Spices protect against the consequences of high blood sugar

Herbs and spices are rich in antioxidants, and a new University of Georgia study suggests they are also potent inhibitors of tissue damage and inflammation caused by high levels of blood sugar.

Researchers, whose results appear in the current issue of the Journal of Medicinal Food, tested extracts from 24 common herbs and spices. In addition to finding high levels of antioxidant-rich compounds known as phenols, they revealed a direct correlation between phenol content and the ability of the extracts to block the formation of compounds that contribute to damage caused by diabetes and aging.

“Because herbs and spices have a very low calorie content and are relatively inexpensive, they’re a great way to get a lot of antioxidant and anti-inflammatory power into your diet,” said study co-author James Hargrove, associate professor of foods and nutrition in the UGA College of Family and Consumer Sciences.

Hargrove explained that when blood sugar levels are high, a process known as protein glycation occurs in which the sugar bonds with proteins to eventually form what are known as advanced glycation end products, also known as AGE compounds. The acronym is fitting because these compounds activate the immune system, resulting in the inflammation and tissue damage associated with aging and diabetes.

The researchers found a strong and direct correlation between the phenol content of common herbs and spices and their ability to inhibit the formation of AGE compounds. Spices such as cloves and cinnamon had phenol levels that were 30 percent and 18 percent of dry weight, respectively, while herbs such as oregano and sage were eight and six percent phenol by dry weight, respectively. For comparison, blueberries – which are widely touted for their antioxidant capabilities – contain roughly five percent phenol by dry weight.

Study co-author Diane Hartle, associate professor in the UGA College of Pharmacy, said various phenols are absorbed differently by the body and have different mechanisms of action, so it’s likely that a variety of spices will provide maximum benefit.

“If you set up a good herb and spice cabinet and season your food liberally, you could double or even triple the medicinal value of your meal without increasing the caloric content,” she said.

She added that controlling blood sugar and the formation of AGE compounds can also decrease the risk of cardiovascular damage associated with diabetes and aging. She explained that high blood sugar accelerates heart disease partly because AGE compounds form in the blood and in the walls of blood vessels. The AGE compounds aggravate atherosclerosis, which produces cholesterol plaques.

The UGA researchers tested for the ability to block AGE compounds in a test tube, but animal studies conducted on the health benefits of spices lend support to their argument. Cinnamon and cinnamon extracts, for example, have been shown to lower blood sugar in mice. Interestingly, cinnamon lowers blood sugar by acting on several different levels, Hargrove said. It slows the emptying of the stomach to reduce sharp rises in blood sugar following meals and improves the effectiveness, or sensitivity, of insulin. It also enhances antioxidant defenses.

Hargrove said their findings suggest it’s likely that the herbs and spices they studied will provide similar benefits in animal tests. He points out that because humans have been consuming herbs and spices for thousands of years, they come without the risk of possible side effects that accompany medications.

“Culinary herbs and spices are all generally recognized as safe and have been time-tested in the diet,” he said. “Indeed, some of spices and herbals are now sold as food supplements because of their recognized health benefits.”

Study co-author Phillip Greenspan, associate professor in the College of Pharmacy, noted that most people don’t get their recommended five to nine servings of fruits and vegetables a day. Rather than seasoning their food with salt – which provides no beneficial phenols and has been linked to high blood pressure – he recommends that people use a variety of herbs and spices to help boost the nutritional quality of their meals.

“When you add herbs and spices to food, you definitely provide yourself with additional benefits besides taste,” Greenspan said.

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Article adapted by MD Only from original press release.
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Contact: Sam Fahmy
University of Georgia

Arthritis sufferers get relief with Boswellia in 7 days

An enriched extract of the ‘Indian Frankincense’ herb Boswellia serrata has been proven to reduce the symptoms of osteoarthritis. Research published today in BioMed Central’s open access journal Arthritis Research & Therapy has shown that patients taking the herbal remedy showed significant improvement in as little as seven days.

