Research and development pipelines are flowing with a record number of drugs for treating diabetes and related conditions, according to a report from the Pharmaceutical Research and Manufacturers of America released in late May, which showed 235 medicines in development to treat the disease.
According to the American Diabetes Association, 24 million Americans are living with diabetes, up from 21 million in 2005. The most rapidly growing incidence of the disease, Type 2, has increased along with the incidence of obesity in the United States.
To read the entire article, click here.
Monday, August 16, 2010
Tuesday, August 10, 2010
Many diabetic foot amputations are preventable
It costs $1,400 to cover the oozing sore on the diabetic's foot with a piece of artificial skin, helping it heal if patients keep pressure off that spot. So when Medicare paid for the treatment but not the extra $100 for a simple walking cast to protect it, an artificial skin maker last year started giving free casts to some needy patients.
Without the right cushioning, "the person will walk to the bus stop and destroy it," fumes Dr. David G. Armstrong of the Southern Arizona Limb Salvage Alliance.
To read the complete story, click here.
Monday, June 28, 2010
Diabetes an independent risk factor for vascular disease
New data suggest that although diabetes doubles the risk of vascular disease, elevated fasting glucose has little effect on the risk of coronary heart disease (CHD) or major ischemic events. The results of a meta-analysis of 1.2 million patients in 120 randomized, controlled trials were presented Saturday morning at a special symposium cosponsored by ADA and The Lancet, which published the study in their June 26 issue.
“We’ve known for decades that diabetes is a risk for vascular disease,” said lead author Nadeem Sarwar, PhD, University of Cambridge, United Kingdom. “But how the risk varies by age, sex, and levels of other risk factors remains unknown.”
Sarwar represented the Emerging Risk Factors Collaboration, which designed and conducted the study. The collaboration represents more than 12 million person-years of risk, he said, with a mean follow-up of 10 years.
Analysis of contributed studies showed that diabetes roughly doubles the risk of cardiovascular events regardless of other factors. Having diabetes increases the risk of coronary death by 2.31 times and increases the risk of a nonfatal myocardial infarction (MI) by 1.82 times.
The presence of diabetes also increases the risk for ischemic stroke by 2.27 times, for hemorrhagic stroke by 1.56 times, and for other vascular deaths by 1.73 times.
Overall, the hazard ratios (HRs) for CHD were higher for women than for men and higher in younger (40-59 years) patients than in those 70 years old and older. The HRs were also higher for fatal events compared with nonfatal MIs.
Why diabetes produces a greater risk in groups that would be expected to be at lower risk is not clear, Sarwar said. Diabetes may be associated with more severe vascular lesions, but further study is needed.
“We did not see a linear relationship between fasting glucose and cardiovascular disease,” Sarwar continued. “The risk is essentially flat for serum glucose between 3.9% and 5.6%, then increases sharply.”
The analysis suggests that diabetes is responsible for about 10% of all vascular deaths, roughly 325,000 people annually in the developed world.
“Diabetes doubles the risk for vascular diseases independent of other factors,” Sarwar concluded. “In people who do not have diabetes, fasting glucose is not a useful predictor of vascular disease.”
~ Drug Topics ~
“We’ve known for decades that diabetes is a risk for vascular disease,” said lead author Nadeem Sarwar, PhD, University of Cambridge, United Kingdom. “But how the risk varies by age, sex, and levels of other risk factors remains unknown.”
Sarwar represented the Emerging Risk Factors Collaboration, which designed and conducted the study. The collaboration represents more than 12 million person-years of risk, he said, with a mean follow-up of 10 years.
Analysis of contributed studies showed that diabetes roughly doubles the risk of cardiovascular events regardless of other factors. Having diabetes increases the risk of coronary death by 2.31 times and increases the risk of a nonfatal myocardial infarction (MI) by 1.82 times.
The presence of diabetes also increases the risk for ischemic stroke by 2.27 times, for hemorrhagic stroke by 1.56 times, and for other vascular deaths by 1.73 times.
Overall, the hazard ratios (HRs) for CHD were higher for women than for men and higher in younger (40-59 years) patients than in those 70 years old and older. The HRs were also higher for fatal events compared with nonfatal MIs.
Why diabetes produces a greater risk in groups that would be expected to be at lower risk is not clear, Sarwar said. Diabetes may be associated with more severe vascular lesions, but further study is needed.
