Hiển thị các bài đăng có nhãn Diabetes. Hiển thị tất cả bài đăng
Hiển thị các bài đăng có nhãn Diabetes. Hiển thị tất cả bài đăng

Thứ Ba, 7 tháng 2, 2012

Pancreas May 'Taste' Fructose, Hinting at Links to Diabetes

MONDAY, Feb. 6 (HealthDay News) -- New research shows that the pancreas has sweet-taste receptors -- like those found on the tongue -- that can "taste" fructose.

Fructose is a common ingredient in many foods and beverages. Nutrition experts have warned that Americans take in far too much fructose and the new findings might bolster their concerns.

In lab studies of pancreas cells from both humans and mice, the researchers found that when the pancreas tastes fructose from foods, it responds by producing more insulin. Insulin is a hormone that allows sugar from the blood to enter the body's cells. However, excess levels of insulin, or an inefficient use of insulin, have been linked to obesity and type 2 diabetes, the researchers said.

"The coolest thing in my mind is that we now understand that taste isn't only for the tongue. We have a whole slew of cells for controlling how we deal with sugars," said the study's senior author, Bjorn Tyrberg, an assistant professor and scientific advisor in histology and cellular imaging at the Sanford-Burnham Medical Research Institute in Orlando, Fla.

He added that fructose had not been linked to insulin secretion in the past, but that this study shows when the pancreas tastes fructose, there is an effect on insulin secretion when glucose is also present.

Fructose and glucose are two different types of sugars. Fructose is found naturally in things like fruit and honey. One source of fructose, called high-fructose corn syrup, is added to many processed foods, such as sodas and cereals, according to Tyrberg.

What isn't yet clear, he said, is what effect fructose has on the body's metabolism. "We've shown that fructose is not inert with insulin secretion," he said, but added that whether this connection plays a role in obesity or the development of type 2 diabetes isn't known.

Results of the study appear online Feb. 7 in the Proceedings of the National Academy of Sciences.

Normally, when you eat, beta cells in the pancreas respond to the rise in glucose levels by secreting more insulin. Insulin attaches to other cells in the body and opens the cells, allowing glucose to enter the cells and provide energy. But researchers wanted to know what role fructose played in the release of insulin.

Using cells from humans and mice, the researchers found that fructose activated sweet-taste receptors on beta cells, causing them to secrete insulin. When glucose and fructose were encountered together, as would often happen with commonly consumed foods today, even more insulin was released.

When the researchers inactivated -- or turned off -- the sweet-taste receptors in the beta cells, they no longer secreted insulin when exposed to fructose. The researchers say these findings suggest that these sweet-taste receptors in the pancreas may play a role in metabolic diseases, such as obesity and type 2 diabetes. They're currently developing studies in humans to confirm what they've found in human and mouse cells in the lab.

Commenting on the study, Dr. Spyros Mezitis, an endocrinologist and clinical investigator at Lenox Hill Hospital in New York City, said that it showed that "when you eat fructose and glucose together, you get even more of an insulin release. That means sugar gets out faster, and the body is pushed harder."

And, he added, "if you have a high sugar consumption, you may tire out your pancreas, and that exhaustion might cause the pancreas to not release enough insulin anymore. If you already have type 2 diabetes, this could push the body more and hasten the progression of the disease."

But "right now this is speculation. We need human studies to understand this connection over time," Mezitis said. Still, this may be "one more piece of evidence that we should be curtailing fructose in our diets," he suggested.

A spokesperson for the Corn Refiners Association declined to comment on the study's findings.

More information

Learn more about type 2 diabetes from the U.S. National Library of Medicine.


View the original article here

Diabetes Takes Toll on Women's Hearing: Study

FRIDAY, Feb. 3 (HealthDay News) -- Diabetes is associated with hearing loss in women, especially if the blood sugar disease isn't well-controlled, new research indicates.

The study, done by researchers at Henry Ford Hospital in Detroit, examined the medical records of 990 men and women who had hearing tests between 2000 and 2008. Patients with diabetes were divided into two groups: well-controlled and poorly controlled.

Among women aged 60 to 75, hearing loss was 14 percent worse even in well-controlled diabetics compared to those without diabetes. That is not a clinically significant loss, noted study author Dr. Kathleen Yaremchuk, chairwoman of the department of otolaryngology at the Henry Ford Healthcare System in Detroit.

"An individual might not notice it," Yaremchuk said.

On the other hand, poorly controlled diabetics' hearing was 28 percent worse than the non-diabetic group's hearing.

Younger women who had diabetes, well-managed or not, were more likely to have hearing loss than those unaffected by the illness, the study found.

Diabetes is known to affect the eyes, kidneys and other organs, Yaremchuk said. "Our study shows it can affect hearing as well."

In the study, presented recently at the Triological Society's annual meeting in Miami Beach, Fla., there was no link between hearing loss among men and diabetes, whether it was well-managed or not. Men are more likely in general to suffer from hearing loss than women, so the prevalence of the condition among males may mask diabetes' effect, the study suggested.

