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  • richardmitnick 10:06 am on February 26, 2017 Permalink | Reply
    Tags: Diabetes, Fasting-mimicking diet may reverse diabetes, ,   

    From USC: “Fasting-mimicking diet may reverse diabetes” 

    USC bloc

    University of Southern California

    February 24, 2017
    Beth Newcomb

    Periodic cycles of fasting reprogram pancreatic cells and restore insulin production, USC researchers find.

    A diet designed to imitate the effects of fasting appears to reverse diabetes, a new USC-led study shows.

    1
    Study participants at risk for high blood pressure or diabetes could benefit from a cycle of fasting. (Illustration/iStock)

    The fasting-like diet promotes the growth of new insulin-producing pancreatic cells that reduce symptoms of Type 1 and Type 2 diabetes in mice, according to the study on mice and human cells led by Valter Longo, director of the Longevity Institute at the USC Leonard Davis School of Gerontology.

    “Cycling a fasting-mimicking diet and a normal diet essentially reprogrammed non-insulin-producing cells into insulin-producing cells,” said Longo, a professor of biological sciences at the USC Dornsife College of Letters, Arts and Sciences.

    By activating the regeneration of pancreatic cells, the researchers were able to rescue mice from late-stage Type 1 and Type 2 diabetes. They also reactivated insulin production in human pancreatic cells from Type 1 diabetes patients.

    The reprogrammed adult cells and organs prompted a regeneration in which damaged cells were replaced with new functional ones, Longo said.

    The study published on Feb. 23 in the journal Cell is the latest in a series of studies to demonstrate promising health benefits of a brief, periodic diet that mimics the effects of a water-only fast.

    Reversing insulin resistance and depletion

    In Type 1 and late-stage Type 2 diabetes, the pancreas loses insulin-producing beta cells, increasing instability in blood sugar levels. The researchers simulated Type 1 diabetes in mice by administering high doses of the drug streptozotocin— killing the insulin-producing b-cells — and studied mice with Type 2 diabetes, characterized by insulin resistance and eventual loss of insulin production, which have a mutation in the gene Lepr.

    The study showed a remarkable reversal of both types of diabetes in mice placed on the fasting-mimicking diet for four days each week. They regained healthy insulin production, reduced insulin resistance and demonstrated more stable levels of blood glucose. This was the case even for mice in the later stages of the disease.

    The diet cycles switched on genes in the adult mice that are normally active only in the developing pancreases of fetal mice. The genes set off production of a protein, neurogenin-3 (Ngn3), thus generating new, healthy insulin-producing beta cells.
    Next steps: clinical study

    Longo and his team also examined pancreatic cell cultures from human donors and found that, in cells from Type 1 diabetes patients, fasting also increased expression of the Ngn3 protein and accelerated insulin production. The results suggest that a fasting-mimicking diet could alleviate diabetes in humans.

    Longo and his research team have gathered evidence indicating several health benefits of the fasting-mimicking diet. Their recent study published in Science Translational Medicine demonstrated that the fasting-mimicking diet reduced risks for cancer, diabetes, heart disease and other age-related diseases in human study participants who followed the special diet for five days each month in a three-month span.

    Prior studies on the diet have shown potential for alleviating symptoms of the neurodegenerative disease multiple sclerosis, increasing the efficacy of chemotherapy for cancer treatments and decreasing visceral fat.

    These findings warrant a larger FDA trial on the use of the fasting-mimicking diet to treat human diabetes patients to help them produce normal levels of insulin while improving insulin function, Longo noted.

    “Hopefully, people with diabetes could one day be treated with an FDA-approved fasting-mimicking diet for a few days each month and gain control over their insulin production and blood sugar,” he said.

    Among the study’s lead authors were Chia-Wei Cheng and Roberta Buono of USC Davis and Valentina Villani of the Saban Research Institute. Other co-authors were Min Wei and Dean Pinchas Cohen of USC Davis; Sanjeeve Kumar of the Keck School of Medicine of USC; Omer Yilmaz of the Koch Institute at MIT, Julie Sneddon of the University of California, San Francisco, and Laura Perin of the Saban Research Institute. The study was funded by the National Institutes of Health/National Institute on Aging (grants AG20642, AG025135 and P01 AG034906) to Longo.

    Longo is the founder of and has an ownership interest in L-Nutra; the company’s food products are used in the human studies of the fasting-mimicking diet. Longo’s interest in L-Nutra was disclosed and managed per USC’s conflicts of interest policies. USC has an ownership interest in L-Nutra and the potential to receive royalty payments from L-Nutra. USC’s financial interest in the company has been disclosed and managed under USC’s institutional conflict of interest policies.

    See the full article here .

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    USC campus

    The University of Southern California is one of the world’s leading private research universities. An anchor institution in Los Angeles, a global center for arts, technology and international business, USC’s diverse curricular offerings provide extensive opportunities for interdisciplinary study, and collaboration with leading researchers in highly advanced learning environments. With a strong tradition of integrating liberal and professional education, USC fosters a vibrant culture of public service and encourages students to cross academic as well as geographic boundaries in their pursuit of knowledge.

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  • richardmitnick 10:23 am on January 13, 2017 Permalink | Reply
    Tags: , Diabetes, , , , Sugar stands accused   

    From Harvard: “Sugar stands accused” This Is Important for All 

    Harvard University

    Harvard University

    Sugar was in the dock at Harvard Law School this week, accused of a prime role in the twin epidemics of obesity and diabetes sweeping the country.

