Tuesday, May 6th, 2014
Both type 1 and type 2 diabetes may be on the rise among young people, a new study published in the Journal of the American Medical Association suggests. Reuters has more:
Though researchers can’t say why exactly these rates continue to go up, it is important to monitor them, Dr. Dana Dabelea told Reuters Health.
Dabelea worked on the study at the Colorado School of Public Health in Aurora.
“This should draw attention to the seriousness of pediatric diabetes especially for the clinical and public health community,” she said. “At the individual level, every new case of diabetes at a young age means a lifelong burden of difficult, expensive treatment and a high risk of complications.”
Dabelea and her team analyzed data from health plans in California, Colorado, Ohio, South Carolina and Washington state, as well as from American Indian reservations in the Southwest, including more than 3 million patients under age 19.
In 2001, about 14.8 kids in every 10,000 were diagnosed with type 1 diabetes, formerly known as “juvenile diabetes,” in which the body’s own immune system destroys insulin-producing cells in the pancreas. Insulin is needed to remove sugar from the bloodstream so it can be used for energy.
By 2009, that rate had risen to 19.3 kids in every 10,000, a 21 percent increase, the authors found. Type 1 diabetes was most common among white children.
In type 2 diabetes, which is much more common but not usually diagnosed until adulthood, the body still makes insulin but can’t use it effectively. For the current study, the authors looked at type 2 diabetes among kids ages 10 and up.
Among that group in 2001, 3.4 kids in every 10,000 were diagnosed with type 2 diabetes, which increased to 4.6 per 10,000 in 2009, a 31 percent increase. This type of diabetes was most common among American Indian and black youth.
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Image: Child with insulin shot, via Shutterstock
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Wednesday, February 19th, 2014
A woman’s diet during pregnancy may directly affect her child’s brain in a way that determines the baby’s risk of becoming obese or overweight during childhood, new research has found. More from The Atlantic:
The article, published in the journal Cell in January, looks at the impact a mother’s diet has on her offspring’s health. This line of research isn’t new—otherstudies have shown links between a woman’s health during pregnancy and her child’s weight later in life—but this is one of the first to provide a potential explanation for this phenomenon.
To explore this, researchers first fed pregnant mice a diet high in fat at varying stages during their pregnancy to figure out when the most critical period was.
It turns out that mother mice that were fed a high-fat diet while they were nursing had significantly heavier male offspring with a higher percentage of body fat than moms fed a normal diet during this time. These males also had higher insulin resistance and glucose intolerance, precursors for type-2 diabetes, even if they themselves consumed a normal diet. Interestingly, these poor health effects were only present in the female offspring if they ate a high-fat diet, but not if they ate normally.
Following this discovery, the researchers looked at what was going on in the brains of these mice that might be linked to their increase in body fat, particularly focusing on the hypothalamus, a major hormonal relay station in the brain that helps to regulate our metabolism. Two chemicals that are maintained through the hypothalamus and are key players in controlling our hunger and satiety are aGRP/Neuropeptide Y, which are released when we’re hungry, stimulating our appetites, and POMC, which is involved in triggering satiety once we’ve eaten.
In baby mice, neurons continue to develop after they’re born, but in humans, neural development is more established at birth. Therefore, the nursing stage in mice actually corresponds to the third trimester of pregnancy in humans, meaning that the most critical period for people is during the last trimester.
In the case of POMC and aGRP, the researchers discovered that there was a lower density of axon fibers—the part of the cell that connects neurons in one area of the hypothalamus to another—in mice with mothers that were fed a high-fat diet. This may then have had an effect on the processing of insulin and glucose in these mice, potentially leading to the glucose intolerance and elevated insulin levels that the scientists witnessed.
Moreover, it appears that a target of these neurons that is involved in suppressing appetite and stimulating the metabolism was also significantly affected. Specifically, the genetic expression of the thyroid-stimulating hormone TRH was significantly lower in the offspring of the high-fat mother mice. This means that there was a reduced potential for the release of this hormone, which is involved in weight-regulation.