Osteoarthritis is the most common form of arthritis; it commonly affects weight-bearing joints such as the knees and hips, along with the hands, wrists, feet and spine. The symptoms include pain, stiffness and limited movement. This randomised, double-blinded, placebo-controlled trial of 70 patients will be of great interest to sufferers, especially those who don’t get adequate relief from existing treatments.

The study was led by Siba Raychaudhuri, a faculty member of the University of California, Davis, in the United States. According to Raychaudhuri, “The high incidence of adverse affects associated with currently available medications has created great interest in the search for an effective and safe alternative treatment”. The extract the authors used was enriched with 30% AKBA (3-O-acetyl-11-keto-beta-boswellic acid), which is thought to be the most active ingredient in the plant. Raychaudhuri said, “AKBA has anti-inflammatory properties, and we have shown that B. serrata enriched with AKBA can be an effective treatment for osteoarthritis of the knee”. This is a proprietary product developed by Laila Nutraceuticals.

B. serrata has been used for thousands of years in the Indian system of traditional medicine known as ‘Ayurveda’. This study is the first to prove that an enriched extract of the plant can be used as a successful treatment.

The same authors have previously tested the safety of their remedy in animal experiments. They say that, “In this study, the compound was shown to have no major adverse effects in our osteoarthritis patients. It is safe for human consumption and even for long-term use”.

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Article adapted by MD Only from original press release.
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Contact: Graeme Baldwin
BioMed Central 

 

References

1. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin(R) for treatment of osteoarthritis of the knee Krishanu Sengupta, Krishnaraju V Alluri, Andey Rama Sathis, Simanchala Mishra, Trimurtulu Golakoti, Kadainti VS Sarma, Dipak Dey and Siba P Raychaudhuri Arthritis Research & Therapy (in press)

2. Arthritis Research & Therapy is an international, peer-reviewed online and print journal, publishing original research, reviews, commentaries and reports. Studies relate to the rationale and treatment of arthritis, autoimmune disease and diseases of bone and cartilage. The journal is edited by Prof Peter E Lipsky (USA) and Prof Sir Ravinder N Maini (UK) and has an Impact Factor of 4.04.

3. BioMed Central (http://www.biomedcentral.com/) is an independent online publishing house committed to providing immediate access without charge to the peer-reviewed biological and medical research it publishes. This commitment is based on the view that open access to research is essential to the rapid and efficient communication of science.

Weight-loss more effective than insulin for type 2 diabetics

DALLAS — March 11, 2008 — Weight-loss and major lifestyle changes may be more effective than intensive insulin therapy for overweight patients with poorly controlled, insulin-resistant type 2 diabetes, according to a diabetes researcher at UT Southwestern Medical Center.

The National Heart, Lung, and Blood Institute of the National Institutes of Health recently halted part of an ongoing clinical trial on diabetes and heart disease after more than 250 people died while receiving intense treatment to drive their blood glucose levels below current clinical guidelines.

The evidence is compelling that when insulin levels are high, certain tissues are overloaded with fatty molecules, which leads to insulin resistance. And yet, the high blood glucose levels of many obese patients with insulin-resistant type 2 diabetes are being treated with increasing amounts of insulin in an attempt to overpower that resistance. While high doses of insulin may lower glucose levels, it will also increase the fatty molecules and may cause organ damage. 

In a commentary in the March 12 issue of The Journal of the American Medical Association, Dr. Roger Unger, professor of internal medicine, wrote about the recent findings of his own and other labs that link insulin resistance to excess accumulation of fatty molecules in liver and muscle.

Dr. Unger, who has investigated diabetes, obesity and insulin resistance for more than 50 years said intensive insulin therapy is contraindicated for obese patients with insulin-resistant type 2 diabetes because it increases the fatty acids that cause diabetes. Instead, the most rational therapy eliminates excess calories, thereby reducing the amount of insulin in the blood and the synthesis of the fatty acids stimulated by the high insulin. Giving more insulin simply increases body fat.  

