surges in the fluid.

The researchers developed an algorithm that lets them predict blood glucose based on measurements of interstitial fluid glucose, as well as a calibration method that takes into account the rate at which glucose hits the fluid.

The team has done a small study on human volunteers, and plans another study this fall. The effort is one of many using techniques such as spectroscopy and ultrasound to check glucose without breaking the skin. Earlier this year, in fact, MIT engineers also announced work on designing carbon nanotubes that can be injected beneath the skin to reveal continuous blood glucose levels in real time–kind of like a high-tech tattoo.

Morrow, on the field at least, has had a brief and, until today, unremarkable major league career. Before today, he had a 16 and 18 lifetime record and a 4.71 earned run average. Today, however, he nearly secured his place in baseball immortality.

But to millions of diabetics around the world, Morrow was, or at least should have been, a role model already.

In his senior year in high school, Morrow began losing weight and drinking inordinate amounts of water. He mentioned his situation to a friend who said the symptoms sounded similar to that of diabetes. Morrow saw a doctor and a short while later, he was diagnosed with Type 1 diabetes.

Morrow, however, did not allow the chronic disease slow him down. In fact, he sees the steps he needs to take to manage his diabetes as being very similar to the things all successful Major League Baseball players must do; he realized that routine would be a very important part of his life going forward.

Brandon Morrow - Diabetes News | ControllingDiabetes.com

In an interview earlier this year, Morrow said about battling diabetes, “Right off the bat it’s all about routine. You’ve got to keep your sugar levels stable and in a good range. So develop your routine, especially on game days. It doesn’t have to be a worry. Find what works for you so then you don’t have to worry about, ‘Man, am I going to go low during a game?’ Once you have that routine down, you’re fine.”

While ultimately talent matters the most when competing at the top level of any sport, the discipline and focus required for Morrow to compete in the Major Leagues likely seems like small potatoes when compared to the importance his health routine commands; the ability to stay focused on testing, adjusting and measuring his blood sugar levels regardless of what else is going on that day.

On some level, the routine inherent to playing Major League Baseball may make it easier for Morrow to stay focused on his diabetic needs and routine. But similarly, the focus and discipline that Morrow has demonstrated throughout his adult life when staying focused on his health needs must make his baseball routine seem easy by comparison.

Today, Brandon Morrow, a type 1 diabetic, conquered theTampa Bay Rays in near no-hit fashion; it must somehow seems rather trivial in comparison to his battle against diabetes while also meaning everything in the world to diabetics around both Canada and the United States.

Source: Sean Brennan, “Toronto Blue Jays pitcher Brandon Morrow manages diabetes with routine, faces New York Yankees”, nydailynews.com

A study in mice found that the breakdown of old bone to make way for new bone growth also helps to keep a healthy level of glucose in the blood.

A hormone called osteocalcin seems to be the link, it showed.

The Columbia team, writing in Cell, say the findings may lead to better drugs to help control Type 2 diabetes.

Study leader Dr Gerard Karsenty, from Columbia University Medical Center, had already done work showing osteocalcin, which is released by bone, can regulate glucose levels.

It switches on the production of insulin in the pancreas which in turn improves the ability of other cells to take in glucose from the blood.

But in the latest study, he found that osteocalcin only works when bone is being broken down during its natural turnover.

Further tests on osteocalcin and glucose levels in a small group of patients with a genetic defect in their bone turnover supported the initial findings in mice.

‘Important implications’Type 2 diabetes is the most common form of the condition and is caused when the body no longer properly responds to insulin leading to out of control blood sugar.

The results suggest that for some people, diabetes may be triggered by changes in the skeleton.

Also drugs designed to stimulate this link between bone and insulin may lead to better treatments for type 2 diabetes, he adds.

One important consequence of the finding is that bone-strengthening drugs used in conditions such as osteoporosis may interfere with this process and cause problems with blood sugar.

“This research has important implications for both diabetes and osteoporosis patients,” he said.

“First, this research shows that osteocalcin is involved in diabetes onset

“Secondly, bone may become a new target in the treatment of type 2 diabetes as it appears to contribute strongly to glucose intolerance

“And finally, osteocalcin could become a treatment for type 2 diabetes.”

