DIABETES - The Global Spike

"Why there’s been a dangerous diabetes spike around the globe" PBS NewsHour 4/6/2016

aka 'Being more wealthy can be dangerous to your health."

In fairness, I have Type II Diabetes.

Excerpt

SUMMARY:  According to a new study from the World Health Organization, diabetes cases have quadrupled over the last 40 years, mostly in poorer nations.  Today, 8.5 percent of all adults worldwide suffer from the chronic disease, and 3.7 million deaths are linked every year.  For more on the emerging health crisis, William Brangham talks to Dr. Etienne Krug of the World Health Organization.

JUDY WOODRUFF (NewsHour):  And now, an alarming new report about the dramatic growth of diabetes across the globe.

The World Health Organization said today that an estimated 422 million people are now suffering from this chronic lifelong disease.

William Brangham has more.

WILLIAM BRANGHAM (NewsHour):  The WHO’s report tracked the global rise of diabetes over the last 40 years.  And it showed a quadrupling of the number of cases worldwide.  It’s now estimated that 8.5 percent of adults in the world have the disease, and the costs are tremendous.  An estimated 3.7 million deaths every year are linked to diabetes and higher-than-normal blood sugar levels.

The fastest growth of the disease has been in Africa, the Middle East and Asia.

Joining me now is Dr. Etienne Krug.  He’s the World Health Organization’s point person for dealing with diseases like diabetes.

Dr. Krug, these are genuinely shock numbers.  How do you explain this incredible growth of diabetes?

DR. ETIENNE KRUG, World Health Organization:  Well, we have seen a steady growth now for several decades, which largely, particularly for people with type 2 diabetes, is linked to our changes in the way we eat and changes in our levels of physical activity.

We are seeing more and more unhealthy eating and a reduction in physical activity, which contributes both to overweight, which in turn is a big cause of type 2 diabetes.

WILLIAM BRANGHAM:  We tend to think of diabetes as a disease that afflicts wealthier nations, but your report indicates that poorer countries are increasingly bearing a bigger and bigger burden.

HEALTH - Diabetes Rates, San Diego County

"OFFICIALS CHEER DROP IN U.S. DIABETES RATES" by Paul Sisson, San Diego Union-Tribune 12/2/2015

NOTE:  This is from the online version of the paper, therefore no article link.

County pattern is also encouraging, disease experts say

Fewer cases of diabetes are being diagnosed in U.S. adults, according to promising federal statistics released Tuesday.

The number of diabetes cases had been climbing for decades, driven by the nation’s surging obesity rates.  In 2009, the number of new cases reached 1.7 million.  By last year, it dropped to 1.4 million.  “After so many years of seeing increases, it is surprising,” said Edward Gregg, a diabetes expert who has been tracking the numbers for the U.S. Centers for Disease Control and Prevention.  It is unclear whether the national decline extends to San Diego County.  While nationwide diabetes data for 2014 was made public Tuesday, the most recently available countywide statistics are from 2012.

Still, the local pattern is encouraging.  According to the CDC, the San Diego region saw a significant decline in diabetes incidence between 2011 and 2012, with the number of cases per 1,000 people dropping from 7.8 to 6.6.

Tuesday’s announcement gave Dr. Wilma Wooten, the county’s public health officer, hope that diabetes rates are continuing to drop as an assortment of local programs target weight loss through exercise, healthier eating and stress reduction.  “There have been millions in grants awarded to many community organizations, and it’s quite encouraging to see some indication that all of the effort maybe paying off,” Wooten said. Officially, the CDC does not know for sure what is causing the diabetes rate to decrease.  Public-health experts would like to think it is the result of a push to get people to be less sedentary and cut back on sugary foods and drinks.  “This is what’s supposed to happen when you put a lot of effort into prevention over the years,” said Gregg, who is scheduled to present the new data at a conference in Vancouver today.

The drop in national diabetes rates did not fall evenly across all demographic groups.

The biggest declines in new diabetes case rates were in men, white people, young and middle-aged adults, and in people with more than a high school education.  But there have not been substantial declines in other groups, including the elderly and minorities.