“Evolution was unprepared for the change in the American diet to processed fast food and drive-through lanes,” he said. “There’s no way that our genes could evolve to gird themselves against the superabundance of very, very high-calorie foods that have flooded the U.S.”

Before the discovery of insulin, starvation was the only treatment for diabetes, said Dr. Unger, who is a member of the National Academy of Sciences.

“Today there are many treatment options, including bariatric surgery, if necessary, to lower the fat content in the body before you start giving insulin,” he said. “The fat is causing insulin resistance and killing the insulin-producing beta cells in the pancreas — that is what is causing type 2 diabetes.”

Giving more insulin simply channels the glucose into fat production. There is now a spectrum of therapies that improve diabetes by correcting the insulin resistance by reducing the body fat. Insulin treatment would be indicated only if all these fail.

Dr. Unger said insulin should be given to patients with insulin deficiency, but not if the insulin levels are already very high but ineffective. “Giving more insulin to an insulin-resistant patient is akin to raising the blood pressure of a patient with high blood pressure to overcome resistance to blood flow. Instead, you would try to reduce the resistance,” he said.

In the commentary, Dr. Unger said the increase in the number of patients with insulin-resistant type 2 diabetes can be traced to the epidemic of obesity that began in the U.S. after World War II, when food preparation was moved from the family kitchen to factories and companies that produce high-fat, calorie-dense foods, leading both men and women to consume substantially more calories on a daily basis. In addition, technological advancements such as televisions, computers and automobiles reduced the number of calories burned per day.

Type 2 diabetes occurs when the body is unable to make enough of the hormone insulin to compensate for insulin resistance. The condition affects between 18 million and 20 million people in the U.S.

Factors that increase the risk of type 2 diabetes include obesity, age and lack of exercise. Over a period of years, high blood sugar damages nerves and blood vessels, leading to complications such as heart disease, stroke, blindness and kidney disease. 

Dr. Unger’s research is supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases, the Department of Veterans Affairs, and the Juvenile Diabetes Research Foundation.

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Article adapted by MD Only from original press release.
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Contact: Kristen Holland Shear
UT Southwestern Medical Center

Early diet modification may prevent type 1 diabetes in children

Within the next 10 years the EU-funded Diabetes Prevention study, part of an international study called TRIGR (Trial to Reduce IDDM in the Genetically at Risk), coordinated at the University of Helsinki, Finland, will generate a definite answer to the question whether early nutritional modification may prevent type 1 diabetes later in childhood.

Type 1 diabetes is a growing health problem among European children. European data indicate that the disease incidence has increased five-six-fold among children under the age of 15 years after World War II, and there are no signs that the increase in incidence is levelling off. The most conspicuous increase has been seen among children under the age of 5 years.

The TRIGR study is the first study ever aimed at primary prevention of type 1 diabetes. The study is designed to answer to the question whether excluding cow’s milk protein from the infant’s diet decreases the risk of future diabetes. All subjects are followed for 10 years to get information on whether the dietary recommendations for infants at increased genetic risk of type 1 diabetes should be revised.

Starting in May 2002, 76 study centres from 15 countries (Australia, Canada, the Czech Republic, Estonia, Finland, Germany, Hungary, Italy, Luxembourg, the Netherlands, Poland, Spain, Sweden, Switzerland and USA) have been recruiting families for the study. To be eligible the newborn infant has to have at least one family member (mother, father and/or sib) affected by type 1 diabetes and carry a HLA genotype conferring increased risk for type 1 diabetes. The initial recruitment target of 2032 eligible infants was reached at the be-ginning of September 2006, but the Study Group has decided to continue recruitment till the end of December 2006 (when the EU contribution will finish) to make the study even more powerful statistically.

A majority of the study participants (52%) have been recruited in Europe. The International Coordinating Cen-tre (ICC) is located at the University of Helsinki, Helsinki, Finland and the Data Management Unit (DMU) at the University of South Florida, Tampa, Florida, USA. The trial has logistically been a true challenge for both the ICC and DMU. DMU has been successful in establishing a secure, real-time, web-based, interactive data management system that works extremely well. This system can be directly applied to future international mul-ticentre studies.