“We did not see a linear relationship between fasting glucose and cardiovascular disease,” Sarwar continued. “The risk is essentially flat for serum glucose between 3.9% and 5.6%, then increases sharply.”
The analysis suggests that diabetes is responsible for about 10% of all vascular deaths, roughly 325,000 people annually in the developed world.
“Diabetes doubles the risk for vascular diseases independent of other factors,” Sarwar concluded. “In people who do not have diabetes, fasting glucose is not a useful predictor of vascular disease.”
~ Drug Topics ~
Sunday, June 27, 2010
Diabetes exposure in utero increases risk of early ESRD
Being exposed to diabetes in utero substantially increases the risk of premature end-stage renal disease (ESRD), found Robert G Nelson, MD (left).
The finding comes from a study of Pima Indians 5 to 44 years old with type 2 diabetes, 102 of whom were the offspring of diabetic mothers and 1,748 without diabetes exposure in utero.
“Pima Indians have the highest rate of type 2 diabetes in the world. We’ve been studying the population since 1965, so we have extensive longitudinal data that allows us to look not only at disease in the parents, but in the offspring, and follow them into adulthood,” said Nelson.
An earlier study by Nelson and colleagues showed that exposure to diabetes in utero caused a dramatic increase in the development of diabetes in youth. About one-third of cases of diabetes in young adulthood are attributable to diabetes exposure in utero, he said.
Genetic susceptibility from the mother can partially explain the early onset of diabetes in the offspring, Nelson said. Intrauterine exposure also is associated with higher birth weight and higher weight in childhood and adolescence compared with persons without such exposure.
In the current study, the participants were followed for a maximum of 40 years, from their onset of diabetes until either death, onset of ESRD, or age 45 years.
Fifty-seven of the participants who were exposed to diabetes in utero developed ESRD before age 45, which was 4 times the rate of ESRD compared with controls who were not exposed to diabetes in utero.
Twenty percent of ESRD that occurs in the population before age 45 is attributable to exposure to diabetes in utero,” said Nelson. Assuming this relationship is causal, “if you delayed the development of diabetes until after the onset of childbearing years, you would reduce the incidence of diabetic ESRD by about 20%,” he said.
If the offspring are exposed to diabetes in utero, diabetes prevention efforts in the form of lifestyle modifications (diet and exercise) are needed to slow or prevent the development of diabetes and its complications, Nelson said.
~ Drug Topics ~
The finding comes from a study of Pima Indians 5 to 44 years old with type 2 diabetes, 102 of whom were the offspring of diabetic mothers and 1,748 without diabetes exposure in utero.
“Pima Indians have the highest rate of type 2 diabetes in the world. We’ve been studying the population since 1965, so we have extensive longitudinal data that allows us to look not only at disease in the parents, but in the offspring, and follow them into adulthood,” said Nelson.
An earlier study by Nelson and colleagues showed that exposure to diabetes in utero caused a dramatic increase in the development of diabetes in youth. About one-third of cases of diabetes in young adulthood are attributable to diabetes exposure in utero, he said.
Genetic susceptibility from the mother can partially explain the early onset of diabetes in the offspring, Nelson said. Intrauterine exposure also is associated with higher birth weight and higher weight in childhood and adolescence compared with persons without such exposure.
In the current study, the participants were followed for a maximum of 40 years, from their onset of diabetes until either death, onset of ESRD, or age 45 years.
Fifty-seven of the participants who were exposed to diabetes in utero developed ESRD before age 45, which was 4 times the rate of ESRD compared with controls who were not exposed to diabetes in utero.
Twenty percent of ESRD that occurs in the population before age 45 is attributable to exposure to diabetes in utero,” said Nelson. Assuming this relationship is causal, “if you delayed the development of diabetes until after the onset of childbearing years, you would reduce the incidence of diabetic ESRD by about 20%,” he said.
If the offspring are exposed to diabetes in utero, diabetes prevention efforts in the form of lifestyle modifications (diet and exercise) are needed to slow or prevent the development of diabetes and its complications, Nelson said.
~ Drug Topics ~
Monday, June 14, 2010
Diabetes-related leg amputations could be prevented and need not be costly: IDF
By BOBBY RAMAKANT | CNS
Published: Apr 12, 2010 17:28
Of more than one million lower extremity amputations performed each year worldwide, 70 percent happen to people with diabetes. In India alone, almost 40,000 legs are amputated every year as a consequence of diabetes.