That made sense to Jane Campbell, director of the Center for Health Promotion at Paradise Valley Hospital in National City, which each year serves about 45,000 South County residents striving to avoid or overcome obesity and diabetes.

Although she said the center’s programs that target diabetes continue to draw more enrollees, Campbell also said she has noticed a significant change in recent years that suggests the region may have turned a corner in the diabetes battle.

“We’ve had more and more people who come in and say, ‘I’m not diabetic, but I want to prevent it’ or ‘I’m not diabetic, but I want to get my blood sugar checked,’” Campbell said.  “People are starting to realize that even if they don’t necessarily have the risk factors, they could still have diabetes.  I think maybe awareness is finally starting to filter its way into the population as a whole.”

While greater public recognition might seem like a warm and fuzzy concept devoid of concrete impact, Dr. Parag Agnihotri, medical director of the Sharp Rees-Stealy Medical Group in San Diego County, said getting people to think about diabetes before they become diabetic is a vital part of the larger fight.

“We have to take a step back and look at addressing people in the pre-diabetes stages if we really want to see the numbers drop.  To do this, we clearly need to raise awareness,” he said.

Rees-Stealy is five years into a program that seeks to help patients manage their diabetes through nutrition counseling, medication management and regular follow up.  The idea is to come up with a solution that lasts.

Agnihotri said a study of 100 patients participating in the program has shown that they lost 50 pounds on average— and have been able to keep the weight off for four years.  “We saw their fasting blood glucose levels drop, and we saw almost a 40 percent reduction in their medication regimen,” he said.

Ultimately, doctors, nurses, dietitians and public- health experts emphasize that the battle against diabetes is far from over.  There are still 1.4 million new adult cases of diabetes each year, and overall, there are about 22 million Americans living with diabetes.

Dr. Daniel Einhorn, medical director of the Scripps Whittier Diabetes Institute in San Diego, said he was encouraged by the latest numbers in the same way that he was encouraged by the gradual decline of smoking.

“If you remember, it happened in dribs and drabs, and gradually we have all agreed that we should get rid of second-hand smoke,” Einhorn said.

He noted that studies, including one out of UC San Diego, have indicated that like smoking, there is a social aspect to obesity.  So making headway against the overall obesity rate might create social pressure for more positive changes, especially those concerning visible habits like soda consumption.

“There is some evidence that obesity is a social disease.  If you have obese friends, you are more likely to gain weight.  I’m hoping that there will be some parallel to what we saw with exposure to second-hand cigarette smoke so that the most egregious obesity behaviors are done less.  Hopefully, that will portend more improvement for the diabetes rate in the future,” Einhorn said.

The Associated Press contributed to this report.

MEXICO - Diabetes

"Mexico’s sugar clinics help patients gain control over diabetes" PBS NewsHour 11/9/2015

Excerpt

SUMMARY:  In Mexico, over 70 percent of citizens are overweight or obese and 14 percent of Mexican adults now suffer from diabetes, though half of those affected aren't even aware they have the disease.  Special correspondent Fred de Sam Lazaro reports on the struggle to bring the disease under control.

FRED DE SAM LAZARO (NewsHour):  The North American Free Trade Agreement brought Mexico chain restaurants, malls and big box stores with abundant shelves, and an epidemic of diabetes.

JAVIER LOZANO, Founder, Clinicas del Azucar:  Regular food, but sugar free.

FRED DE SAM LAZARO:  Javier Lozano, whose mother suffers from the disease, thinks he can make a difference.  Three years ago, he opened a chain called Clinicas del Azucar, or the Sugar Clinics.

JAVIER LOZANO:  Our dream was, imagine there’s a clinic in every corner.  Just as we have franchise for hamburgers and pizza and fried chicken.

FRED DE SAM LAZARO:  The clinics are a one-stop shop to see a doctor or nutritionist, get your eyes checked, or feet, then pick up a pair of shoes or snacks.

Lozano, a 33-year-old MIT graduate, hopes to have 200 outlets by 2020, but it’s a tiny fraction of the demand in a country that by then could have 20 million diabetics.

