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[IP] DIABETES IN CONTROL.com NEWSLETTER



Diabetes In Control Newsletter - http://www.diabetesincontrol.com

DIABETES IN CONTROL.com NEWSLETTER

The Newsletter for Professionals in diabetes care

November 13, 2000 Issue 26


Dry Wine Increases Insulin Sensitivity!


Skol! Prosit! To Your Health!as it happens, these glass-clinking
salutations are quite appropriate!  With Thanksgiving and the holiday
season right around the corner, its pure delight to learn that moderate
consumption ( a glass or two) of dry (not sweet) wine with a meal can
actually help accelerate the weight loss and health benefits of a  low
carb program.

For feature go to: www.diabetesincontrol.com/feature11.htm

Item #3

ASPIRIN, EVEN AT LOW DOSE, CARRIES RISK OF
GASTROINTESTINAL BLEEDING  (?) (More info to follow)

This study comes from the British Medical Journal published last week.
Because aspirin is recommended by the ADA for people with diabetes (unless
contraindicated), I wanted more information regarding the use of enteric
coated low dose aspirin.  I have researched other studies which, show that
enteric coated aspirin does not have the same harmful gastrointestinal
effects as plain aspirin.  I contacted the  researchers for the study and
I am waiting for an answer.  I do not believe they had enough patients in
the study using enteric coated aspirin to reach their conclusion that it
made no difference if the aspirin was enteric coated or not.   I will
report the response as soon as I receive it.

The Study Follows:

Long term use of aspirin to prevent heart problems carries an increased
risk of gastrointestinal bleeding, according to a study in this week's
BMJ. Furthermore, no evidence exists that reducing the dose or using
expensive "modified release" formulations of aspirin would reduce the
likelihood of bleeding. (I will have a response to this question in next
weeks issue because other studies show a reduced risk for enteric coated
aspirin)

Researchers at the Radcliffe Infirmary in Oxford analysed 24 previous
studies of aspirin, involving almost 66,000 patients, to establish the
risk of gastrointestinal bleeding from long term treatment with aspirin.
There were two main results. Firstly, bleeding occurred, on average, in
2.5% of patients taking aspirin compared with 1.4% who were not; this
difference was statistically significant. Secondly, there was no evidence
to suggest that switching to a low dose or modified release formulation of
aspirin would reduce the problem. Given the widespread use of aspirin for
the prevention of heart problems, these findings have important
implications for everyday practice, say the authors. Patients and doctors
need to consider the trade-off between the benefits and harms of long term
treatment with aspirin, they conclude.

For complete article: www.diabetesincontrol.com/issue26/item3.htm



Item #7

Diabetes-Related Preventive-Care Practices Deemed Inadequate

Current levels of preventive care for diabetic patients fall far short of
Healthy People 2010 goals, the Centers for Disease Control and Prevention
(CDC) concludes in the October 27th issue of the Mortality and Morbidity
Weekly Report.

Researchers analyzed data from the 1997 to 1999 Behavioral Risk Factor
Surveillance System (BRFSS), a random-digit-dialed telephone survey of the
civilian non-institutionalized US population over age 18 years.
Respondents with diabetes were asked questions about four preventive care
practices: annual dilated eye examination, annual foot examination,
self-monitoring of blood glucose, and glycosylated hemoglobin (HbA1C)
measurement.

"This report summarizes the results of that analysis, which indicate that
levels of preventive-care practices among persons with diabetes are lower
than the national health objectives for 2010," the authors of the report
note. The levels of preventive care for each practice varied by state and
by demographic group, but overall were some 15% to 20% lower than the
goals.

Edward Tierney, an epidemiologist with the CDC's National Center for
Chronic Disease Prevention and Health Promotion, stated "One of the things
that we are trying to do with this report is to establish a baseline for
the 2010 objective of where we would like states to be,".

"It is something that is going to involve a collaborative effort of the
healthcare systems, healthcare providers, public health officials and
patients," said Tierney, who added, "There is sometimes an impression that
you can't do anything about diabetes, and the message that we are trying
to get out is that you can do something about it."