Finally, the researchers also found evidence of abnormalities in pancreatic cells, again suggesting an impairment in the processing of glucose and insulin release.
Image: Pregnant woman eating, via Shutterstock
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Tuesday, August 20th, 2013
A new study of children with type 1 diabetes suggests that insulin pumps are better at controlling the disease than insulin injections. Kids who use an insulin pump may also experience fewer complications, the researchers said. Here’s more from HealthDay News:
[The researchers] compared outcomes for 345 children, aged 2 to 19, who were using insulin pumps to control their type 1 diabetes to a similar number of children who were receiving insulin injections.
The children were followed for a median of three and a half years.
During the follow-up period, episodes of dangerously low blood sugar levels (severe hypoglycemia) in the insulin-pump group fell by about half, the researchers said. In contrast, episodes of severe hypoglycemia in the insulin-injection group rose, from about seven events per 100 patients per year to more than 10 events by the end of the study.
The researchers also looked at rates of hospital admission for diabetic ketoacidosis, a shortage of insulin that causes the body to switch to burning fats and to produce acidic ketone molecules that cause complications and symptoms. This a frequent complication in children with type 1 diabetes.
Admissions for diabetic ketoacidosis were lower in the insulin-pump group than in the insulin-injection group — 2.3 and 4.7 per 100 patients per year, respectively, according to the study.
Of the 345 patients with insulin pumps, 38 stopped using them at some point during the study: six in the first year, seven in the second year, 10 in the third year and the remainder after three years.
The study authors said some children stop because they tire of the extra attention needed to manage the pump, or are concerned about the physical sight of the pump. Other children sometimes take a temporary “pump holiday” and then start using a pump again.
Image: Insulin pump, via Shutterstock
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Monday, March 5th, 2012
A new technology that mimics the monitoring of blood sugar and release of insulin done by a healthy pancreas is making a difference in the lives of some children, leading a CNN.com medical writer to refer to it as a “vacation from diabetes.”
From Elizabeth Cohen’s report:
Medical device companies are racing to be the first to market an artificial pancreas, which takes over the work of the diabetic’s malfunctioning organ. The device could potentially be used for Type 1 diabetics or Type 2 diabetics who use insulin.
“It’s transformative technology,” says Aaron Kowalski, assistant vice president for treatment therapies research at the Juvenile Diabetes Research Foundation.
JDRF is funding artificial pancreas trials at 13 sites worldwide, including Yale University, Stanford University, the University of Virginia and the University of Colorado. Device companies also are funding several other studies.
“It’s looking incredibly promising,” Kowalski says. “I hope very much we’ll have a system on the market within four years, and I’ll be very disappointed if we don’t.”
In January, [12-year-old] Elle [Shaheen] walked into Massachusetts General Hospital to start the trial.
Doctors fitted her for an artificial pancreas. In the future, the device will be the size of a cell phone, but for now Elle is hooked up to a laptop.
For three days, the device did the work Elle’s pancreas can no longer do.
“It went very smoothly — her blood sugar control was really very, very good,” said Dr. Steven Russell, an instructor at Harvard Medical School. “We were really very pleased by what we saw with Elle.”
Russell’s research partner, Edward Diamano, an associate professor of biomedical engineering at Boston University, says the device learned Elle’s blood sugar patterns and made changes accordingly.
“It’s making adjustments every five minutes,” he says.
For that one weekend, Elle didn’t have to draw blood, and she could eat foods she hadn’t eaten in large quantities for four years.
“She ate Spaghetti-O’s and grilled cheese and french fries and hamburgers,” Shaheen says. “She ate between 67 and 100 grams of carbs a day, and usually she can only eat between 40 and 50.”
Image: Diabetic child checking blood sugar, via Shutterstock.
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