DR. SIMON BARQUERA, National Institute of Public Health:  Basically, diabetes prevalence has been doubling every six to 10 years.

FRED DE SAM LAZARO:  Dr. Simon Barquera of Mexico’s National Health Institute says it now affects 14 percent of Mexican adults, a population with widespread genetic predisposition to diabetes.

Adding to the risk, 72 percent are obese or overweight.  Those numbers are now higher than Mexico’s northern neighbors, but with double the impact.  Far fewer Mexicans have their symptoms under control.

DR. SIMON BARQUERA:  For example, in Canada and the U.S., more than half of the population with diabetes has adequate control, in Mexico, only 25 percent.

PEDIATRICS - Ending of Coke Relationship

"American Academy of Pediatrics decides relationship with Coke is not so sweet" PBS NewsHour 9/30/2015

Excerpt

SUMMARY:  Coca-Cola, the world's largest producer of sugary beverages, had been a partner and sponsor of the American Academy of Pediatrics.  But the Academy is now ending its relationship after revelations that the company has paid for scientific research playing down the role of soda in obesity.  Hari Sreenivasan learns more from Anahad O'Connor of The New York Times.

HARI SREENIVASAN (NewsHour):  Coke is the world’s largest producer of sugary beverages, so you might not think the American Academy of Pediatrics would partner with the company.  But that had indeed been the case until this week.  It was a main sponsor of the academy’s Web site, healthychildren.org, and a past sponsor of the group’s national conference.

It’s provided over $100 million in financial support to other professional medical and health groups as well.  The Academy is now ending its relationship with Coke.  And it comes after a recent story in The New York Times laid out how the company has paid for scientific research that plays down the role of soda in obesity.

Anahad O’Connor has been working on these stories, joins me now.

So, I guess the first story — or the most recent story first, what’s the connection between Coke and the Academy of Pediatrics?

ANAHAD O’CONNOR, The New York Times:  So, the first story I did was looking at Coke’s — the money that they were paying a lot of researchers and institutions to do research that, you know, was downplaying the role of sugary drinks in obesity.

And in response to that story, the CEO of Coca-Cola said, we’re not trying to deceive the public.  We’re trying to work with institutions to promote active healthy living, and we are going to release all of the funding that we provided to scientists, universities, to health groups over the past five years.

And so they released a trove of data showing this extensive number of grants.  And in that data, we saw that the American Academy of Pediatrics was in there, and Coke had provided something like $3 million to the Academy, at least over the past five years.

HARI SREENIVASAN:  And how do the pediatricians feel?

ANAHAD O’CONNOR:  So, the actual members of the Academy — and there’s more than 64,000 pediatricians who are part of this Academy — it’s very prestigious — a lot of them are very upset.  When I spoke to them, they said they couldn’t believe that the Academy had partnered with Coke or worked with it to any extent, because sugary drinks are considered a very major factor in the obesity epidemic, especially among children.

These pediatricians see the effects of it firsthand.  They see type 2 diabetes, hypertension.  You know, all these diseases that used to occur in middle age and later in life, they see them in children now.  And they think that sugary drinks are a primary influence of that.  So, pediatricians were very upset.

HEALTH - 50% of U.S. Adults at Risk Due to Dibetes

"Study finds half of U.S. adults at risk for health problems related to elevated blood sugar" PBS NewsHour 9/15/2014

This issue pertains to me, I have Type 2 Diabetes.  There is one thing doctors and health care providers could do; perform the A1C blood test at least annually for everyone under 60yrs, and every six months for seniors.

The A1C blood test provides a 6mth snapshot of your blood sugar levels.

Excerpt

GWEN IFILL (NewsHour):  We have talked frequently about the growing burden of diabetes.  But new data show the picture is more sobering than ever.  A recent study found the risk for some cancers, such as those in the breast, liver, pancreas or stomach, is 15 percent higher if a person has higher-than-normal blood sugar, a condition often referred to as pre-diabetes.

And the Centers for Disease Control is reporting that one out of three Americans over the age of 20, or 85 million people, have pre-diabetes.  Another 29 million already have diabetes, which would put half of the U.S. adult population at risk of developing serious health problems.