Item #8

New Treatment Guidelines Address Diabetic Foot Disorders

The American College of Foot and Ankle Surgeons (ACFAS) announced new
clinical practice guidelines for the diagnosis and treatment of diabetic
foot disorders. The guidelines appear as a supplement to the current issue
of The Journal of Foot and Ankle Surgery.

Foot problems caused by complications of diabetes -- poor circulation,
neuropathy and infection -- are the leading cause of hospitalizations of
diabetic patients, with an estimated 15 percent experiencing a serious
foot problem sometime in their lives. The College's new guidelines are
intended for podiatrists, primary-care physicians, vascular surgeons and
other medical specialists who treat diabetic patients.

Diabetes is a significant public health burden and every practitioner
involved in diabetes care must be aware of the risk factors and diagnostic
modalities concerning diabetic foot problems, and make appropriate
decisions to treat or refer to a podiatric surgeon.

The evidence-based guidelines are designed to improve understanding of the
causes of diabetic foot problems and provide information about new
treatments for foot ulcers and other diabetic foot conditions. For
complete article: www.diabetesincontrol.com/issue26/item8.htm


Item #12

New Drug Has Potential to Prevent Diabetes

NEUROCRINE  ANNOUNCED THE COMPLETION OF A PHASE I CLINICAL STUDY WITH APL
COMPOUND NBI-6024 IN PATIENTS WITH TYPE I DIABETES OR INSULIN-DEPENDENT
DIABETES MELLITUS (IDDM).

The pre-clinical data suggest that this therapeutic intervention, if
administered prophylactically, may have the potential to prevent the onset
of diabetes in those patients who are at high risk, such as first-degree
relatives of patients with IDDM. In addition, there is the potential to
intervene in newly diagnosed patients or patients who still have residual
intact (beta)-islet cells function by preventing further destruction, and
preserving endogenous insulin production, thereby mitigating disease
progression. When combined with the commercialization of novel genetic
screening and immune function diagnostic products for early identification
of IDDM, this strategy will address both the primary cause and the
development of a true cure for IDDM.

NEUROCRINE ALSO ANNOUNCED THE COMPLETION OF A PHASE I CLINICAL STUDY WITH
APL COMPOUND NBI-6024 IN PATIENTS WITH TYPE I DIABETES OR
INSULIN-DEPENDENT DIABETES MELLITUS (IDDM). THE PHASE I STUDY INCLUDED
TWENTY PATIENTS IN A SINGLE DOSE, DOSE ESCALATION STUDY. PRELIMINARY
SAFETY DATA FROM THIS STUDY INDICATED THAT NBI-6024 WAS SAFE AND WELL
TOLERATED. TWO ADDITIONAL CLINICAL STUDIES ARE PLANNED TO START IN Q3,
2000. THESE STUDIES WILL ASSESS THE SAFETY AND BIOLOGICAL ACTIVITY OF
MULTIPLE DOSES OF NBI-6024 IN BOTH ADULT AND PEDIATRIC PATIENTS WITH TYPE
1 DIABETES.

"Now that it is possible to predict almost a million individuals
developing insulin-dependent diabetes mellitus, it is essential to develop
a safe and effective preventive therapy. An important avenue in this
regard are forms of immunologic vaccinations, such as the APL," said Dr.
George Eisenbarth, executive director of the Barbara Davis Center for
Childhood Diabetes, Professor, University of Colorado.

NBI-6024 is based on Neurocrine's proprietary APL technology platform
which was discovered and developed by Neurocrine scientists and
co-founder, Dr. Larry Steinman, M.D., Professor, Department of Neurology
and Neurological Sciences, Stanford University School of Medicine. For
complete article: www.diabetesincontrol.com/issue26/item12.htm

Dont forget to check out our 6 open studies for patients with diabetes at
www.diabetesincontrol.com/specialedition



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