Dr Victoria King, head of research at Diabetes UK, said: “The research is interesting and this area of investigation could open up the possibility of more targets for drugs to treat or prevent type 2 diabetes.”

But she warned the research was in the very early stages.

“What we do know at this stage is that lifestyle changes such as maintaining a healthy weight, eating a balanced diet and being more physically active can help to reduce your risk of developing type 2 diabetes, and can also help people diagnosed with the condition to manage it more effectively.”

In a paper published on June 14, 2010, in the Archives of Internal Medicine, the researchers reported that frequently eating white rice increased the risk of type 2 diabetes. Those who reported eating at least 5 weekly servings of white rice had a 17% percent higher risk than those who ate less than 1 serving per month. In contrast, those eating at least 2 weekly servings of brown rice had an 11% lower risk of developing type 2 diabetes than those eating less than 1 serving per month. The findings held even after scientists adjusted for several factors that might influence the results, including age, weight and family history of diabetes.

In a new study, researchers at the Harvard School of Public Health and Brigham and Women’s Hospital analyzed rice consumption and diabetes risk among nearly 200,000 people who had participated in 3 large studies of nurses and other health professionals. Every 2-4 years, the participants completed questionnaires about their diet, lifestyle and health conditions. During 14 to 22 years of follow-up, about 5,500 cases of type 2 diabetes arose among participants. The research was funded in part by NIH’s National Cancer Institute (NCI) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

The researchers calculated that replacing just one-third of a typical daily serving of white rice with the same amount of brown rice might reduce the risk of type 2 diabetes by 16%. The same replacement with other whole grains, such as whole wheat and barley, could lead to a 36% reduced risk, the scientists estimated. The current Dietary Guidelines for Americans recommend that at least half our carbohydrates come from whole grains.

The researchers note that a potential limitation of their study is that the analyses were based on participants’ self-reported intake of brown and white rice, which may not be accurate. However, they note that the large number of people studied, and the consistent results across all 3 study groups, add validity to the findings.

“Rice consumption in the U.S. has dramatically increased in recent decades,” says lead author Dr. Qi Sun. “We believe replacing white rice and other refined grains with whole grains, including brown rice, would help lower the risk of type 2 diabetes.”

Researchers have developed an implantable sensor that continually monitors blood sugar then transmits the information to a receiver without wires.

The device was tested in a pig for more than a year without trouble.

A research team at the University of California at San Diego calls the device a “milestone in diabetes treatment.”

The researchers say it also takes the field of diabetes a step closer to development of an “artificial pancreas” that could control the way the body handles blood sugar.

Scientists believe the device, that detects oxygen in the tissue where it’s implanted to measure glucose, will be able to send information to cell phones.

That would be especially helpful for parents of diabetic children who spend days and nights worrying whether their child is threatened by nocturnal hypoglycemia.

Details of the research is reported in the journal “Science Translational Medicine.”

The researchers hope to begin human trials for the device in a few months.

For the new study, researcher William H. Herman, MD, MPH, professor of medicine and epidemiology at the University of Michigan, Ann Arbor, evaluated a large database of managed care patients who had diabetes. He found that those who suffered fractures were more likely to be taking the class of drugs known as TZDs (thiazolidinediones), such as Actos and Avandia.

The fracture risk he found, Herman tells WebMD, was primarily among postmenopausal women, who already tend to have lower bone density. “Diabetic women over 50 with fractures were 70% more likely to be taking a TZD drug than women without fractures,” he says.

The study is published online in the Journal of Clinical Endocrinology & Metabolism.

“A lot of the focus [with this class of drugs] has been on cardiovascular risk,” Herman tells WebMD. Recently, an FDA advisory panel voted to keep the drug Avandia, linked with a higher risk of death and cardiovascular problems in older patients, on the market, but with stronger warnings.

But Herman notes that the side effect of fractures is also important to examine. “Fractures do have a major impact on quality of life,” he says.

Diabetes Drugs and Fracture Risk: A Closer Look

In the new study, Herman and his colleagues used data from a large study known as TRIAD, identifying  786 cases of fractures and comparing them to 2,657 patients who had diabetes but no fracture history.

Of the 786 patients with fractures, only 54 were women less than 50 years old, while 457 were women 50 and older and 275 were men.