Dr. David Nathan is director of the Diabetes Center at Massachusetts General Hospital, as well as professor of medicine at Harvard Medical School.  He joins me now.

Dr. Nathan, what explains this kind of increase over just a decade, an increase of 27 percent?

DR. DAVID NATHAN, Director, Diabetes Center at Massachusetts General hospital:  Well, we have been seeing this increase not just in the past decade, but over even the past several decades.

And it seems to be attributable almost entirely to the co-epidemic, if you will, of obesity and overweight.  So, now in the U.S., for example, 35 percent of the population is overweight, and another 35 percent is actually obese.  And obesity and overweight, as well as sedentary lifestyle, are the major risk factors for the development of diabetes.

GWEN IFILL:  Let’s make the distinction between type 2 diabetes and pre-diabetes.  How often does one lead to the other?

DR. DAVID NATHAN:  Well, so pre-diabetes is a term that we invented a number of years ago, and it’s meant to capture those persons who are at average-than-average or at very high risk for developing diabetes.

The term is a bit unfortunate, because not everyone with pre-diabetes actually develops diabetes, but approximately 50 percent we think go on to develop diabetes over time.

DIABETES (EU) - Combo Drug Better at Lowering Blood Sugar

Now all I need is for the U.S. to get with it, and approve the combo.

"UPDATE 1-Novo wins EU recommendation for two-in-one diabetes drug" by Ben Hirschler, Reuters 7/25/2014

Excerpt

A Novo Nordisk drug combining its long-acting insulin degludec with its type 2 diabetes treatment Victoza has been recommended for approval in Europe, in an important boost for the Danish company.

The European Medicines Agency said on Friday it had issued a positive opinion for Xultophy, previously known as IDegLira, implying the medicine is likely to be formally approved by the European Commission within three months.

Novo said it planned to launch Xultophy in the first European markets in the first half of 2015.

Jakob Riis, executive vice president of marketing and medical affairs at Novo Nordisk, said Britain, Germany and Denmark were likely to be among the first launch markets for the product.

Clinical trial results have shown that the once-daily injection lowers blood sugar more than each medicine taken on its own, setting a new standard for sugar control in diabetic patients.

Prospects for degludec - already on sale separately in Europe under the brand name Tresiba - and the new combination with Victoza are critical for Novo, which is the world's biggest insulin maker.

Shares in Novo gained 1.6 percent on news of the favorable European decision, outperforming the European drugs sector which slid 0.3 percent by 1200 GMT.

Victoza has been a major growth driver for the group in the past few years but its sales are now rising more slowly, and Novo suffered a major setback in 2013 when U.S. regulators demanded more data on the safety of Tresiba before approving it.

With diabetes affecting 382 million people worldwide and the number of cases expected to rise to 592 million by 2035, according to the International Diabetes Federation, the disease represents a huge market for pharmaceutical companies.

Novo's main rivals in the space are Sanofi and Eli Lilly, which are also major suppliers of insulin.

Combination therapies for the growing type 2 diabetes health crisis are becoming increasingly common as patients continually require additional medicines as the disease progresses.

In addition to good blood sugar control, patients taking Xultophy also tend to lose weight.  Weight loss is a particularly beneficial effect as obesity is a leading cause of type 2 diabetes and insulin tends to cause weight gain.

HEALTH - The History of Insulin

"How a Boy Became the First to Beat Back Diabetes" by Howard Markel, PBS Newshour 1/11/2013

On Jan. 11, 1922, a 14-year-old boy hovered between life and death. His name was Leonard Thompson and he was suffering the end stages of diabetes mellitus.

Because the only treatment available was a starvation diet, the boy weighed a mere 65 pounds when he was admitted to the Toronto General Hospital. Worse, Leonard was drifting in and out of a diabetic coma. His father was so desperate to save the boy that he agreed to let the doctors inject Leonard with a newly discovered wonder drug that had never been tried on another human being. The doctors called it insulin.

Insulin was discovered a year earlier by Frederick Banting, a tenacious, young surgeon from London, Ontario. During the fall of 1920, Dr. Banting became fascinated by studies on the role of the pancreas in regulating the metabolism of sugar and carbohydrates.

