Monthly Archives: April, 2011

Can Gastric Bypass Cure Type 2 Diabetes?

written by Michael O’Leary

Researchers say something about gastric bypass surgery changes the body’s metabolism that quickly improves Type 2 diabetes. But, before you call a surgeon, no one is going to be performing the surgery to treat diabetes anytime soon.

As written in reports by Reuters and WebMD, a small study by researchers at Columbia University in New York and Duke University in North Carolina compared the effects of surgery on 10 obese patients with 11 others who lost as much weight without the surgery. Both groups lost about 20 pounds.

What they found was that the surgery group had dramatic improvements in their diabetes.  Study co-author Dr. Blandine LaFerrere of Columbia characterized them as “remission.” She told WebMD that one month after the surgery all of the surgery patients no longer required diabetes medications. About half of the dieters remained on drugs even after losing the 20 pounds. The study was published online today ahead of print publication in the journal Science Translational Medicine.

To find out why the surgery had this effect when the dieting didn’t, they analyzed blood samples taken from both groups. What they found was significantly lower levels of several types of amino acids associated with insulin resistance and cardiovascular disease in the blood of the surgery group compared to the dieters.

The discovery, if confirmed in larger studies, offers researcher some attractive new treatment strategies for Type 2 diabetes that might lead to treatments that are as effective as the surgery.

The type of surgery used in the study is called bariatric surgery, in which the surgeon physically reduces the size of the stomach. This is different than the Lap-Band® surgery that restricts the stomach size with an adjustable band around the upper part of the stomach. Still why the surgery has this effect on the amino acid levels in the blood remains a mystery. Whether the Lap-Band surgery would have the same effect is also unknown.

Can Older Diabetics Relax About Their HbA1c?

written by Michael O’Leary

If you’ve been managing type 2 diabetes for a while, you know that current advice is to maintain your glucose levels at 7 percent or less, as this is where blood glucose levels are for non-diabetics.

A large observational trial published online this week, in Diabetes Care, however, raises questions about this long-held advice in people over the age of 60.

The new study published this week involved 71,092 people with type 2 diabetes who were all 60 years or older. As expected, the researchers found that those participants with very high blood sugar levels had higher risks of complications and death.

Surprisingly, however, they also found a modestly increased risk of death among those with the lowest blood sugar levels.

The in between group, those with well-managed blood sugar levels, had the lowest number of major complications and death.

The result seems to confirm a similar finding in the 2008 ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial. That trial involved people ranging in age from 40 to 70 and tested three strategies for reducing cardiovascular risk in people with type 2 diabetes. One of the strategies was intensive glucose-lowering to 6 percent or lower. That study was stopped early due to a higher rate of death among the older people in the intensive glucose-lowering group.

courtesy of National Institute of Diabetes and Digestive and Kidney Diseases

Your doctor is not likely to change your treatment based on a single study, but it may be something you want to discuss.

Thank Goodness! Diet Soda Doesn’t Cause Diabetes

I tend to consume between 30 and 40 gallons of diet soda per day.  (This may be a slight exaggeration.)  As such, it was a relief to see research published in the American Journal of Clinical Nutrition this past week.  Researchers at Harvard looked at the nutrition and health history of over 40,000 men – tracking them for over twenty years.  Men who regularly drank diet soda were slightly more likely to develop diabetes – but the differences evaporated when you took into account differences in weight, cholesterol, and blood pressure.

From a Reuters Health article about the study:

Prior studies have suggested that people who drink diet soda regularly might be more likely to get diabetes than those who stay away from artificially-sweetened drinks.

But this study indicates that the link is a result of other factors common to both diet soda drinkers and people with diabetes, including that they are more likely to be overweight.

That seems to be good news for folks (including diabetics) that have the occasional Diet Coke.  (Actually, my beverage of choice is Diet Dr. Pepper.)

The study also had good news for individuals who drink coffee.  Again, from the Reuters Health article:

The study also found that drinking coffee on a daily basis – both regular and decaffeinated – was linked to a lower risk of diabetes. Researchers aren’t sure why that is, but it could be due to antioxidants or vitamins and minerals in coffee…

More good news!  Off to Starbucks…

Good News on Lixisenatide and Ongoing Research

Sanofi-Aventis announced that things are looking good for lixisenatide in trials they are currently conducting.  Lixisenatide is in the same family of drugs as Byetta (scientific name: exenatide) – which are called GLP-1 agonists.  (More info on GLP-1 agonists here and here).

The research shows thus far that lixisenatide is able to lower your HbA1c (just like Byetta does), but doesn’t cause as many hypoglycemic episodes.  Sanofi-aventis has a large, global trial looking for type 2 diabetes patients who have had an acute coronary event in the past 90 days.  For more info, go here: http://www.corengi.com/study/nct/NCT01147250

More Evidence for Metformin

Recent research published in the European Heart Journal (link here) demonstrated again the utility of metformin.  Over 100,000 Danish residents who were prescribed either metformin or other diabetes drugs were followed over a period of nine years.

Compared to glimepiride (Amaryl), glyburide (known as Diabeta, Glycron, Glynase, or Micronase), glipizide (Glucotrol), and tolbutamide (Orinase, Tol-Tab), patients on metformin had better survival and lower numbers of cardiovascular events.

This is consistent with another published research paper from last month that looked at over 160 published studies and came to the conclusion that metformin is currently the best choice as a first-line agent for treating diabetes.  (Blog post here.)

First April Diabetes Research News Update

Research News About Actos, Merck Clinical Trial Changes, and Lipitor Causing Diabetes – http://eepurl.com/dhc5Q

Food Fight! Scientists Battle of Words Regarding Syrup’s Benefits for Diabetes Patients

Last Friday, lots of media outlets trumpeted a press release from The Federation of Quebec Maple Syrup Producers about the potential health benefits of maple syrup, particularly for diabetes.  The press release was based on research presented at the American Chemical Society’s annual meeting in California last week.  The research, presented by Navinda Seeram of the University of Rhode Island, talked about the existence of polyphenols in maple syrup – which may help control blood sugar.

Navinda Seeram

While their products are much more delicious, I have to admit you don’t see as much research coming out The Federation of Quebec Maple Syrup Producers compared to pharmaceutical companies.  That said, its interesting to hear about the breadth of compounds that are present in naturally-made maple syrup.  (I liked that the press release made clear that this wasn’t an April Fool’s joke.)

The problem, however, is that the existence of these compounds in maple syrup may not provide much or any health benefit at all.  Right after the weekend, the Montreal Gazette ran a story entitled Canadian scientist slams maple syrup study touting health benefits.  Dr. Joe Schwarcz, of McGill University, wasn’t having any of this.

Joe Schwarcz

From the article:

“But some of the claims surrounding the U.S. findings have drawn a sharp rebuke from Joe Schwarcz, director of the McGill University Office for Science and Society and a popular author and commentator on scientific issues.

“This study is of academic interest, and that is all,” Schwarcz told Postmedia News. “To suggest that maple syrup is healthy because it contains a number of phenolic compounds is rumpled thinking that needs to be straightened out. Phenolics are not rare — they are abundant in fruits and vegetables.”

Its clear that the maple syrup federation was focusing on the mere presence of these compounds – and not whether or not there was any clinical evidence to their benefits at these levels.  (There hasn’t been any demonstrated clinical benefit.)  Joe Schwarcz takes it one farther – saying:

“The only reason to eat maple syrup is that it tastes good. Any suggestion that it is ‘healthy’ is irresponsible and may make scientifically shallow people eat more.”