    1
    Gary Taubes signs copies of his book “The Case Against Sugar” following his talk for the Food Law and Policy Clinic. The acclaimed science writer hypothesizes that sugar “has deleterious effects on the human body that lead to obesity and diabetes, and that it should be considered a prime suspect [in the national dietary epidemic].” Stephanie Mitchell/Harvard Staff Photographer

    Science journalist and author Gary Taubes ’77 made his case that sugar consumption — which has risen dramatically over the last century — drives metabolic dysfunction that makes people sick. The hour-long talk was sponsored by the Food Law and Policy Clinic and drawn from Taubes’ new book, The Case Against Sugar.

    A reputation for “empty calories” — devoid of vitamins and nutrients but otherwise no different from other foods containing an equal number of calories — has allowed sugar to maintain a prominent place in the U.S. diet. Taubes is dubious. First, all calories are not equal because the body metabolizes different foods in different ways. More specifically, there may be something about eating too much sugar — in particular fructose, which is metabolized in the liver — that implicates it in metabolic disease.

    “I’m making an argument that sugar is uniquely toxic,” said Taubes. “It has deleterious effects on the human body that lead to obesity and diabetes.”

    Taubes laid out a case that he admitted was “largely circumstantial,” though one he considers compelling enough that it would gain at least an indictment from an impartial jury. The problem with the evidence, he said, is that public health researchers haven’t focused enough attention on sugar.

    “The research doesn’t exist beyond reasonable doubt that sugar is to blame,” Taubes said.

    Diabetes, Taubes noted, was once a rare disease. He traced its rise through the 1800s and 1900s from just a fraction of 1 percent of the cases seen at Massachusetts General Hospital to a condition that afflicts nearly 10 percent of the U.S. population, according to the Centers for Disease Control and Prevention. That increase, he said, coincides with an increase in sugar in the American diet.

    He tied today’s problems to both the sugar industry and some of the scientists responsible for informing the public about diet. Two researchers prominent in Harvard’s history didn’t escape blame: Elliott Joslin, the founder of the Harvard-affiliated Joslin Diabetes Center, and Frederick Stare, the founder of the Harvard T.H. Chan School of Public Health’s Nutrition Department.

    See the full article here .

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    Harvard University campus

    Harvard is the oldest institution of higher education in the United States, established in 1636 by vote of the Great and General Court of the Massachusetts Bay Colony. It was named after the College’s first benefactor, the young minister John Harvard of Charlestown, who upon his death in 1638 left his library and half his estate to the institution. A statue of John Harvard stands today in front of University Hall in Harvard Yard, and is perhaps the University’s best known landmark.

    Harvard University has 12 degree-granting Schools in addition to the Radcliffe Institute for Advanced Study. The University has grown from nine students with a single master to an enrollment of more than 20,000 degree candidates including undergraduate, graduate, and professional students. There are more than 360,000 living alumni in the U.S. and over 190 other countries.

     
  • richardmitnick 10:35 am on May 25, 2016 Permalink | Reply
    Tags: , Diabetes, , , Nerve damage found in prediabetics   

    From Hopkins via The Baltimore Sun: “Nerve damage found in prediabetics” Why to Avoid Dunkin’ Donuts 

    Johns Hopkins
    Johns Hopkins University

    1

    5.25.16
    Andrea K. McDaniels

    2
    Michael Jackson suffers from significant nerve damage stemming from prediabetes. (Lloyd Fox / Baltimore Sun)

    The pain shot across the tops of Michael Jackson’s feet as if someone was pounding him with a sledgehammer, sometimes becoming so unbearable he couldn’t sleep.

    The aerospace engineer blamed it on arthritis until his primary care physician ruled that out. Tests for Lupus and Lou Gherig’s disease also came back negative. Finally, a doctor cut a small sample of skin from one of Jackson’s feet and counted the nerve fibers under a microscope.

    Jackson suffered from significant nerve damage stemming from prediabetes — a condition in which people have high blood glucose levels but not enough to be classified as diabetes.

    Doctors have known for a while that those with prediabetes can experience mild weakness, numbness and pain from nerve damage, but a new Johns Hopkins study suggests that so-called neuropathy is much more significant than once thought. Like Jackson, patients can experience excruciating pain more typically associated with full-blown diabetes. About 50 percent of people with diabetes have neuropathy, according to the National Institute of Neurological Disorders and Stroke.

    The numbness associated with neuropathy can contribute to some diabetics’ eventual need for amputation. Diabetics tend to have poor blood circulation, which can lead to infection and ulcers. A patient may not notice an injury or infection due to lack of feeling, leading to amputation.

    The Johns Hopkins researchers say their findings provide evidence that patients should be screened for prediabetes and neuropathy much earlier than once thought. The medical community also needs to do a better job at treating and diagnosing those with prediabetes, the researchers concluded. An estimated one in three Americans — 86 million people — have prediabetes, according to the U.S. Centers for Disease Control, and may be at particular risk to the unknown consequences of the disease.

    “It means that even mild blood sugar elevations are important and it’s important for us to be aggressive in how we treat that,” said Dr. Michael Polydefkis, the study’s senior author and a professor of neurology at the Johns Hopkins University School of Medicine and director of the Cutaneous Nerve Lab.

