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Experts say the tiny device could be more effective than medication, diet and exercise, with initial studies showing blood glucose levels dropping within weeks.
Doctors are trialling a new implant which could give hope to millions of diabetics.
More than three million people in the UK have Type 2 diabetes, and medics say the sleeve implant has the potential to be a more effective treatment than medication, diet and exercise.
The tiny EndoBarrier device is put into the small intestine via the mouth for up to 12 months.
It acts as a barrier to prevent food being absorbed and ensures it bypasses a section of the upper intestine, allowing less time for digestion and improving resistance to insulin.
In a 24-month study involving 160 participants, experts at Imperial College Healthcare NHS Trust and Southampton General Hospital will compare EndoBarrier with standard medical therapy for the management of obese people with Type 2 diabetes.
Results of an initial study showed a drop in blood glucose levels within weeks – reducing the need for diabetes medication. Patients also achieved significant weight loss similar to that seen following gastric band surgery.
Prof Julian Teare, a consultant gastroenterologist and study lead based at Imperial College London, said: “Type 2 diabetes affects millions of people in the UK and many of these people have been unsuccessful at managing their diabetes with their current treatment regimens.
“While previous clinical trials and commercial experience suggest that EndoBarrier therapy is a safe and effective treatment option for Type 2 diabetes, results from this study should provide definitive evidence to help guide treatment decisions.
“The use of a lower cost and less invasive alternative to bypass surgery may mean we can treat thousands more people living with Type 2 diabetes every year.”
Mr James Byrne, a consultant surgeon and co-lead based at Southampton General Hospital, said: “We know weight loss surgery is currently the most effective and longest-lasting treatment option for Type 2 diabetes.
“However, it is not the right approach for everyone and will not significantly impact the epidemic of Type 2 diabetes we see in the UK.
“Other strategies for this condition are urgently required and our research will confirm whether or not EndoBarrier therapy can help to deliver and, more importantly, sustain improvements in diabetes control.”
Source The Mirror
Diabetes is a disease in which certain cells in the pancreas fail to produce enough, or any, insulin and/or where the other cells of the body fail to use insulin properly.
Type 2 diabetes is the form of the disease that usually affects adults, especially the elderly, and is an acquired disease which can result from prolonged periods of elevated blood sugar, stress, or other illness or disease.
Type 1 diabetes typically develops during childhood and involves the body attacking its own insulin-producing cells leading to an inability to control blood glucose (sugar) levels. Gestational diabetes is the form of the disease that arises during pregnancy.
Many factors play a role in the development of type 2 diabetes and these same factors often affect successful management of the condition.
Understanding how diabetes develops can help patients to control the condition and lead to a full and happy life despite their disease.
Often diabetes arises due to a combination of stress, smoking, lack of physical exercise, and a diet high in simple sugars and other pro-inflammatory foods and low in essential nutrients and fibre, all of which all conspire to burn out pancreatic beta cells and cause insulin resistance.
When we eat simple carbohydrates such as white rice, potatoes, white bread, and pasta, as well as sugar in the form of glucose, maltose, dextrose or sucrose, the body has to produce large amounts of insulin quickly in order to get the sugar out of the blood and into cells where it can act as fuel.
When this happens repeatedly the cells that produce insulin can become overworked and stop functioning as well, and the rest of the body’s cells may become resistant to the effects of insulin, leading to perpetually high blood sugar even in-between meals.
Testing for fasting blood glucose is a key element of diagnosing diabetes, as well as assessing blood glucose after a meal to determine the body’s ability to produce and react to insulin.
Those who are pre-diabetic, namely those whose fasting blood glucose levels are elevated, but not yet at the threshold for diabetes diagnosis, may be able to reverse their condition and prevent themselves developing full-blown diabetes and avoid all of the problems connected with the disease.
High blood glucose is problematic because it can damage blood vessels leading to impaired circulation and reduction in the supply of oxygen and nutrients to cells, tissues, and organs like the brain, heart, and kidneys.
Diabetes can lead to serious and life threatening complications, such as a heart attack, stroke, or kidney failure.
The good news is that there are many things that someone diagnosed with diabetes can do to keep their blood glucose within acceptable levels and to maintain or even improve their quality of life.