These figures were mentioned by Prof. Jean Claude Mbanya, president of International Diabetes Federation (IDF), in his message to the mid-term continuing medical education (CME) meeting on "high-risk diabetic foot" organized by the Association of Surgeons of India (ASI), UP Chapter and Indian Podiatry Association (IPA) in Kanpur last Sunday.
Mbanya's message, which was also handed out to the media, said the latest data from the IDF indicates that “diabetes affects 285 million people around the world, and is increasingly on the rise.”
“Of the many serious complications that can affect individuals with diabetes, it is the complications of the foot that take the greatest toll," Mbanya said.
On a positive note, he said, amputations could be prevented and need not be expensive.
"Many of these amputations can be prevented. Better education and improved management of foot care can be performed at relatively low costs and have been shown to reduce the number of lower extremity amputations by 50-85%," he said.
And this can be done through a concerted effort involving members of the global diabetes community to increase awareness in levels of health care services worldwide, Mbanya said.
"It is time to reduce the unnecessary suffering that foot complications can bring. With relatively low investment, it is possible to advance education and prevention that will result in lower rates of amputation, and better quality of life for people with diabetes. The time to act is now!" he said.
Mbanya is a professor of medicine and endocrinology at the University of Yaoundé I in Cameroon. He is also the director of the National Obesity Centre University of Yaounde, Cameroon, and chief of the Endocrinology and Metabolic Diseases Unit of Hospital Central in Yaoundé
Published: Apr 12, 2010 17:28
Of more than one million lower extremity amputations performed each year worldwide, 70 percent happen to people with diabetes. In India alone, almost 40,000 legs are amputated every year as a consequence of diabetes.
These figures were mentioned by Prof. Jean Claude Mbanya, president of International Diabetes Federation (IDF), in his message to the mid-term continuing medical education (CME) meeting on "high-risk diabetic foot" organized by the Association of Surgeons of India (ASI), UP Chapter and Indian Podiatry Association (IPA) in Kanpur last Sunday.
Mbanya's message, which was also handed out to the media, said the latest data from the IDF indicates that “diabetes affects 285 million people around the world, and is increasingly on the rise.”
“Of the many serious complications that can affect individuals with diabetes, it is the complications of the foot that take the greatest toll," Mbanya said.
On a positive note, he said, amputations could be prevented and need not be expensive.
"Many of these amputations can be prevented. Better education and improved management of foot care can be performed at relatively low costs and have been shown to reduce the number of lower extremity amputations by 50-85%," he said.
And this can be done through a concerted effort involving members of the global diabetes community to increase awareness in levels of health care services worldwide, Mbanya said.
"It is time to reduce the unnecessary suffering that foot complications can bring. With relatively low investment, it is possible to advance education and prevention that will result in lower rates of amputation, and better quality of life for people with diabetes. The time to act is now!" he said.
Mbanya is a professor of medicine and endocrinology at the University of Yaoundé I in Cameroon. He is also the director of the National Obesity Centre University of Yaounde, Cameroon, and chief of the Endocrinology and Metabolic Diseases Unit of Hospital Central in Yaoundé
Tuesday, May 11, 2010
The Diabetic Foot in End Stage Renal Disease
Diabetic foot lesions remain a major cause of morbidity in patients with renal failure, especially those on dialysis. Foot complications are encountered at a more than twofold frequency in diabetic patients with end-stage renal disease, and the rate of amputations is 6.5–10 times higher in comparison to the general diabetic population. The causal pathways of the diabetic foot in renal failure are multiple and inter-related. Three major pathologies—neuropathy, ischemia, and infection—are the main contributory factors. Increased awareness of this condition and careful clinical examination are indispensable to avoid serious complications. Appropriate management needs to address all contributory factors. Treatment options include revascularization, off-loading to relieve high-pressure areas, and aggressive control of infection. Equally important is the collaboration between health care providers in a multidisciplinary foot care setting. Moreover, patient education on the measures required to achieve both primary and secondary prevention is of great value. Certainly, technical innovations have made considerable progress possible, but there is a need for further improvement to reduce the number of amputations.
~ informahealthcare.com ~
~ informahealthcare.com ~
Tuesday, May 4, 2010
Prevent diabetes problems: Keep your feet and skin healthy
What are diabetes problems?