    The Hopkins study is different from those done in the past because it showed deterioration over the entire length of sensory nerve fibers and not just at the ends, which suggests the damage is not localized.

    The patients with prediabetes, studied over a period of three years, continued to have worsening damage to their small nerve fibers throughout the study just as patients with full-blown diabetes did. Skin samples taken from the ankle, thigh and knee showed a 10 percent loss in the density of nerve cells by the end of the study.

    “I expected that people with diabetes would do worse, but I didn’t really expect people with prediabetes to experience a similar rate of degradation of their small nerve fibers,” Polydefkis said.

    The results come as medical providers already are trying to better diagnose prediabetes.

    For the last few years, the American Medical Association has worked to increase public awareness about prediabetes and get more phyisicians to screen at-risk patients. Working with the U.S. Centers for Disease Control, the association is offering doctors more information about prevention programs for their patients.

    The medical association also is participating in a public service campaign to raise awareness of prediabetes as a serious health problem. The campaign encourages people to find out if they have prediabetes and to take steps to reverse their condition to avoid developing full diabetes.

    If caught early, prediabetes can be treated with lifestyle changes, such as weight loss, exercise and diet modification to bring blood sugar levels down. Some doctors also believe the medicine used to treat diabetes could be used for prediabetes as well.

    Untreated prediabetes could progress to diabetes and lead to lifelong health problems, including cardiovascular disease and skin problems. Diabetes can destroy the blood vessels of the retina leading to blindness and damage the kidneys, which the body uses to filter out waste, leading some patients to need dialysis treatment to survive. Research shows that 15 percent to 30 percent of overweight people with prediabetes will develop type 2 diabetes within five years unless they make lifestyle changes.

    “We know that people who take preventive measures early on can slow the rate of decline,” said Dr. Ruth S. Horowitz, chief of the division of endocrinology and metabolism at Greater Baltimore Medical Center.

    There are some limits to the study. The sample size was small with 62 people, including 16 who were prediabetic and 52 with tingling and pain in their hands and feet.

    Still, the Hopkins research could help convince insurance companies to eventually cover the treatment of prediabetes, some doctors said. Insurance companies don’t always cover nutritional education and supplies for glucose testing until a patient has full-blown diabetes.

    “This study reinforces the need for us to address prediabetes as an even more serious problem,” said Stephen N. Davis, chair of the department of medicine at the University of Maryland School of Medicine. “It really does show there are consequences with prediabetes.”

    Jackson continues to cope with the consequences of his neuropathy. His nerve damage has gotten worse over time. He has lost much of the feeling in his feet and once dropped a cinder block on his foot without knowing until he looked down. His balance is off and he sometimes finds himself falling over in the shower. He is trying to manage the condition with medications and eating better.

    “As a kid I ate a lot of candy,” he said. “I was drowning myself with sugar as a kid, but back in the day nobody said much about sugar. I have tried to cut back now and it has helped.”

    See the full article here .

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    Johns Hopkins Campus

    The Johns Hopkins University opened in 1876, with the inauguration of its first president, Daniel Coit Gilman. “What are we aiming at?” Gilman asked in his installation address. “The encouragement of research … and the advancement of individual scholars, who by their excellence will advance the sciences they pursue, and the society where they dwell.”

    The mission laid out by Gilman remains the university’s mission today, summed up in a simple but powerful restatement of Gilman’s own words: “Knowledge for the world.”

    What Gilman created was a research university, dedicated to advancing both students’ knowledge and the state of human knowledge through research and scholarship. Gilman believed that teaching and research are interdependent, that success in one depends on success in the other. A modern university, he believed, must do both well. The realization of Gilman’s philosophy at Johns Hopkins, and at other institutions that later attracted Johns Hopkins-trained scholars, revolutionized higher education in America, leading to the research university system as it exists today.

     
  • richardmitnick 12:07 pm on March 2, 2016 Permalink | Reply
    Tags: , Diabetes, , smart shoe to help reduce amputations   

    From EPFL: “Diabetes: a smart shoe to help reduce amputations” 

    EPFL bloc

    École Polytechnique Fédérale de Lausanne EPFL

    02.03.16
    Sarah Perrin

    Smart shoe for diabetics
    Smart shoe. No image credit.

    EPFL researchers have developed a shoe sole with valves that electronically control the pressure applied to the arch of the foot. The goal is to relieve foot ulcers commonly caused by diabetes and help them heal to avoid dangerous secondary infections.

    Diabetes can lead to dangerous complications that all too often end in amputation of the foot or even death. To avoid these eventualities, a team of researchers from EPFL is collaborating with the Geneva University Hospitals (HUG) on a smart shoe. The technology is based on actuators that electronically control the stiffness of the sole in order to reduce the onset of diabetic foot ulcers and prevent existing ones from worsening. An initial prototype has just been completed.

    Every year in Europe, 250,000 diabetics have a leg amputated, and the mortality rate is 30% at 30 days and 50% at one year. Foot ulcers are the root cause of most of the amputations. These wounds, which are the result of vascularization and excess pressure, easily worsen in part because they are not painful. Many diabetics are unaware of how serious they are and continue to walk normally, preventing the ulcers from healing. They don’t see their doctor until the lesion reaches the bone, at which point the risk of secondary infection and then gangrene is high.

    Controlling viscosity

    The challenge for doctors is threefold. They need to find a way to remove all pressure from the ulcers as soon as they appear, keep it off as long as necessary for them to fully heal, and quickly react to new ulcers, which can reappear at any time elsewhere on the arch of the foot.