The TRIGR study is generating a wealth of information on breast-feeding practices, infant nutrition and growth in young children in various countries. At 2 weeks of age almost all the participating infants were breast-fed. Exclusive breast-feeding continued longer in Europe than in North America. More than one third of the infants (35 %) received other foods in addition to breast milk and/or infant formulas at the age of 4 months, while WHO recommends that supplementary food should be introduced at the earliest by the age of 6 months. In Europe the first foods to be introduced are typically vegetables and fruits, whereas gluten-free cereals are most commonly introduced in North America.

Newborn infants in Northern Europe (NE) had a higher birth weight but a shorter birth length than infants in Central and Southern Europe (CSE). The NE children remained heavier than those from CSE at least up to the age of 18 months. The NE children were also taller than the CSE children starting already from the age of 3 months up to the age of 18 months. Accelerated growth in infancy has been identified as a risk factor for type 1 diabetes later in childhood. Accordingly the observed growth pattern may contribute to the higher incidence of type 1 diabetes in NE compared to CSE.

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Article adapted by MD Only Weblog from original press release.
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Contact: Hans K. Åkerblom
University of Helsinki

More information:
Study websites: http://www.trigr.org

Soft drinks linked to development of diabetes in children

Researchers have found new evidence that soft drinks sweetened with high-fructose corn syrup (HFCS) may contribute to the development of diabetes, particularly in children. In a laboratory study of commonly consumed carbonated beverages, the scientists found that drinks containing the syrup had high levels of reactive compounds that have been shown by others to have the potential to trigger cell and tissue damage that could cause the disease, which is at epidemic levels. HFCS is a sweetener found in many foods and beverages, including non-diet soda pop, baked goods, and condiments. It is has become the sweetener of choice for many food manufacturers because it is considered more economical, sweeter and more easy to blend into beverages than table sugar. Some researchers have suggested that high-fructose corn syrup may contribute to an increased risk of diabetes as well as obesity, a claim which the food industry disputes. Until now, little laboratory evidence has been available on the topic.

In the current study, Chi-Tang Ho, Ph.D., conducted chemical tests among 11 different carbonated soft drinks containing HFCS. He found ‘astonishingly high’ levels of reactive carbonyls in those beverages. These undesirable and highly-reactive compounds associated with “unbound” fructose and glucose molecules are believed to cause tissue damage, says Ho, a professor of food science at Rutgers University in New Brunswick, N.J. By contrast, reactive carbonyls are not present in table sugar, whose fructose and glucose components are “bound” and chemically stable, the researcher notes.

Reactive carbonyls also are elevated in the blood of individuals with diabetes and linked to the complications of that disease. Based on the study data, Ho estimates that a single can of soda contains about five times the concentration of reactive carbonyls than the concentration found in the blood of an adult person with diabetes.

Ho and his associates also found that adding tea components to drinks containing HFCS may help lower the levels of reactive carbonyls. The scientists found that adding epigallocatechin gallate (EGCG), a compound in tea, significantly reduced the levels of reactive carbonyl species in a dose-dependent manner when added to the carbonated soft drinks studied. In some cases, the levels of reactive carbonyls were reduced by half, the researchers say.

“People consume too much high-fructose corn syrup in this country,” says Ho. “It’s in way too many food and drink products and there’s growing evidence that it’s bad for you.” The tea-derived supplement provides a promising way to counter its potentially toxic effects, especially in children who consume a lot of carbonated beverages, he says.

But eliminating or reducing consumption of HFCS is preferable, the researchers note. They are currently exploring the chemical mechanisms by which tea appears to neutralize the reactivity of the syrup.

Ho’s group is also probing the mechanisms by which carbonation increases the amount of reactive carbonyls formed in sodas containing HFCS. They note that non-carbonated fruit juices containing HFCS have one-third the amount of reactive carbonyl species found in carbonated sodas with HFCS, while non-carbonated tea beverages containing high-fructose corn syrup, which already contain EGCG, have only about one-sixth the levels of carbonyls found in regular soda.

