23 May 2008

Act early to blunt diabetes impact

Aggressive insulin treatment or lifestyle changes at the onset of diabetes can sharply curb the incidence and impact of the disease over the long haul, claim two new studies.

Aggressive insulin treatment or lifestyle changes at the onset of diabetes can sharply curb the incidence and impact of the disease over the long haul, according to two new studies.

Intensive insulin therapy through daily injections for Type 2 diabetes, which affects some 250 million people worldwide, is typically started late in the course of the disease.

But researchers in China found that if this treatment is undertaken before the body loses the ability to control sugar levels in the blood - a condition known as glycaemia - patients recover normal levels faster.

Type 2 diabetes can cause conditions ranging from kidney failure to blindness and heart disease, and complications can lead to death. The condition, strongly linked to obesity, occurs when the liver fails to produce enough insulin or becomes resistant to the hormone, which controls blood sugar levels.

How the study was done
A team led by Jianping Weng of Sun Yat-Sen University in Guangzhou divided nearly 400 patients aged 25 to 70 with Type 2 diabetes into three groups.

Two received intensive insulin therapy, either through an under-the-skin drip or multiple daily injections. The third was given standard oral diabetic drugs.

Treatment was stopped when regular blood glucose control had been restored for two weeks, after which patients regulated sugar levels through diet and exercise alone.

The study, published in the British journal The Lancet, found that more patients in the two insulin-intensive groups hit normal levels, and did so faster, in four to six days rather than nine, compared to the control group.

As significant, remission rates - the number of patients whose blood sugar remained at acceptable levels - were nearly twice as high in the first two groups.

Second study urges controlled diet and exercise
The second study, led by Guangwei Li of the China-Japan Friendship Hospital in Beijing and also published in The Lancet, showed that a controlled diet and exercise over six years prevented or delayed diabetes onset by up to an additional 14 years.

Previous studies have shown the efficacy of lifestyle changes in controlling diabetes, but questions remained on the long-term impact. Li found that a monitored diet coupled with physical activity halved the incidence of diabetes during the six years of intervention, and by 43 percent over 20 years.

Type 2 diabetes has become rampant in both developed and developing countries as a result of traditional diets being abandoned for processed and junk foods and people getting less exercise.

Once a disease that affected only adults, it has become common among obese adolescents as well. The International Diabetes Federation forecasts the number of cases - including many adolescents - will explode from 246 million today to 380 million by 2025.

A less common form of diabetes called Type 1 is caused by permanent destruction of insulin-producing beta cells in the pancreas, and usually occurs early in life. It is lethal unless treated with insulin. – (Sapa, May 2008)

Read more:
Caffeine ups type 2 diabetes risk
Blood test could predict diabetes


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Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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