    In response to this challenge, researchers from EPFL’s Integrated Actuators Laboratory (LAI) in Neuchâtel came up with an idea: embed the sole of a shoe with around 50 small electromagnetic valves filled with magnetorheological material. “We can control the viscosity of the material, which is made up of suspended iron microparticles,” said Yves Perriard, the director of LAI. “When we apply a magnetic field, the particles react immediately and align themselves with it, causing the material to change from liquid to solid state in a fraction of a second.”

    This means that the rigidity in different parts of the shoe sole can be controlled separately depending on where the sensitive areas and wounds are. The system should not only help the wounds heal quickly but also prevent the onset of new ulcers.

    Fewer constraints

    This invention offers a number of advantages, such as considerably simplifying diabetics’ day-to-day life. “A number of other solutions exist, such as bandages and pressure-relief insoles,” said Zoltan Pataky, an internal medicine specialist at HUG who started the project. “But they are very restrictive and need to be constantly adjusted, and so patients are often reluctant to use them and doctors hesitate to prescribe them. The advantage of this shoe is that, in addition to relieving the arch of the foot wherever necessary, it immediately adjusts the pressure as some ulcers heal and others appear.” The lab is currently searching for industry partners to further develop the project.

    See the full article here .

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    EPFL campus

    EPFL is Europe’s most cosmopolitan technical university with students, professors and staff from over 120 nations. A dynamic environment, open to Switzerland and the world, EPFL is centered on its three missions: teaching, research and technology transfer. EPFL works together with an extensive network of partners including other universities and institutes of technology, developing and emerging countries, secondary schools and colleges, industry and economy, political circles and the general public, to bring about real impact for society.

     
  • richardmitnick 1:17 pm on December 15, 2015 Permalink | Reply
    Tags: , Diabetes, ,   

    From Hebrew University via START-UP ISRAEL: “With artificial pancreas, diabetics can put the needles away” 

    START-UP ISRAEL

    Hebrew U of Jerusalem bloc

    The Hebrew University

    December 14, 2015
    David Shamah

    1
    Prof. Eduardo Mitrani (Courtesy)

    As scientists race to come up with ways to improve the human body through bio-artificial organs, one of the first such advances is likely to be the pancreas, which is being developed by Hebrew University team together with a Ramat Gan start-up.

    Diabetes, a disease in which the body is unable to regulate its blood sugar levels, is growing to epidemic proportions. By 2035, nearly 600 million people will have some form of diabetes, either Type 1 formerly known as juvenile diabetes, in which people born with the condition cannot produce the insulin needed to regulate blood glucose, or Type II acquired diabetes, which usually develops in patients with weight problems.

    “Our bioartificial pancreas is aimed at the most extreme cases of diabetes,” Prof. Eduardo Mitrani, who led the Hebrew Univeristy team, told The Times of Israel. “The engineered bio-pancreas can be implanted virtually anywhere in the body. There it can secrete the insulin the body needs in a regulated manner and deliver it directly to the bloodstream, thus eliminating the need for glucose measurement and attempts to regulate its levels by insulin injections.”

    Diabetics, and the people they live and work with, are all too familiar with the routine. The patient must, at various times of the day, whip out a glucometer to figure out how much glucose is in the bloodstream. Then, it’s time to inject life-sustaining insulin, the hormone that enables the body’s cells to absorb and use glucose, which is needed to produce energy.

    But it is extremely difficult to obtain a good steady control of glucose levels, said Mitrani. “That really illustrates the problem. Although there are guidelines and plenty of data, advanced diabetic patients still have a hard time figuring out exactly how much insulin to administer. In addition, insulin levels fluctuate throughout the day, so insulin needs can change by the moment. The main problem with diabetes is not the disease itself but the side effects caused by the fluctuations in glucose levels.”

    Some researchers have attempted to overcome these problems by transplanting the body’s own pancreatic beta-cells in the hope that they will be able to jump-start the organ in patients with extreme cases of diabetes. “The problem with this approach today is that the vast majority of these transplanted cells die within two days of transplantation, so 50% of the patients are still insulin-dependent one year after transplantation. Five years later, only 10% remain insulin-independent,” said Mitrani.

    Mitrani and Betalin Therapeutics, a Ramat Gan biotech start-up, are trying another approach, one they believe will be much more effective. Betalin’s Engineered Micro Pancreas (EMP) is based on the premise that in order for beta cells to properly function, it is necessary to provide an appropriate connective tissue scaffold that ensures the long term survival and proper function of the cells.

    The proprietary platform technology developed by Mitrani has been licensed from the Hebrew University to Betalin via Yissum, The Hebrew University’s Technology Transfer Company.

    Studies of the Betalin solution (published last month in the journal Tissue Engineering Part A) show that human islets, or beta cells derived from them in EMPs, function in vitro similarly to freshly dissected pancreatic islets – meaning that they produce insulin immediately, and continue to do so. The tests showed similar, regulated insulin levels for over three months, as compared to the manual insertion method, where the cell islets retained functionality for only a few days.

    In addition to supporting regulated levels of insulin secretion, the EMPs quickly integrate into the body and “connect to the network” by inducing the formation of a proper vascular network that connect to the nearest blood vessels, said Mitrani.

