14 November 2008

Diabetes: the good and the bad

Diabetes is proving to be one of the great medical challenges of modern times. Today, on World Diabetes Day, let's take a look at what medical science has achieved this year.

Diabetes is indeed proving to be one of the great medical challenges of modern times.

The latest statistics of the World Health Organisation (WHO) estimate that 180 million people worldwide suffer from diabetes, and with obesity rates rising due to our increasingly inactive lifestyles this number is expected to grow exponentially. In fact, the WHO reckons that if current world trends continue, this figure will double by 2030.

With these stats in mind, scientists are working harder than ever to try to find an elixir that will turn the tide on this wave of diabetes. Here's a look at the highlights of what medical science achieved in this field in 2008.

The good
An encouraging breakthrough was made right here by a team of researchers from the Nelson Mandela Metropolitan University in Port Elizabeth. They found that an extract from a local herb, "cancer bush" (Sutherlandia frutescens), lowered the blood sugar levels of diabetic rats, reversed their insulin resistance and decreased intestinal glucose uptake.

The results of two other studies had promising outcomes for the management of diabetes. The first study, conducted by researchers from Mount Sinai Hospital in Toronto, Canada, discovered that a newer, longer-acting form of Byetta (exenatide), given once weekly, actually achieves better blood sugar control in diabetics than does the standard formulation, which is given twice daily.

The second study, by a team of researchers from the Juvenile Diabetes Research Foundation, showed that devices that constantly monitor blood sugar levels of people with diabetes help them control their glucose better than the old-fashioned method of pricking their fingers throughout the day. In turn, tight blood sugar control reduces the risk of long-term complications from diabetes such as blindness, kidney failure, heart disease and amputation.

Diabetics have even more to look forward to. Researchers working on an artificial pancreas believe that they are just a few years away from a nearly carefree way for people with diabetes to monitor blood sugar and inject insulin as needed. A team from Britain's University of Cambridge has been testing devices in patients with type-1 diabetes. A continuous glucose sensor is implanted under the skin, and transmits blood sugar readings to a monitor. A computer calculates the right dose of insulin, which is then delivered by an insulin pump.

The bad
Unfortunately not all discoveries were good news.

Researchers from the State University of New York, US, found that young men with type-2 diabetes have abnormally low levels of testosterone – this could have profound implications on their sexual and reproductive health.

In addition, further research has found that diabetes holds implications for a person's mental health and abilities too.

Developing diabetes before age 65, and greater severity of diabetes, may be important in the development of mild cognitive impairment among individuals in their 70s and 80s, researchers from the Mayo Clinic in Minnesota, US, reported. The investigators suggested that severe diabetes is more likely to be associated with chronic high blood sugar, which, in turn, increases the likelihood of disease in the small blood vessels of the brain and may contribute to brain cell damage and cognitive impairment.

Furthermore, scientists believe that people being treated for type-2 diabetes are at an increased risk for depression, and at the same time individuals with depression have a moderately increased risk of developing type-2 diabetes. A John Hopkins University School of Medicine study found that the psychological stress associated with diabetes management may lead to elevated depressive symptoms. In fact, they found that depression symptoms were twice as high in people being treated for type-2 diabetes, compared to a control group. And, in a potential vicious circle, lifestyle factors brought on by depression, such as caloric intake and physical activity, could lead to diabetes. The study discovered that participants who had symptoms of depression were about 30% more likely to develop diabetes than others.

A new finding which is of particular concern for the South African population is that diabetes increases a person's risk of developing tuberculosis by three-fold. Researchers at the Harvard School of Public Health in Boston, US, found evidence that diabetes predisposes people to TB infection and impairs their ability to respond to infection.

Although some of the news seems disheartening, each new finding puts researchers one step closer to designing medication to treat this disease (and all its accompanying burdens) in its entirety.

- (Wilma Stassen, Health24, November 2008)

Sources: Journal of Ethnopharmacology; The Lancet; Reuters Health; HealthDay News; Archives of Neurology

Read more:
Diabetes Centre


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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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