Too much glucose in the blood for a long time can cause diabetes problems. This high blood glucose, also called blood sugar, can damage many parts of the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes. You can do a lot to prevent or slow down diabetes problems.
This information is about feet and skin problems caused by diabetes. You will learn the things you can do each day and during each year to stay healthy and prevent diabetes problems.
How can diabetes hurt my feet?
High blood glucose from diabetes causes two problems that can hurt your feet:
* Nerve damage. One problem is damage to nerves in your legs and feet. With damaged nerves, you might not feel pain, heat, or cold in your legs and feet. A sore or cut on your foot may get worse because you do not know it is there. This lack of feeling is caused by nerve damage, also called diabetic neuropathy. Nerve damage can lead to a sore or an infection.
* Poor blood flow. The second problem happens when not enough blood flows to your legs and feet. Poor blood flow makes it hard for a sore or infection to heal. This problem is called peripheral vascular disease, also called PVD.
Smoking when you have diabetes makes blood flow problems much worse. For example, you get a blister from shoes that do not fit. You do not feel the pain from the blister because you have nerve damage in your foot. Next, the blister gets infected. If blood glucose is high, the extra glucose feeds the germs. Germs grow and the infection gets worse. Poor blood flow to your legs and feet can slow down healing. Once in a while a bad infection never heals. The infection might cause gangrene. If a person has gangrene, the skin and tissue around the sore die. The area becomes black and smelly.
To keep gangrene from spreading, a doctor may have to do surgery to cut off a toe, foot, or part of a leg. Cutting off a body part is called an amputation.
What can I do to take care of my feet?
Wash your feet in warm water every day. Make sure the water is not too hot by testing the temperature with your elbow. Do not soak your feet. Dry your feet well, especially between your toes.
Look at your feet every day to check for cuts, sores, blisters, redness, calluses, or other problems. Checking every day is even more important if you have nerve damage or poor blood flow. If you cannot bend over or pull your feet up to check them, use a mirror. If you cannot see well, ask someone else to check your feet.
If your skin is dry, rub lotion on your feet after you wash and dry them. Do not put lotion between your toes.
File corns and calluses gently with an emery board or pumice stone. Do this after your bath or shower. ~ NDIC ~
Too much glucose in the blood for a long time can cause diabetes problems. This high blood glucose, also called blood sugar, can damage many parts of the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes. You can do a lot to prevent or slow down diabetes problems.
This information is about feet and skin problems caused by diabetes. You will learn the things you can do each day and during each year to stay healthy and prevent diabetes problems.
How can diabetes hurt my feet?
High blood glucose from diabetes causes two problems that can hurt your feet:
* Nerve damage. One problem is damage to nerves in your legs and feet. With damaged nerves, you might not feel pain, heat, or cold in your legs and feet. A sore or cut on your foot may get worse because you do not know it is there. This lack of feeling is caused by nerve damage, also called diabetic neuropathy. Nerve damage can lead to a sore or an infection.
* Poor blood flow. The second problem happens when not enough blood flows to your legs and feet. Poor blood flow makes it hard for a sore or infection to heal. This problem is called peripheral vascular disease, also called PVD.
Smoking when you have diabetes makes blood flow problems much worse. For example, you get a blister from shoes that do not fit. You do not feel the pain from the blister because you have nerve damage in your foot. Next, the blister gets infected. If blood glucose is high, the extra glucose feeds the germs. Germs grow and the infection gets worse. Poor blood flow to your legs and feet can slow down healing. Once in a while a bad infection never heals. The infection might cause gangrene. If a person has gangrene, the skin and tissue around the sore die. The area becomes black and smelly.
To keep gangrene from spreading, a doctor may have to do surgery to cut off a toe, foot, or part of a leg. Cutting off a body part is called an amputation.
What can I do to take care of my feet?
Wash your feet in warm water every day. Make sure the water is not too hot by testing the temperature with your elbow. Do not soak your feet. Dry your feet well, especially between your toes.
Look at your feet every day to check for cuts, sores, blisters, redness, calluses, or other problems. Checking every day is even more important if you have nerve damage or poor blood flow. If you cannot bend over or pull your feet up to check them, use a mirror. If you cannot see well, ask someone else to check your feet.
If your skin is dry, rub lotion on your feet after you wash and dry them. Do not put lotion between your toes.
File corns and calluses gently with an emery board or pumice stone. Do this after your bath or shower. ~ NDIC ~
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