    “The micro pancreas aims at solving problems currently associated with transplantation of naked islets. In our system, prior to transplantation, islets are cultured within a biological scaffold that supports their survival, leading to long term functionality of the majority of the cells.”

    The technology is being tested in several beta studies in Israel and the company is raising money for further tests and approval by the FDA and its Canadian counterpart Health Canada in order to start clinical trials in US and Canada. If all goes well, an artificial pancreas could be on the market within five years.

    Mitrani collaborated with Prof. James Shapiro, Medicine and Surgical Oncology, University of Alberta, Canada on the project.

    “We have been collaborating for the past two years with Prof. Mitrani to explore his most promising approach for providing a stable extracellular matrix combined with our highly successful ‘Edmonton Protocol’ islet cell transplant treatment in Type 1 diabetes. If Betalin’s new microscaffold technique continues to demonstrate efficacy, it has the potential to substantially improve cellular engraftment and survival both for islets and potentially for stem cell engraftment in future for clinical application,” Shapiro said.

    See the full article here .

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    Hebrew University of Jerusalem campus

    The Hebrew University of Jerusalem, founded in 1918 and opened officially in 1925, is Israel’s premier university as well as its leading research institution. The Hebrew University is ranked internationally among the 100 leading universities in the world and first among Israeli universities.

    The recognition the Hebrew University has attained confirms its reputation for excellence and its leading role in the scientific community. It stresses excellence and offers a wide array of study opportunities in the humanities, social sciences, exact sciences and medicine. The university encourages multi-disciplinary activities in Israel and overseas and serves as a bridge between academic research and its social and industrial applications.

    The Hebrew University has set as its goals the training of public, scientific, educational and professional leadership; the preservation of and research into Jewish, cultural, spiritual and intellectual traditions; and the expansion of the boundaries of knowledge for the benefit of all humanity.

     
  • richardmitnick 10:09 am on December 6, 2015 Permalink | Reply
    Tags: , Diabetes,   

    From Harvard: “Positive sign in America’s food fight” 

    Harvard University

    Harvard University

    December 3, 2015
    Alvin Powell

    1
    “The number of people diagnosed with diabetes increased dramatically from early 1990s until 2010-2011, then plateaued over the past several years, and came down substantially in 2014,” said Frank Hu, a professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health and the principal investigator of the diabetes component of the landmark Nurses’ Health Study. “I think the trend is pretty robust.” Stephanie Mitchell/Harvard Staff Photographer

    Is there light at the end of the “diabesity” tunnel? New data from the Centers for Disease Control and Prevention seem to confirm that recent reports showing the U.S. diabetes epidemic beginning to decline are not a statistical blip.

    The CDC reported this week that the number of new diabetes cases in the United States rose by 1.4 million in 2014, a rate more than three times that of the early 1980s, but significantly lower than the 1.7 million of 2009.

    Frank Hu, a professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health and the principal investigator of the diabetes component of the landmark Nurses’ Health Study, responded to the CDC findings in an interview with the Gazette. While cause for hope, Hu said, these slim gains are no reason to relax efforts in the nation’s fight to reverse the epidemic.

    GAZETTE: The Centers for Disease Control and Prevention released statistics showing new cases of diabetes declining from prior years in 2014. What is the significance of these numbers?

    HU: I think the new data confirmed that the trend we have been seeing in the past several years is not an artifact; it’s real. So I think that’s good news.

    The number of people diagnosed with diabetes increased dramatically from early 1990s until 2010-2011, then plateaued over the past several years, and came down substantially in 2014. I think the trend is pretty robust.

    GAZETTE: Even with the decline, we’re still getting more than a million new cases in a year. What is the overall picture of diabetes today?

    HU: The prevalence remains very high. That’s the reason it’s really too early to celebrate. We are still facing a diabetes epidemic and a major public health challenge in the U.S. and globally in terms of diabetes. Right now, almost 29 million people in the U.S. have diagnosed and undiagnosed diabetes. So that’s a huge number. And that large number of diabetes patients will have major implications for health care costs and impose a large burden on the health care system.

    GAZETTE: What kinds of complications do you typically see with diabetes?

    HU: The most common complication, of course, is cardiovascular disease. About two-thirds of people with diabetes will die of heart disease, stroke, and other cardiovascular events. That’s the reason it’s extremely important to reduce cardiovascular risk factors among people with diabetes.

    Diabetes is the most important cause of several other devastating complications such as blindness, non-traumatic lower limb amputations, and dialysis and kidney failure. That’s the reason it’s so expensive to manage and treat diabetes.

    Right now, we don’t have a cure and people with diabetes have to be put on multiple medications to control their blood sugar. Eventually, those drugs are not effective anymore and these patients have to be put on insulin. It’s a lifelong treatment.

    GAZETTE: How tightly bound are the diabetes and obesity epidemics? Is it possible to fight one without affecting the other?

    HU: Obesity and type 2 diabetes go hand in hand. That is the reason we have this new terminology called “diabesity.” Obesity is the single most important risk factor for diabetes and the recent increase in diabetes in the U.S. and globally is largely due to rising obesity.

    GAZETTE: Is the slowing growth in diabetes cases an indication that things are getting better with obesity?

    HU: That’s an interesting question. Of course diabetes is a multifactorial disease, but, as I mentioned, obesity is the single greatest risk factor for diabetes.