Soon enough, he hit upon the idea of ligating, or tying off, the pancreatic duct in order to isolate the gland's "internal secretion," a yet-to-be-identified biological substance which facilitated this critical metabolic process. Soon after, Banting took his idea to a world-renowned University of Toronto physiologist named J.J.R. Macleod.

Initially skeptical of the young surgeon's idea, Macleod eventually and somewhat begrudgingly lent Banting a makeshift laboratory for his use during the summer of 1921. Macleod also provided some dogs for him to experiment upon and assigned an eager medical student named Charles Best to help Dr. Banting with the necessary chemical analyses.

The results were nothing short of remarkable. By the summer's end, Banting and Best were able to isolate an extract of pancreas from the pancreatic duct-ligated dogs and successfully use that crude extract to treat diabetic dogs, both in terms of normalizing their blood sugar levels and relieving their diabetic symptoms.

Upon return from his summer vacation in Scotland, Professor Macleod was so impressed by the results that he dedicated his entire research team, including a talented biochemist named J.B. Collip, to the purification and production of insulin, with the goal of using the life-giving substance on human patients suffering from diabetes. By the winter of 1921-1922, Banting and Best were presenting their results at prestigious medical conferences to great acclaim and excitement.

Alas, the first trial of insulin on a human was not terribly encouraging. Although the pancreatic extract lowered Leonard Thompson's blood sugar by about 25 percent, the boy developed a severe allergic reaction to insulin. Consequently, the experiments were temporarily halted until a better means of purifying insulin could be developed.

Two weeks later, on Jan. 23, 1922, Leonard underwent a second series of insulin injections and the results were stunning. His life was, literally, saved by insulin and he became the poster boy of the now commonplace medical miracle.

Banting and Best wrote these results up for the February 1922 issue of the Journal of Laboratory and Clinical Medicine. No stuffy medical paper, the discovery of insulin and its application to human beings made front-page news around the world.

By 1923, insulin was produced in seemingly unlimited quantities by the Eli Lilly Company of Indianapolis. It was a blockbuster drug of gargantuan proportions and a reprieve from certain death for tens of thousands of diabetics that year, and millions in the years since.

Later, in 1923, Banting and Macleod (but not Best or Collip) received the Nobel Prize for Medicine or Physiology. Banting magnanimously shared his prize money with Best; Macleod followed suit by sharing his prize money with Collip. Leonard lived another 13 years, thanks to insulin, before succumbing to pneumonia, most likely a complication of his diabetes, at the age of 27 in 1935.

Insulin opened the door for a series of discoveries on hormones and a slew of other "wonder drugs" that continue to improve and save the lives of billions of people around the world.

A quintessential Eureka moment of 20th century medical science, the discovery of insulin by a determined surgeon assisted by a mere medical student continues to inspire a legion of scientists working in 21st century laboratories. And it all began with a borrowed laboratory, a few experimental dogs, a desperate patient, and an inspired surgeon with an extremely good idea.

HEALTH - Diabetes, Nanosensor Could Herald No-Finger-Prick Testing

NOTE: There is a lack of details in the article, like cost or HOW the biosensor inserted, just to name two. Otherwise it's potentially good news.

"Nanoscale biosensor measures glucose without needle pricks" Nanowerk News 9/4/2012

Pricking a finger everyday is just part of everyday life for many diabetes patients. A non-invasive measurement approach could release them from the constant pain of pin pricks. The linchpin is a biosensor engineered by Fraunhofer researchers: A tiny chip combines measurement and digital analysis – and can be radioed to a mobile device.

Sticking yourself in the finger day after day: For many diabetics, this means of checking blood glucose is an everyday part of life. Especially for patients with Type-1 diabetes, who always have to keep a close eye on their levels, since their bodies are incapable of producing the insulin to break down the glucose in the blood. Several times a day, they have to place a tiny drop of blood on a test strip. It is the only way they can ascertain the blood glucose value, so they can inject the correct amount of insulin needed. And this pricking is not only a burdensome: it may also cause inflammation or cornification of the skin. And for pain-sensitive patients, the procedure is agony.