Men are exposed to more environmental causes of hearing loss, such as loud noise, either in the workplace or during leisure activities, such as attending large sporting events, explained Yaremchuk.

Managing diabetes properly should help prevent hearing loss or keep it from getting worse, Yaremchuk said.

What's unknown is if better management of diabetes can reverse hearing loss that's already occurred.

"We do not know if losing weight and improving control of diabetes will reverse the hearing loss that is seen. However, it will stop progression of the hearing loss," she said.

Recommendations call for diabetics' to have their vision checked every year, said Dr. Spyros Mezitis, a clinical endocrinologist at Lenox Hill Hospital in New York City.

This latest finding suggests diabetics may also need to have their hearing tested, Mezitis said.

"This study will help make doctors more aware to ask about hearing, particularly in women between 60 and 75," said Mezitis, also an assistant professor of clinical medicine at New York Presbyterian Hospital-Cornell Medical Center.

About 26 million Americans have diabetes, mostly type 2, which is associated with obesity.

Because this study was presented at a medical meeting, the conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

To learn more about diabetes, visit U.S. National Institutes of Health.


View the original article here

Metformin Preferred Drug for Type 2 Diabetes, Experts Say

MONDAY, Feb. 6 (HealthDay News) -- When it comes to the treatment of type 2 diabetes, the first line of defense is lifestyle changes such as losing weight and exercising more often.

But, if those lifestyle changes don't get blood sugar levels under control, the American College of Physicians (ACP) recommends the drug metformin as the first oral treatment that should be given.

If metformin alone can't control blood sugar levels, the ACP advises combining metformin with another blood-sugar lowering medication. But, the evidence isn't yet strong enough for the doctor's group to recommend one medication over another for combination therapy.

"Most diabetes medications do lower [blood sugar], but metformin is more effective with fewer side effects. And, the cost is less," said Dr. Amir Qaseem, director of clinical policy at the American College of Physicians, and the lead author of the new guidelines.

However, the ACP is recommending that metformin only be prescribed after someone has tried to change his or her lifestyle, he added.

"Diet, exercise and weight loss are so important in controlling type 2 diabetes. You can't just give pharmaceutical agents and not have lifestyle changes," Qaseem said.

The new guidelines are published in the Feb. 7 issue of the Annals of Internal Medicine.

Type 2 diabetes is a disease that causes high blood sugar levels. Over time, this can lead to blood-vessel damage in the eyes, kidneys, heart and nerves. Almost 26 million Americans have diabetes, and as many as 95 percent of those have type 2 diabetes, according to the new guidelines.

"Diabetes is a really important health-care issue in this country. It's a major cause of morbidity and mortality, and the prevalence of the disease is going up," Qaseem said.

Obesity and a sedentary lifestyle are significant risk factors for type 2 diabetes, although not everyone who has the disease is overweight.

There are currently 11 different classes of medications approved by the U.S. Food and Drug Administration for the treatment of type 2 diabetes, according to the guidelines. These medications work by lowering blood sugar levels.

To come up with the new guidelines on oral diabetes treatments, the reviewers looked at data for each available class of medication to assess how effective it was in lowering blood sugar, cholesterol and weight. They also looked at how much each medication was able to reduce the risk of complications from type 2 diabetes. And, they reviewed the safety of each type of medication.

They found that metformin was the most effective in lowering hemoglobin A1C (HbA1C) levels. HbA1C levels are a measure of long-term blood sugar control, estimating average blood sugar levels over several months.

The researchers also found that combination therapy with two drugs was more effective at lowering HbA1C than therapy with just one agent. However, when comparing different combination therapies, no particular combination stood out as superior to the others.

Metformin also appeared to be the most effective medication for lowering levels of LDL (bad) cholesterol, according to the guidelines. Metformin also seemed to be more effective at preventing all-cause mortality and heart disease.

Dr. Joel Zonszein, director of the clinical diabetes program at Montefiore Medical Center in New York City, said he would recommend starting medication along with lifestyle changes, instead of waiting to see if lifestyle medications work or not.

"Lifestyle changes fail in the majority of people. Why wait to start treating them? There should not be inertia. If you're more aggressive early in the disease you may be able to protect some of the beta cells," he said. Beta cells are cells in the pancreas that produce insulin, a hormone needed to metabolize carbohydrates in food.

Zonszein also said that many of the studies used to develop the new guidelines were short-term studies, often sponsored by drug manufacturers. He said to really know what treatments are best, longer-term studies are needed, as are studies that look at different combinations of diabetes medications.

He said he also would have liked the guidelines to address the use of cholesterol-lowering medications and blood-pressure lowering medications, as these are common problems seen in people with type 2 diabetes.

More information

The American Diabetes Association has more information on the types of oral medications available for type 2 diabetes.


View the original article here