    In the past several years it looks like the obesity epidemic has plateaued in the U.S., although the last wave of data indicated a modest increase in women. But overall, when you look at the trend in the past decade, the increase has been much smaller. The plateau of the obesity epidemic may account for the plateau of diabetes prevalence and perhaps even a modest reduction in the diagnosed diabetes cases.

    Another potential factor is an overall improvement of diet quality in the U.S. We published a recent paper in Health Affairs and, in that study, we found that there is modest improvement in overall diet quality in the U.S. That is primarily driven by two factors. One is that the consumption of sugar-sweetened beverages has declined by almost 25 percent and [the other is] the consumption of trans fats has decreased by 70 percent.

    Those are major positive trends in terms of diet. Both factors are important for diabetes. There is also modest improvement in consumption of fruits and modest reduction in red meat intake.

    Improvement in diet quality accounts for about a 12 percent reduction in diabetes prevalence in the U.S. in the past decade. That’s actually independent of changes in body weight and an interesting finding that hasn’t been widely described in the media or the literature.

    GAZETTE: So the quality of our diet improving could have a positive effect on diabetes even if the obesity rate continues to inch up?

    HU: If you look at the question from another perspective, the improvement in diet quality may have also contributed to the plateau of the obesity epidemic because we know that both quality and quantity of the diet are important.

    We don’t have good data on quantity of dietary intakes — the number of calories consumed daily — but in terms overall quality it looks like there has been modest improvement. But we still have a long way to go in terms of achieving a more optimal diet quality. Overall, I think improvement in diet quality may have contributed to the plateau of both obesity and diabetes in the U.S. population.

    GAZETTE: Any idea what might be working as far as intervention strategies?

    HU: Sugar-sweetened beverage consumption had decreased substantially. I think there is increasing public awareness about the deleterious effect of sugary beverages on obesity and diabetes. And there are certainly more policies that have helped to reduce consumption of sugary beverages in schools, in government buildings, and perhaps in certain communities.

    GAZETTE: Do we know how these numbers break down among subgroups?

    HU: The CDC did present data by different ethnic groups and different educational levels. There is a huge disparity in terms of diabetes prevalence by race and SES [socioeconomic status]. African-Americans and Hispanics have disproportionately higher prevalence of diabetes and people with a lower SES also have a much higher prevalence of diabetes.

    This disparity in diabetes prevalence corresponds very well to the gap in obesity prevalence and also the gap in diet quality. We have seen diet quality improve much greater for those in the higher SES group than for those in the lower SES group and also much greater improvement in normal-weight people than obese people.

    GAZETTE: What is most important for the public to know about diabetes today?

    HU: Diabetes is largely preventable by diet and lifestyle.

    A lot of people think diabetes is a genetic disease and cannot be modified by what they eat and what they do. Diabetes runs in the family, but genetics plays only a small part in the diabetes epidemic. Unhealthy diet and lifestyle account for the vast majority of type 2 diabetes cases.

    That’s the reason we need multipronged approaches to tackle this problem. We need to encourage people to change their diet and lifestyle, their behavior, habits, and I think equally important — perhaps more important — to create a healthy environment that can facilitate and support individuals to adopt healthy behaviors.

    See the full article here .

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    Harvard University campus

    Harvard is the oldest institution of higher education in the United States, established in 1636 by vote of the Great and General Court of the Massachusetts Bay Colony. It was named after the College’s first benefactor, the young minister John Harvard of Charlestown, who upon his death in 1638 left his library and half his estate to the institution. A statue of John Harvard stands today in front of University Hall in Harvard Yard, and is perhaps the University’s best known landmark.

    Harvard University has 12 degree-granting Schools in addition to the Radcliffe Institute for Advanced Study. The University has grown from nine students with a single master to an enrollment of more than 20,000 degree candidates including undergraduate, graduate, and professional students. There are more than 360,000 living alumni in the U.S. and over 190 other countries.

     
  • richardmitnick 4:00 pm on October 10, 2014 Permalink | Reply
    Tags: , , Diabetes,   

    From Caltech: “Sensors to Simplify Diabetes Management” 

    Caltech Logo
    Caltech

    10/10/2014
    Jessica Stoller-Conrad

    For many patients diagnosed with diabetes, treating the disease can mean a burdensome and uncomfortable lifelong routine of monitoring blood sugar levels and injecting the insulin that their bodies don’t naturally produce. But, as part of their Summer Undergraduate Research Fellowship (SURF) projects at Caltech, several engineering students have contributed to the development of tiny biosensors that could one day eliminate the need for these manual blood sugar tests.

    two
    From left to right: Sagar Vaidyanathan, a visiting undergraduate researcher from UCLA, and Caltech sophomore Sophia Chen. Chen spent her summer in the laboratory of Hyuck Choo, assistant professor of electrical engineering, studying new ways to power tiny health-monitoring sensors and devices.
    Credit: Lance Hayashida/Caltech Marketing and Communications

    Because certain patients with diabetes are unable to make their own insulin—a hormone that helps transfer glucose, or sugar, from the blood into muscle and other tissues—they need to monitor frequently their blood glucose, manually injecting insulin when sugar levels surge after a meal. Most glucose monitors require that patients prick their fingertips to collect a drop of blood, sometimes up to 10 times a day for the rest of their lives.

    In their SURF projects, the students, all from Caltech’s Division of Engineering and Applied Science, looked for different ways to do these same tests but painlessly and automatically.

    man
    Senior applied physics major Mehmet Sencan has approached the problem with a tiny chip that can be implanted under the skin. The sensor, a square just 1.4 millimeters on each side, is designed to detect glucose levels from the interstitial fluid (fluid found in the spaces between cells) that is just under the skin. The glucose levels in this fluid directly relate to the blood glucose concentration.