The daily sticking of the finger may soon become a thing of the past, thanks to a diagnostic system with Fraunhofer technology built-in. The underlying concept is a biosensor that is located on the patient’s body. It is also able to measure glucose levels continuously using tissue fluids other than blood, such as in sweat or tears. The patient could dispense with the constant needle pricks. In the past, such bioelectric sensors were too big, too imprecise and consumed too much power. Researchers at the Fraunhofer Institute for Microelectronic Circuits and Systems IMS in Duisburg have recently achieved a major breakthrough: They have developed a biosensor in nano-form that circumvents these hurdles.

Diagnostic system in miniature

The principle of measurement involves an electrochemical reaction that is activated with the aid of an enzyme. Glucose oxidase converts glucose into hydrogen peroxide (H2O2) and other chemicals whose concentration can be measured with a potentiostat. This measurement is used for calculating the glucose level. The special feature of this biosensor: the chip, measuring just 0.5 x 2.0 millimeters, can fit more than just the nanopotentiostat itself. Indeed, Fraunhofer researchers have attached the entire diagnostic system to it. “It even has an integrated analog digital converter that converts the electrochemical signals into digital data,” explains Tom Zimmermann, business unit manager at IMS. The biosensor transmits the data via a wireless interface, for example to a mobile receiver. Thus, the patient can keep a steady eye on his or her glucose level. “In the past, you used to need a circuit board the size of a half-sheet of paper,” says Zimmermann. “And you also had to have a driver. But even these things are no longer necessary with our new sensor.”

Durable biosensor

The minimal size is not the only thing that provides a substantial advantage over previous sensors of this type. In addition, the sensor consumes substantially less power. Earlier systems required about 500 microamperes at five volts; now, it is less than 100 microamperes. That increases the durability of the system – allowing the patient to wear the sensor for weeks, or even months. The use of a passive system makes this durability possible. The sensor is able to send and receive data packages, but it can also be supplied with power through radio frequency.

The glucose sensor was engineered by the researchers at Noviosens, a Dutch medical technology firm. Since it can be manufactured so cost-effectively, it is best suited for mass production. These non-invasive measuring devices for monitoring blood glucose levels may become the basis for a particularly useful further development in the future: The biochip could control an implanted miniature pump that, based on the glucose value measured, indicates the precise amount of insulin to administer. That way, diabetes patients could say goodbye to incessant needle-pricks forever.

HEALTH - Diabetic Bloodless Glucometer

A good question.....

"Bloodless glucometer uses light to check blood sugar in 20 seconds or less" by Deanna Pogorelc, MedCity News 6/28/2012

When will diabetics in the U.S. get a bloodless glucometer that will allow them to check their blood sugar without a finger prick?

The short answer is, we don’t know for sure. But a company that’s wrapped up initial testing of its bloodless glucometer and closed a series B round of financing thinks it has a good shot at becoming the “first noninvasive technology with a real shot at diagnostic accuracy,” in the words of its CEO.

Grove Instruments’ Optical Bridge technology uses near-infrared spectroscopy to measure a person’s real-time blood sugar in less than 20 seconds. The company’s first product is an accessory-free, battery-operated personal glucose meter used on the fingertip or earlobe.

Grove is one of several companies working on a noninvasive diabetes test using spectroscopy including DIRAmed, C8 MediSensors and InLight Solutions. Challenges in developing devices using this technique have included water interference and low signal-to-noise ratio, but Grove thinks it has developed solutions to these problems.

“Yes, we work in near-infrared spectroscopy space, but our methodology and our particular construct is unique within the space,” said CEO Arthur Combs. “We have strong validation that we have unique technology.”

That validation has come in the form of funding through 10 SBIR grants awarded by the NIDDK NIH and a loan from the Massachusetts Life Sciences Center Accelerator Program, Combs said.

It’s also come in the form of results from a large study conducted last fall to test the device’s measurements against standard blood glucose determination. The company collected nearly 4,000 data pairs; the results, which are pending publication, indicate that the device was able to meet the ISO 15197 standard for accuracy, Combs said.