Blood glucose management is helped by:
Eating healthy meals with a low glycaemic index/load
Regular physical activity (such as walking daily, swimming, or cycling)
Maintaining a healthy weight, with an emphasis on improved muscle tone and reduced body fat
Taking medications for diabetes and other conditions as prescribed by a physician
Carefully monitoring blood glucose levels
Learning about effective stress management and keeping stress levels low
All of these things can help patients regulate their blood sugar more effectively and minimise damage to their body from elevated blood glucose.
It is also important for smokers to stop smoking as it exacerbates the effects of the disease and can complicate management of the blood sugar by increasing the destruction of insulin-producing cells in the pancreas.
Careful blood pressure management also helps reduce the negative effects of diabetes, as does keeping cholesterol in check and having regular physical examinations and eye examinations so as to diagnose any issues early and to take appropriate measures.
Diabetics should take good care of their feet and attend a chiropodist regularly for any treatment they require.
It is important for patients to discuss the target range for their blood glucose with their healthcare provider and to find effective ways to manage blood glucose.
Staying positive and having realistic expectations about the condition helps with diabetes management.
It can also help to talk to others with diabetes, and there are many peer-support groups available where people can share tips and realise that they are not alone in the effective management of the condition.
People who need treating with repeated courses of antibiotics may be at increased risk of developing type 2 diabetes, researchers have found.
The European Journal of Endocrinology study traced antibiotic prescriptions given out to a million UK patients.
The authors say the findings do not necessarily mean that the drugs trigger diabetes – instead, infections may be a warning sign that diabetes is imminent.
They say more work is now needed to understand the link.
The study looked at how many antibiotic prescriptions had been given to 208,000 diabetic patients – both type 1 and type 2 diabetics – at least one year before they were diagnosed with their condition, compared with 816,000 non-diabetic patients of the same age and sex.
Nearly half of the patients had been prescribed antibiotics at some point over the course of the study period.
And the researchers found the risk of type 2 diabetes went up with the number of antibiotic prescriptions a patient received.
- The risk of type 2 diabetes was 8% higher among patients prescribed two to five courses of penicillin-type antibiotics, and 23% higher among those given more than five courses of these drugs
- For another class of antibiotics known as quinolones, type 2 diabetes risk was 15% higher among patients prescribed two to five courses and 37% higher among those given more than five courses
No link was found with antifungal drugs and antiviral drugs. And antibiotic use did not appear to affect risk of type 1 diabetes.
Red flag or trigger?
The researchers, Dr Ben Boursi and colleagues from the University of Pennsylvania in the US, believe changes to gut bacteria triggered by taking antibiotics might explain their findings.
Our guts are lined with billions of bacteria and antibiotics can wipe some of these out.
Studies in animals and humans have hinted that changes to this “digestive ecosystem” might contribute to conditions such as diabetes and obesity.
Dr Boursi said: “Over-prescription of antibiotics is already a problem around the world as bacteria become increasingly resistant to their effects.
“Our findings are important, not only for understanding how diabetes may develop, but as a warning to reduce unnecessary antibiotic treatments that might do more harm than good.”
But some say repeated infections could be a sign that diabetes is developing. People with type 2 diabetes are prone to skin and urine infections, for example.
Prof Jodi Lindsay from St George’s, University of London, said that since people with type 2 diabetes were at increased risk of developing infections, it was hard to tease the two apart.
“This is a very large and helpful study linking diabetes with antibiotic consumption in the UK public, but at this stage we don’t know which is the chicken and which is the egg.
“The idea that antibiotics might contribute to diabetes development might be important and more research needs to be done.”
There are two main types: type 1 and type 2
- In type 1, which accounts for about 10% of diabetes, the body’s immune system destroys the cells that make insulin
- Type 2 diabetes is when the body either cannot make enough insulin or the body’s cells do not react to it
- Insulin treatment is always needed for type 1 diabetes, while if you have type 2 you may be able to control your symptoms by eating a healthy diet, exercising regularly and monitoring your blood sugar.
A “worryingly high” number of children with type 1 diabetes have warning signs of long-term health complications, including blindness, a report says.
And charities say this leaves “great concern” for their future health – some patients show early markers of eye, heart and kidney disease.