The researchers looked at prescriptions participants had filled during the 90 days prior to the fracture date or 90 days before a designated study date for those without fractures.

The finding that women with fractures were much more likely to be taking a TZD drug held for both Avandia and Actos, they found. “So it seems to be a class effect,” Herman says.

The higher the dose, the higher the fracture risk, they found.

Among the men, only those taking a TZD along with a potent diuretic, called a loop diuretic, were more likely to have a fracture. Taking TZD alone did not appear to increase risk in men.

Loop diuretics have been linked with bone density decreases, Herman says.

Why the TZD drugs boost fracture risk may be due to effects such as the reduction of new bone formation or increased bone breakdown, he says.

The fractures found, he says, ”are not typical osteoporosis fractures,” which include those of the spine and hip. They found some spine and hip fractures, but also many lower limb, arm, and leg fractures.

The study was funded by the CDC and the National Institute of Diabetes and Digestive and Kidney Diseases. Herman has served as a consultant for GlaxoSmithKline, which makes Avandia.

Diabetes Drugs and Fractures: Diabetes Expert View

The study does add to existing information about diabetes drugs and fracture risks, says David Kendall, MD, chief scientific and medical officer of the American Diabetes Association, who reviewed the study for WebMD.

”This is certainly not the first of these larger studies where I would say this unanticipated event was noted,” says Kendall, also an associate professor of medicine at the University of Minnesota, Minneapolis.

“Depending on the study, it appears that people who take TZDs for longer periods of time have about a one-and-a-half to twofold increase in their risk of fractures,” he says.

Even so, he says, “These are very effective medicines for some patients. We have to understand there are potential risks. Certainly anyone already considered to be at fracture risk — a woman with osteoporosis — or someone who suffers from instability or frequent falls, you should think carefully about the use of the medications. On the other hand, fractures in total  [in Herman's study] were generally rare. Far more people didn’t have fractures than did have.”

In sum, he says, the study finding “is a new piece of information that needs to be taken into consideration when evaluating the potential benefits and risks of yourdiabetes treatment regimen.”

Diabetes Drugs and Fractures: Industry View

Earlier studies have found the same increased risk for fracture, says Mary Anne Rhyne, a spokeswoman for GlaxoSmithKline, which makes Avandia. “Currently the label for Avandia contains a warning/precaution regarding the risk of fractures with Avandia,  usually occurring in the hand, upper arm, or foot, in females. The label further encourages patients to speak with their doctor for advice on how to keep bones healthy.”

Ongoing studies may shed more light on the link, Rhyne says.

Takeda Pharmaceuticals, which makes Actos, is conducting a study to examine and better understand the issue of fractures while on the drug, says Elissa Johnsen, a spokeswoman.

The company analyzed the entire database of the Actos clinical trials, she says, and did find increased reports of fracture in women taking Actos compared to comparison groups, but found no increase in fracture risk in men taking Actos. This information is included in the drug’s prescribing information, she says.

Diabetes Drugs and Fracture Risk: Take-Home Advice

Those with diabetes on TZD drugs ‘’should not stop these medicines without talking to their doctor,” Herman says.

While he found an increased fracture risk with the drugs, he says, it’s not known if treating patients with the bone-builder drugs can decrease the risk.

Until more is known, he says, “in a woman over 50 with diabetes and known osteoporosis, these drugs should be used with caution if at all.”

Such drugs stand to benefit over 23 million Americans, the report reveals. PhRMA vice president Ed Belkin says that nearly 8 percent of Americans had diabetes in 2007, with medical expenses ballooning to more than $170 billion.

“Clearly, there is an urgent need for our companies to focus on diabetes, the nation’s fifth deadliest disease,” says Belkin. “Since 1987, the diabetes death rate has increased by 45 percent even as the death rates for heart disease, stroke and cancer have declined.”

Belkin also notes that medicine is crucial to helping people with diabetes live a long life. In addition to medication, there are habits people can incorporate into their lifestyles to help fend off the disease.

Type 2 diabetes is the most prevalent form of the disease and can be avoided in some cases through proper diet and exercise, according to the American Diabetes Association.

Drugs used to treat diabetes can be expensive. It’s best for people to take preventative steps whenever possible to avoid becoming sick and paying more for health insurance.