Biomarkers Predict Diabetes – new study

predicting diabetes through biomakersLike me, you may be drawn to new technologies surrounding diabetes diagnosis and management.  Consequently, this Massachusetts General Hospital study involving the early recognition of Type 2 Diabetes on the basis of biomarkers is fascinating.

Basically, the study authors performed  ”metabolomics” on data from 2,422 individuals, which means, they profiled their metabolic status from blood samples and did so  over a 12 year period.

Ten percent of the studied population developed diabetes.

The investigation found that specific amino acids were correlated with the future onset of diabetes.  These included isoleucine, leucine, valine, tyrosine and phenylalanine.  The combined level of three of these were able to identify individual with a five-fold risk of diabetes.

The results underscore that diabetes is not simply a disease about high blood sugar but involves a number of factors which includes amino acid metabolism.

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Eat more salad!

It appears those green leafy vegetables may have some benefit in preventing Type 2 Diabetes:

Increasing the amount of green leafy vegetables in an individual’s diet could help to reduce the risk of type 2 diabetes. An increase of 1.15 servings a day was associated with a 14% decrease in incidence. The data did not show any significant relations between the consumption of fruits, vegetables, or fruit and vegetables combined on the incidence of diabetes. As there was significant heterogeneity between studies, however, we carried out a sensitivity analysis. This showed no significant interactions between the outcomes of variables examined, and thus could not identify differences that occurred between the studies.

Oral Insulin Crystals Could Delay Or Prevent Diabetes In Children

Recently we posted that Bristol University researchers have discovered that the number of children under five-years-old with Type 1 diabetes has increased five-fold over 20 years, and the incidence of childhood Type 1 diabetes has been shown to be increasing all over Europe. It should be noted that the number of children under 15 with Type 1 diabetes doubled over the same time period.
To delay the start of the disease researchers propose that those at high risk could be treated with oral insulin crystals. The idea is that when the immune system encounters the insulin in the intestine it will learn not to perceive it as a threat, and in effect, be “re-educated” to no longer attack the patient’s own insulin producing cells.
Very cool… prevent diabetes but calibrating the immune system to befriend islet cells…. read about it here.

Our Obese Children

The rise of childhood obesity has coincided with the development of adult onset or Type 2 Diabetes in our youth. The statistics have been alarming but failed to illicit the type of reaction in me that this latest report from the New York Times evokes :

The number of U.S. children having obesity surgery has tripled in recent years, surging at a pace that could mean more than 1,000 such operations this year, new research suggests. While the procedure is still far more common in adults, it appears to be slightly less risky in teens, according to an analysis of data on 12- to 19-year-olds who had obesity surgery from 1996 through 2003.
During that time, an estimated 2,744 youngsters nationwide had the operations. The pace tripled between 2000 and 2003, reaching 771 surgeries that year, the study found.

The data was taken between 1996 and 2003 and was presented in the Archives Archives of Pediatric and Adolescent Medicine. The youngest patients were age 12.
Although there are many individuals whose weight is a function of genetic background, the rise of childhood obesity can only be explained by lifestyle choices – decisions made by parents and the training given to kids in the early years. Apart from teasing, harassment, discrimination and physical limitations (e.g., in sports), these obese children have a profoundly greater chance of developing diabetes and heart disease early in life.

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How to Help Prevent Diabetes in Kids

A 12-week program at targets overweight children who have elevated blood sugar but are not yet diabetic. The children attend classes three times a week to exercise, learn about healthy eating and self-esteem and talk with counselors about how to change their unhealthy habits.

Burning or Tingling Feet May Be Warning of Pre-diabetes

Adult onset, or type 2 diabetes, is a growing problem in the United States. Researchers estimate that about 10 percent of Americans will develop diabetes during their lifetime and about twice that number will develop a milder form of diabetes called impaired glucose tolerance, or pre-diabetes. Diabetes and pre-diabetes often do not present any symptoms until a complication arises, making the disease difficult for patients to detect.

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Reduce Your Risk

For my non-diabetic readers, if feeling and looking good isn’t enough motivation:

Overweight people who cut their waist by four inches could reduce their chances of developing diabetes by 50%, according to experts

Obesity is the modern-day curse of prosperity and, although it can beeasily avoided, it generally is not.

Diabetes Test Fails Miserably

A recent article reports that experts fear diabetes testing has failed to detect the disease in thousands of Asians who are unaware that they have the condition.
“Researchers at Hong Kong Chinese University said they believed the test, which worked well with Caucasians, was not suited to Asian subjects,“ the article states.
“We believe it is probably because of the genetic differences between Caucasians and Asians, but we cannot be sure,” Chan Wing-bun, part of the university research team, told AFP.
The study found that the test recommended by the World Health Organization missed diabetes in 40% of those tested, all of whom were Asian.