    Sencan has been involved in optimizing the electrochemical method that the chip will use to detect glucose levels. Much like a traditional finger-stick glucose meter, the chip uses glucose oxidase, an enzyme that reacts in the presence of glucose, to create an electrical current. Higher levels of glucose result in a stronger current, allowing the device to measure glucose levels based on the charge that passes through the fluid.

    Once the glucose level is detected, the information is wirelessly transmitted via a radio wave frequency to a reader that uses the same frequency to power the device itself. Ultimately an external display will let the patient know if their levels are within range.

    Sencan, who works in the laboratory of Axel Scherer, the Bernard Neches Professor of Electrical Engineering, Applied Physics, and Physics, and who is co-mentored by postdoctoral researcher Muhammad Mujeeb-U-Rahman, started this project three years ago during his very first SURF.

    “When I started, we were just thinking about what kind of chemistry the sensor would use, and now we have a sensor that is actually designed to do that,” he says. Over the summer, he implanted the sensors in rat models, and he will continue the study over the fall and spring terms using both rat and mouse models—a first step in determining if the design is a clinically viable option.

    jun
    Junior electrical engineering major Sith Domrongkitchaiporn from the Scherer laboratory, also co-mentored by Mujeeb-U-Rahman, took a different approach to glucose detection, making tiny biosensors that are inconspicuously wearable on the surface of a contact lens. “It’s an interesting concept because instead of having to do a procedure to place something under the skin, you can use a less invasive method, placing a sensor on the eye to get the same information,” he says.

    He used the method optimized by Mehmet to determine blood glucose levels from interstitial fluid and adapted the chemistry to measure glucose in the eyes’ tears. This summer, he will be attempting to fabricate the lens itself and improve upon the process whereby radio waves are used to power the sensor and then transmit data from the sensor to an external computer.

    girl
    SURF student and sophomore electrical engineering major Jennifer Chih-Wen Lin wanted to incorporate a different kind of glucose sensor into a contact lens. “The concept—determining glucose readings from tears—is very similar to Sith’s, but the method is very different,” she says.

    Instead of determining the glucose level based on the amount of electrical current that passes through a sample, Lin, who works in the laboratory of Hyuck Choo, assistant professor of electrical engineering, worked on a sensor that detects glucose levels from the interaction between light and molecules.

    In her SURF project, she began optimizing the characterization of glucose molecules in a sample of glucose solution using a technique called Raman spectroscopy. When molecules encounter light, they vibrate differently based on their symmetry and the types of bonds that hold their atoms together. This vibrational information provides a unique fingerprint for each type of molecule, which is represented as peaks on the Raman spectrum—and the intensity of these peaks correlates to the concentration of that molecule within the sample.

    “This step is important because once I can determine the relationship between peak intensities and glucose concentrations, our sensor can just compare that known spectrum to the reading from a sample of tears to determine the amount of glucose in the sample,” she says.

    Lin’s project is in the very beginning stages, but if it is successful, it could provide a more accurate glucose measurement, and from a smaller volume of liquid, than is possible with the finger-stick method. Perhaps more importantly for patients, it can provide that measurement painlessly.

    girl12
    Also in Choo’s laboratory, sophomore electrical engineering major Sophia Chen’s SURF project involves a new way to power devices like these tiny sensors and other medical implants, using the vibrations from a patient’s vocal cords. These vibrations produce the sound of our voice, and also create vibrations in the skull.

    “We’re using these devices called energy harvesters that can extract energy from vibrations at specific frequencies. When the vibrations go from the vocal folds to the skull, a structure in the energy harvester vibrates at the same frequency, generating energy—energy that can be used to power batteries or charge things,” Chen says.

    Chen’s goal is to determine the frequency of these vibrations—and if the energy that they produce is actually enough to power a tiny device. The hope is that one day these vibrations could power, or at least supplement the power of, medical devices that need to be implanted near the head and that presently run on batteries with finite lifetimes.

    Chen and the other students acknowledge that health-monitoring sensors powered by the human body might be years away from entering the clinic. However, this opportunity to apply classroom knowledge to a real-life challenge—such as diabetes treatment—is an important part of their training as tomorrow’s scientists and engineers.

    See the full article here.

    The California Institute of Technology (commonly referred to as Caltech) is a private research university located in Pasadena, California, United States. Caltech has six academic divisions with strong emphases on science and engineering. Its 124-acre (50 ha) primary campus is located approximately 11 mi (18 km) northeast of downtown Los Angeles. “The mission of the California Institute of Technology is to expand human knowledge and benefit society through research integrated with education. We investigate the most challenging, fundamental problems in science and technology in a singularly collegial, interdisciplinary atmosphere, while educating outstanding students to become creative members of society.”
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  • richardmitnick 3:28 pm on August 23, 2014 Permalink | Reply
    Tags: , Diabetes, Electrical Engineering, ,   

    From Princeton: “Laser device may end pin pricks, improve quality of life for diabetics” 

    Princeton University
    Princeton University

    August 20, 2014
    John Sullivan, Office of Engineering Communications

    Princeton University researchers have developed a way to use a laser to measure people’s blood sugar, and, with more work to shrink the laser system to a portable size, the technique could allow diabetics to check their condition without pricking themselves to draw blood.