Over the past few decades, diabetes researchers have studied with varied success a number of noninvasive ways to measure glucose including the use of saliva, breath and the watery substance at the front of the eye. Other companies currently developing or awaiting approval on noninvasive diabetes testing devices include the Israeli company Integrity Applications — which is anticipating approval in 2013, Echo Therapeutics and OrSense.

Research has demonstrated that self-monitoring of blood glucose has been associated with better glycemic control in type 1 diabetics and can improve health outcomes. “We’re not doing this just because people are babies and won’t stick their finger,” Combs said, adding that barriers to adherence of regular blood glucose testing include pain, blood aversion, complicated testing methods, embarrassment and cost. “Everybody has their own reasons why they don’t test. Our opportunity is to get everyone to benefit.”

The U.S. market for glucose monitoring, currently dominated by Johnson & Johnson, Abbott Laboratories, Roche, Bayer AG and Medtronic, was forecast by the Medtech Insight division of Elsevier Business Intelligence to reach $4 billion by next year.

Formerly known as VivaScan Corp., Grove has been developing this technology for several years. Earlier this year it raised a $2.4 million series B. Its pipeline also includes a professional glucometer for use by providers in screening for diabetes and prediabetes, and a continuous glucose monitor that could be part of the coveted artificial pancreas, according to its website.

HEALTH - Dibetic Deaths Drop

"Steep Fall in Death Rates Among Diabetics" By NICHOLAS BAKALAR, New York Times 5/28/2012

Death rates among people with diabetes have declined substantially in recent years, according to a survey conducted by researchers at the Centers for Disease Control and Prevention and the National Institutes of Health.

Since 1997 the C.D.C. has done five surveys of people with and without diabetes, each sampling about 107,000 adults. Compared with the 1997-98 figures, 2006 death rates from cardiovascular disease had declined 40 percent and all-cause mortality had declined 23 percent among people with diabetes, even after the researchers controlled for age and other health factors. Death rates also declined among those who did not have diabetes, but the decline was not as steep.

The study, in the June issue of Diabetes Care, attributes the progress to advances in medical care and self-management.

But every silver lining has a cloud.

“The good thing is that people with diabetes are living longer,” said one of the authors, Sharon Saydah, a senior research scientist with the C.D.C. “But people with diabetes are at risk for a number of complications — cardiovascular disease, lower leg amputations, kidney disease, eye problems, dementia and other kinds of disability. Preventing all of these complications means that we will have greater health care expenses for people living with diabetes.”

HEALTH - Good News for Type-1 Diabetics, Artificial Pancreas

"Could implantable electronics revolutionise the healthcare industry?" by Laura Hopperton, New Electronics 11/8/2011

Excerpt

Leading edge semiconductor technology is enabling the development of smaller and more powerful medical devices for use inside the human body.

Despite the challenges of designing for environments that are typically inhospitable to conventional electronics, research teams from around the world are developing novel methods for the continuous, real time monitoring and sensing of a range of chronic diseases.

These advances, according to Dr Timothy Constandinou, deputy director of the Center for Bio-Inspired Technology at Imperial College London, are providing patients with a more portable, precise and personal way of managing their illness than ever before.

"We've come a long way since the days of the humble pacemaker," he noted. "Advances in biomedicine and information and communications technologies have enabled the healthcare industry to move towards a smarter, more decentralized approach centered not on the physician, but the patient.

"Our research involves a strong combination of integrated miniature sensing with intelligent processing, leveraging on state of the art semiconductor technology. We aim to make electronics work with biological processes, while still remaining small and consuming tiny amounts of energy."

Perhaps most significant of all about Imperial's research is that it relies heavily on a biologically inspired approach. Dr Constandinou explains: "This means that, rather than take a problem and engineer a mathematical solution, we say to ourselves 'how does the body do it?' and then model some electronics around that."

Dr Constandinou and his fellow biomedical engineers recently completed work on an artificial pancreas, which they believe has the potential to 'close the loop' on Type 1 diabetes.

The bionic system comprises an electrochemical sensor that monitors blood sugar levels continuously; a chip that mimics the unique electrical characteristics of alpha and beta cells in the human pancreas; and two small pumps worn on the body.