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Vision Problems Can Occur During Pre-Diabetes

“Pre-diabetes” is an ambigious term used to describe those who have elevated glucose levels or an abnormal response to carbohydrate load but do not exhibit the physiological markers necessary to be classified as having diabetes. In particular, those with pre-diabetes often experience widely ranging glucose levels following meals but yet have normal HbA1c levels because their average glucose level is normal.
Forbes Health reports the results of a study indicating close to eight percent of people living with this condition are likely to have diabetic retinopathy.
The research involved participants in the Diabetes Prevention Program (DPP), which included over 3,200 people with impaired glucose tolerance, another term for pre-diabetes.

The Effect of Metformin and Intensive Lifestyle Intervention on the Metabolic Syndrome: The Diabetes Prevention Program Randomized Trial

Background: The metabolic syndrome is a high-risk state for diabetes and cardiovascular disease. Little is known about its prevalence and prevention in those with impaired glucose tolerance.
Objective: To determine the prevalence of the metabolic syndrome at baseline in the Diabetes Prevention Program and the effect of intensive lifestyle intervention and metformin therapy on the syndrome’s incidence and resolution.
Design: Randomized, controlled clinical trial.
Setting: Research and community-based centers.
Participants: Participants had impaired glucose tolerance (World Health Organization criteria plus fasting plasma glucose level 5.3 mmol/L [95 mg/dL]) and were followed for a mean of 3.2 years after random assignment to intensive lifestyle intervention, metformin therapy, or placebo.
Interventions: Metformin, 850 mg twice daily, or intensive lifestyle intervention designed to achieve and maintain a 7% weight loss and 150 minutes of exercise per week.
Measurements: The metabolic syndrome was defined as having 3 or more characteristics (waist circumference; blood pressure; and levels of high-density lipoprotein cholesterol, triglycerides, and fasting plasma glucose) that met criteria from the National Cholesterol Education Program Adult Treatment Panel III.
Results: Fifty-three percent of participants (n = 1711) had the metabolic syndrome at baseline; incidence did not vary substantially by age. However, low levels of high-density lipoprotein cholesterol predominated in younger participants (age 25 to 44 years), and high blood pressure predominated in older participants (age 60 to 82 years). In life-table analyses (log-rank test), incidence of the metabolic syndrome was reduced by 41% in the lifestyle group (P < 0.001) and by 17% in the metformin group (P = 0.03) compared with placebo. Three-year cumulative incidences were 51%, 45%, and 34% in the placebo, metformin, and lifestyle groups, respectively. There was no significant heterogeneity by ethnic group.
Limitations: The study involved a volunteer group with impaired glucose tolerance, which limits generalizability.
Conclusions: The metabolic syndrome affected approximately half of the participants in the Diabetes Prevention Program at baseline. Both lifestyle intervention and metformin therapy reduced the development of the syndrome in the remaining participants.
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Preventing Diabetes – Drugs or Diet?

The question was the topic of a recent study aimed at understanding the health benefits of diabetes medication versus diet and exercising habits.
New research suggests changing diet and exercise may have a greater effect than drugs.

People with a condition called metabolic syndrome are at the highest risk for developing heart disease and type 2 (adult-onset) diabetes. Patients with metabolic syndrome have at least three of the following abnormalities: high blood pressure, high triglyceride levels (a bad type of fat in the blood), low high-density lipoprotein cholesterol levels (

What is Your Waist Size? It May Indicate your Risk for Developing Diabetes and Related Complications

Waist size is a good indicator of a person’s risk of insulin resistance — an early stage in the development of diabetes and heart disease, researchers said on Friday.
“A waist circumference of less than 100 cm (39 inches) excludes individuals of both sexes from being at risk of being insulin resistant,” Hans Wahrenberg, of the Karolinska University Hospital in Stockholm, said in a study reported online by the British Medical Journal.
The Swedish researchers studied 2,746 men and women aged 18 to 72 who had waists ranging from 65-150 cm. They measured their height, weight, waist and hip sizes and took a blood sample to test insulin sensitivity.
They found that waist size was a strong predictor of insulin resistance.
more from Reuters

Preventing Diabetes Complications Could Save $2.5 Billion Annually, Says AHRQ

A new research synthesis from HHS’ Agency for Healthcare Research and Quality estimates that the nation could save nearly $2.5 billion a year by preventing hospitalizations due to severe diabetes complications.
Diabetes, an increasingly common chronic disease, currently affects 18 million Americans, or about 6 percent of the population. Complications from the disease that may require hospitalization include heart disease, stroke, kidney failure, blindness, as well as nerve and blood circulation problems that can lead to lower limb amputations. Complications can often be prevented or delayed with good primary care and compliance with the advice from providers. According to the research synthesis:

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