    “We are working hard to turn engineering solutions into useful tools for people to use in their daily lives,” said Claire Gmachl, the Eugene Higgins Professor of Electrical Engineering and the project’s senior researcher. “With this work we hope to improve the lives of many diabetes sufferers who depend on frequent blood glucose monitoring.”

    In an article published June 23 in the journal Biomedical Optics Express, the researchers describe how they measured blood sugar by directing their specialized laser at a person’s palm. The laser passes through the skin cells, without causing damage, and is partially absorbed by the sugar molecules in the patient’s body. The researchers use the amount of absorption to measure the level of blood sugar.

    Sabbir Liakat, the paper’s lead author, said the team was pleasantly surprised at the accuracy of the method. Glucose monitors are required to produce a blood-sugar reading within 20 percent of the patient’s actual level; even an early version of the system met that standard. The current version is 84 percent accurate, Liakat said.

    “It works now but we are still trying to improve it,” said Liakat, a graduate student in electrical engineering.

    team
    A new system developed by Princeton researchers uses a laser to allow diabetics to check their blood sugar without pricking their skin. Members of the research team included, from left, Sabbir Liakat, a graduate student in electrical engineering; Claire Gmachl, the Eugene Higgins Professor of Electrical Engineering; and Kevin Bors, who graduated in 2013 with a degree in electrical engineering. (Photos by Frank Wojciechowski for the Office of Engineering Communications)

    When the team first started, the laser was an experimental setup that filled up a moderate-sized workbench. It also needed an elaborate cooling system to work. Gmachl said the researchers have solved the cooling problem, so the laser works at room temperature. The next step is to shrink it.

    “This summer, we are working to get the system on a mobile platform to take it places such as clinics to get more measurements,” Liakat said. “We are looking for a larger dataset of measurements to work with.”

    The key to the system is the infrared laser’s frequency. What our eyes perceive as color is created by light’s frequency (the number of light waves that pass a point in a certain time). Red is the lowest frequency of light that humans normally can see, and infrared’s frequency is below that level. Current medical devices often use the “near-infrared,” which is just beyond what the eye can see. This frequency is not blocked by water, so it can be used in the body, which is largely made up of water. But it does interact with many acids and chemicals in the skin, so it makes it impractical to use for detecting blood sugar.

    Mid-infrared light, however, is not as much affected by these other chemicals, so it works well for blood sugar. But mid-infrared light is difficult to harness with standard lasers. It also requires relatively high power and stability to penetrate the skin and scatter off bodily fluid. (The target is not the blood but fluid called dermal interstitial fluid, which has a strong correlation with blood sugar.)

    The breakthrough came from the use of a new type of device that is particularly adept at producing mid-infrared frequencies — a quantum cascade laser.

    device
    The new monitor uses a laser, instead of blood sample, to read blood sugar levels. The laser is directed at the person’s palm, passes through skin cells and is partially absorbed by sugar molecules, allowing researchers to calculate the level of blood sugar.

    In many lasers, the frequency of the beam depends on the material that makes up the laser — a helium-neon laser, for example, produces a certain frequency band of light. But in a quantum cascade laser, in which electrons pass through a “cascade” of semiconductor layers, the beam can be set to one of a number of different frequencies. The ability to specify the frequency allowed the researchers to produce a laser in the mid-infrared region. Recent improvements in quantum cascade lasers also provided for increased power and stability needed to penetrate the skin.

    To conduct their experiment, the researchers used the laser to measure the blood sugar of three healthy people before and after they each ate 20 jellybeans, which raise blood sugar levels. The researchers also checked the measurements with a finger-prick test. They conducted the measurements repeatedly over several weeks.

    The researchers said their results indicated that the laser measurements readings produced average errors somewhat larger than the standard blood sugar monitors, but remained within the clinical requirement for accuracy.

    “Because the quantum cascade laser can be designed to emit light across a very wide wavelength range, its usability is not just for glucose detection, but could conceivably be used for other medical sensing and monitoring applications,” Gmachl said.

    Besides Liakat and Gmachl, researchers included Kevin Bors, Class of 2013, Laura Xu, Class of 2015, and Callie Woods, Class of 2014, who worked on the project as undergraduate students majoring in electrical engineering; and Jessica Doyle, a teacher at Hunterdon Regional Central High School.

    Support for the research was provided in part by the Wendy and Eric Schmidt Foundation, the National Science Foundation, Daylight Solutions Inc., and Opto-Knowledge Systems. The research involving human subjects was conducted according to regulations set by the Princeton University Institutional Review Board.

    See the full article here.

    About Princeton: Overview

    Princeton University is a vibrant community of scholarship and learning that stands in the nation’s service and in the service of all nations. Chartered in 1746, Princeton is the fourth-oldest college in the United States. Princeton is an independent, coeducational, nondenominational institution that provides undergraduate and graduate instruction in the humanities, social sciences, natural sciences and engineering.

    As a world-renowned research university, Princeton seeks to achieve the highest levels of distinction in the discovery and transmission of knowledge and understanding. At the same time, Princeton is distinctive among research universities in its commitment to undergraduate teaching.

    Today, more than 1,100 faculty members instruct approximately 5,200 undergraduate students and 2,600 graduate students. The University’s generous financial aid program ensures that talented students from all economic backgrounds can afford a Princeton education.

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