"In a patient with Type 1 ¬diabetes, the body's immune system attacks and kills the insulin, secreting beta cells and causing an increase in blood glucose," explained Dr Constandinou. "Over time, the glucagon secreting alpha cells also tend to fail, so people with Type 1 diabetes become prone to episodes of extremely low blood sugar.

"As such, we designed the chip's control algorithms to mimic the very different behaviors of the two cell populations. An alpha cell tends to react to rapid electrical events (spikes), while the beta cell tends to react in bursts of voltage spikes, punctuated by low voltage silent periods that last for seconds or even minutes. When glucose concentrations rise, the beta cells remain in the high voltage burst state longer, secreting more insulin as a result."

Imperial's bionic pancreas mimics this biological process by detecting the user's glucose level via a sensor every five minutes. If it reports a high level of glucose, the silicon beta cell generates a signal that drives a motor.

This motor pushes a syringe, dispensing insulin into the tissue beneath the skin until the glucose reading at the sensor drops. If the sensor reports a low glucose value, the silicon alpha cell activates the second pump to administer glucagon instead.

"This biometric approach diverges from today's dominant method of delivering only insulin using a relatively simple control system," commented Dr Pantelis Georgiou, who led the project. "The great thing about our system is that it lets people with diabetes do away with multiple insulin injections and administer the insulin in a more biologically faithful way. This reduces any secondary complications and means patients no longer have to worry about what they eat and drink."

COMMENT: I did predict this quit awhile ago because it was technologically possible.

I also have a personal interest, I now have Type-2 Diabetes, which could develop into Type-1 if I am not careful.

This development is, of course, not ready for prime-time. When it does hit the "street" it will be costly, but considering the number of Type-1 Diabetics there are in the world, the costs will come down over the years.

How fast the costs come down will depend on:

• How fast the biomed industry recovers costs of development (or so they tell us)


• The overall demand and usage


• Any government support world-wide

IF government healthcare starts paying for this, and how soon, will have a big effect on the speed costs come down. Governments will have to see a positive cost-benefit to paying for this.

That is they will have to see an overall savings in health care costs when they consider ALL the costs from the complications of Diabetes when compared to the cost of the Artificial Pancreas and implantation.

This could be jump-started by nations whose philosophy considers the health of citizens as being of prime importance and are willing to pay even before costs come down.

The hold back will be market greed. How long will the biomed industry keep prices high, beyond recovering development costs, just to make more money.

HEALTH - Artificial Pancreatic Tissue

"Surgeons Create Functional Artificial Pancreatic Tissue" Medical News Today 10/7/2010

Excerpt

Surgeons from Massachusetts General Hospital, Boston, are reporting on a whole new strategy for controlling insulin dependent diabetes without daily injections of insulin. The surgeons have bio-engineered a novel matrix that serves as a scaffold for seeding supportive stem cells as well as pancreatic islets (the cells that produce insulin in the pancreas).

In a proof-of-concept study presented at the 2010 Annual Clinical Congress of the American College of Surgeons, the researchers note that the matrix not only helps to understand the micro-architecture of the pancreas, but also prolongs the survival and preserves the function of the islets. Islets survived longer in the bio-artificial matrix than in conventional transplantation sites, and they produced significantly more insulin when challenged with glucose. "Islet cell transplantation is the only treatment of insulin dependent diabetes that can consistently establish insulin independence. However, islets only feel at home in the pancreatic niche, and therefore their survival and ability to produce insulin declines rapidly if transplanted, for example, in the liver" according to Claudius Conrad, MD, PhD, primary investigator and chief resident in surgery at Massachusetts General Hospital. "The pancreas provides a very special environment for islets," he explained. "By default, the survival and function of the islet cells will always be worse in any organ other than the pancreas. To engineer an endocrine pancreas, islet- and stem cells require an extracellular matrix (ECM) that provides specific architecture, microstructure, and most importantly microvasculature to form the islet cell specific niche," he said.

Bold emphasis mine

One step closer to a cure for diabetes (which I have).