Data from England and Wales suggests more than 1,000 new cases were recorded in people under-25 last year.
But overall blood sugar control in this group has improved, the study shows.
Type 1 diabetes often appears in childhood. It is caused by the immune system destroying cells in the pancreas, leaving patients unable to control their blood sugar.
This is different to the far more common type 2 diabetes, which is largely due to an unhealthy lifestyle.
The Royal College of Paediatrics and Child Health (RCPCH) looked at figures from young people’s diabetes units across England and Wales in 2013-14.
Its analysis shows that 26,867 children and young people with diabetes were recorded last year, compared with 25,221 in 2012/13.
But just 16% underwent all seven annual health checks that are recommended to monitor their blood sugar control and any complications.
Persistently high blood sugar levels can lead to serious problems, including heart disease and kidney disorders.
The figures suggest:
- More than 27% of young people had high blood pressure – putting them at risk of heart disease
- Some 7% had markers of future kidney disease
- Over 14% had early signs of eye disease – putting them at risk of blindness in later years
- More than 25% were classed as obese.
Kyle O’Keefe, who has type-1 diabetes: “There are lots of things that can go wrong”
Barbara Young, Diabetes UK chief executive, said there was evidence that children were experiencing problems with their eyesight or kidneys before they reached their 18th birthday.
She said: “This is tragic and we have great concerns for their future health if they are already showing signs of complications at such a young age.
“There is an urgent need for the NHS to make the pace of improvement quicker.”
‘Some good news’
Dr Justin Warner, of the RCPCH, said: “This is the first time we have been able to collect and analyse the data on early warning signs and levels are higher than we would expect.
“There is some good news though – we can see from the audit that blood sugar control is getting better across England and Wales.
“We hope this will have a knock-on effect, reducing these early warning signs too.”
The study also looked at type 2 diabetes, which accounts for 5% of all cases of diabetes in children and young people.
Many young people with this form of diabetes live in deprived areas of England and Wales.
Sourced from the BBC Online
Poor diabetes care in England is leading to avoidable deaths, record rates of complications and huge costs to the NHS, a charity is warning.
Diabetes UK says the disease is the fastest growing health threat of our times and current care models are not working to get on top of the problem.
The NHS spends a tenth of its budget on diabetes, but most goes on managing complications not preventing them.
The government says it is focusing on early intervention.
Long and healthy life
Diabetes is a chronic condition and, if poorly managed, can lead to devastating complications, including blindness, amputations, kidney failure, stroke and early death.
Best-practice guidelines say patients should get regular checks to ensure they are controlling their condition well enough to avoid future complications.
But official audits of NHS care in England show many patients do not receive these checks.
Diabetes UK’s own annual snapshot says there has been very little overall improvement in diabetes provision in the past year and that some aspects of care have got worse – such as fewer people with type 1 diabetes receiving an annual check-up.
It says just 41% of people with type 1 diabetes – which must be treated with insulin – receive all the annual checks recommended by the National Institute for Health and Care Excellence, and only 16% meet the three recommended treatment targets for blood sugar, cholesterol and blood pressure.
Young diabetes patients receive fewer vital checks than older patients. There is also wide variation depending on where you live in England.
People with diabetes living in some areas receive better care and treatment than people living in other areas, says the charity.
Barbara Young, Diabetes UK chief executive, said: “This is not a question of spending more money. In fact, better ongoing standards of care will save money and reduce pressure on NHS resources.
“It’s about people getting the checks they need at their GP surgery and giving people the support and education they need to be able to manage their own condition. Doing this, together with improving diabetes care in hospital, would give people with diabetes a better chance of a long and healthy life, and save the NHS a significant amount of money. We want to work with local authorities to be able to help them put good practice into place.”
Prof Kevin Fenton, from Public Health England, said free health checks were available to help spot and manage diabetes. He said disease prevention programmes were also under way.
“PHE and NHS England are developing a nationwide type 2 diabetes prevention programme which will support those most at risk to make essential lifestyle changes – such as losing weight, improving their diet and being more active.
“We need to help people take early action to reduce their risk of developing this serious condition.”