In the future, food and drink manufacturers could reduce concerns about HFCS by adding more EGCG, using less HFCS, or replacing the syrup with alternatives such as regular table sugar, Ho and his associates say. Funding for this study was provided by the Center for Advanced Food Technology of Rutgers University. Other researchers involved in the study include Chih-Yu Lo, Ph.D.; Shiming Li, Ph.D.; Di Tan, Ph.D.; and Yu Wang, a doctoral student.

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Article adapted by MD Only Weblog from original press release.
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Contact: Charmayne Marsh
American Chemical Society

The American Chemical Society — the world’s largest scientific society — is a nonprofit organization chartered by the U.S. Congress and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio.

 

A brisk walk daily is the easiest way to trim waistline

Research from Duke University Medical Center shows that even a modest amount of brisk walking weekly is enough to trim waistlines and cut the risk of metabolic syndrome (MetS), an increasingly frequent condition linked to obesity and a sedentary lifestyle.

It’s estimated that about a quarter of all U.S. adults have MetS, a cluster of risk factors associated with greater likelihood of developing heart disease, diabetes and stroke: large waist circumference, high blood pressure, high levels of triglycerides, low amounts of HDL, or “good” cholesterol, and high blood sugar. To be diagnosed with MetS, patients must have at least three of these five risk factors, and according to many studies, a growing number of people do.

But Johanna Johnson, a clinical researcher at Duke Medical Center and the lead author of a new study examining the impact of exercise on MetS, said a person can lower risk of MetS by walking just 30 minutes a day, six days per week. “That’s about 11 miles per week. And our study shows that you’ll benefit even if you don’t make any dietary changes.”

“The results of our study underscore what we have known for a long time,” said Duke cardiologist William Kraus. “Some exercise is better than none; more exercise is generally better than less, and no exercise can be disastrous.”

The study appears in the December 15 issue of the American Journal of Cardiology.

The results come from a multi-year, federally funded study called STRRIDE (Studies of a Targeted Risk Reduction Intervention through Defined Exercise) that examined the effects of varying amounts and intensity of exercise on 171 middle-aged, overweight men and women.

Before exercising regularly, 41 percent of the participants met the criteria for MetS. At the end of the 8-month exercise program, only 27 percent did.

“That’s a significant decline in prevalence,” said Johnson. “It’s also encouraging news for sedentary, middle-aged adults who want to improve their health. It means they don’t have to go out running four or five days a week; they can get significant health benefits by simply walking around the neighborhood after dinner every night.”

Still, some exercise regimens were better than others. Those who exercised the least, walking about 11 miles per week, gained significant benefit, while those who exercised the most, jogging about 17 miles per week, gained slightly more benefit in terms of lowered MetS scores.

One group puzzled the researchers, however. Those who did a short period of very vigorous exercise didn’t improve their MetS scores as much as those who performed less intense exercise a longer period.

Kraus said there may be more value in doing moderate intensity exercise every day rather than more intense activity just a few days a week.

In all three of the study’s exercise groups, waistlines got smaller over the 8-month period. In general, men who exercised saw greater improvement in their MetS risk factors than women. But Johnson points out that at baseline, the men generally had worse scores than women, “so they had more room to improve,” she said.

Over the course of the STRRIDE study, the inactive control group – those who didn’t change their diet or activity level at all – gained an average of about one pound and a half-inch around the waist. “That may not sound like much, but that’s just six months,” Kraus said. “Over a decade, that’s an additional 20 pounds and 10 inches at the beltline.”

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Article adapted by MD Only Weblog from original press release.
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Contact: Michelle Gailiun
Duke University Medical Center

The study was funded by the National Institutes of Health.

Colleagues at Duke who contributed to the study include Cris Slentz, Gregory Samsa, Lori Bateman and Brian Duscha. Collaborating authors from East Carolina University include Joseph Houmard, Jennifer McCartney and Charles Tanner.