Diabetes is currently estimated to cost the UK £23.7bn. With diabetes becoming more common, this figure is set to rise to £40bn by 2035-36.
Source BBC News
Diabetes in middle age can “age the mind” by five years, potentially hastening the onset of dementia in later life, a new study has shown.
More than three million people in the UK are living with diabetes and there is mounting evidence that the illness is linked to memory and thinking problems in old age.
In a new analysis of health data from nearly 16,000 people in the USA, who have been followed up since the 1980s, researchers saw direct links between the condition and cognitive decline.
They found that, on average, a 60-year-old with diabetes experienced a decline in their brain function that was on par with a 65-year-old without diabetes.
Type 2 diabetes, the most common form, is closely linked to being overweight or obese, and maintaining a healthy diet and exercising regularly are among the best ways to prevent the illness.
The authors of the study, from Johns Hopkins Bloomberg School of Public Health in Maryland, said that their research proved “that to have a healthy brain when you’re 70, you need to eat right when you’re 50.”
Their findings, published in the journal Annals of Internal Medicine, add to mounting evidence that a number of physical health conditions increase a person’s risk of developing dementia.
People with diabetes have trouble regulating levels of sugar in their blood. This can cause damage to the veins, including those in the brain – an effect which may explain diabetes’ link with dementia.
Dr Laura Phipps of Alzheimer’s Research UK, said: “This study adds to a large body of evidence linking diabetes to thinking and memory problems in later life, and suggests that controlling blood sugar levels in midlife may also have long-term benefits for our brain health.
“Evidence suggests we can lower our risk of dementia by keeping healthy: eating a balanced diet, exercising regularly, not smoking, and keeping blood pressure and weight in check.”
Source The Independent
The hunt for a cure for type 1 diabetes has recently taken a “tremendous step forward”, scientists have said.
The disease is caused by the immune system destroying the cells that control blood sugar levels.
A team at Harvard University used stem cells to produce hundreds of millions of the cells in the laboratory.
Tests on mice showed the cells could treat the disease, which experts described as “potentially a major medical breakthrough”.
Beta cells in the pancreas pump out insulin to bring down blood sugar levels.
But the body’s own immune system can turn against the beta cells, destroying them and leaving people with a potentially fatal disease because they cannot regulate their blood sugar levels.
It is different to the far more common type 2 diabetes which is largely due to poor lifestyle.
The team at Harvard was led by Prof Doug Melton who began the search for a cure when his son was diagnosed 23 years ago. He then had a daughter who also developed type 1.
He is attempting to replace the approximately 150 million missing beta cells, using stem cell technology.
Beta cells Lab-made beta cells were transplanted into the mice
He found the perfect cocktail of chemicals to transform embryonic stem cells into functioning beta cells.
Tests on mice with type 1 diabetes, published in the journal Cell, showed that the lab-made cells could produce insulin and control blood sugar levels for several months.
Dr Melton said: “It was gratifying to know that we could do something that we always thought was possible.
“We are now just one pre-clinical step away from the finish line.”
However, his children were not quite so impressed: “I think, like all kids, they always assumed that if I said I’d do this, I’d do it.”
If the beta cells were injected into a person they would still face an immune assault and ultimately would be destroyed.
More research is needed before this could become a cure.
Sarah Johnson, from the charity JDRF which funded the study, told the BBC: “This isn’t a cure, it is a great move along the path. It is a tremendous step forward.
“Replacing the cells that produce insulin as well as turning off the immune response that causes type 1 diabetes is the long-term goal.”
Prof Chris Mason, a stem cell scientist at University College London, said: “A scientific breakthrough is to make functional cells that cure a diabetic mouse, but a major medical breakthrough is to be able to manufacture at large enough scale the functional cells to treat all diabetics.
“This research is therefore a scientific and potentially a major medical breakthrough.
“If this scalable technology is proven to work in both the clinic and in the manufacturing facility, the impact on the treatment of diabetes will be a medical game-changer on a par with antibiotics and bacterial infections.”
Dr Gillian Morrison, from the University of Edinburgh, agreed that this “represents a real advance in the field”.
She said: “The next important challenge will be to find ways to maintain these cells inside the body so they are protected from the immune response and have long-term function.”
Source BBC News