Herbal medicine silymarin shown to help lower blood sugar in type II diabetes

Diabetes is a growing health problem. Giving antioxidants is recognised as one way of helping people with diabetes to control their blood sugar levels.

The herbal medicine extracted from seeds of the Milk Thistle, Silybum marianum (silymarin) is known to have antioxidant properties and research published this week in Phytotherapy Research shows that this extract can help people significantly lower the amount of sugar bound to haemoglobin in blood, as well as reducing fasting blood sugar levels.

Silymarin contains a number of active constituents called flavolignans which are also used to help protect the liver from poisoning.

“We don’t know the exact mechanism of action for this effect, but this work shows that silymarin could play an important role in treating type II diabetes,” says lead author Fallah Huseini, who works at the Institute of Medicinal Plants, which is based in Tehran, Iran.

The data came from a randomized double-blind clinical trial involving 51 people who had had type II diabetes for at least 2 years. One group of 25 patients received 200 mg of silymarin three times a day for 4 months, while the remaining 26 received a placebo treatment. All of the patients continued to use conventional oral hypoglycaemic treatment during the trial. Patients were examined at monthly intervals.

Compared with the beginning of the trial, the treatment group had a significant reduction in fasting blood glucose levels (p<0.001), and a reduction in glycosylated haemoglobin (p<0.001). Both of these measures rose significantly in the placebo group (p<0.0001). There were also non-significant decreases in blood lipids in the treatment group.

“The results are very encouraging, and we now need to do further large multi-centre studies,” says Huseini.

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Article adapted by MD Only Weblog from original press release.
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Huseini, H.F: The Efficacy of Silybum marianum (L.) Gaertn. (Silymarin) in the Treatment of Type II Diabetes: A Randomized, Double-blind, Placebo-controlled, Clinical Trial

Phytotherapy Research is an international journal for the publication of original medicinal plant research, focussing on pharmacology, toxicology and the clinical applications of herbs and natural products in medicine. Papers concerned with the effects of common food ingredients and standardised plant extracts, including commercial products, and mechanistic studies on isolated natural products are particularly welcome. Papers and communications range from case studies to full clinical trials, including studies of herb-drug interactions and other aspects of the safety of herbal medicines. Phytotherapy Research can be accessed online at: http://www.interscience.wiley.com/journal/ptr

John Wiley & Sons Ltd., with its headquarters in Chichester, England, is the largest subsidiary of John Wiley & Sons, Inc. Founded in 1807, John Wiley & Sons, Inc., provides must-have content and services to customers worldwide. Its core businesses include scientific, technical, and medical journals, encyclopaedias, books, and online products and services; professional and consumer books and subscription services; and educational materials for undergraduate and graduate students and lifelong learners. Wiley has publishing, marketing, and distribution centres in the United States, Canada, Europe, Asia, and Australia. The company is listed on the New York Stock Exchange under the symbols JWa and JWb. Wiley’s Internet site can be accessed at http://www.wileyeurope.com/
Contact: Polly Young
John Wiley & Sons, Inc.

Hope for Diabetics at risk of blindness

Brand new research launched at the British Pharmaceutical Conference in Manchester is bringing hope to hundreds of people with diabetes who lose their sight each year as a side-effect of the disease.

People with diabetes commonly experience blindness, or a reduction in sight, when a lack of oxygen at the back of the eye causes tiny blood vessels to overgrow into the vitreous humour, which is a jelly like substance. This jelly like substance is removed during surgery to treat this problem.

Pharmaceutical researchers at the University of East Anglia have revealed that they are developing an artificial form of this vitreous humour so that it can be replaced following surgery or if it has been damaged or degenerated for other reasons.

Biologist Janine Morris working with Pharmacist Susan Barker and Biologist Julie Sanderson at the School of Chemical Sciences and Pharmacy, University of East Anglia, is identifying the essential characteristics of the human and pig vitreous humour so that they can be mimicked artificially.

She says: “I am currently making a gel that imitates the vitreous humour and which is non-cytotoxic to the human eye. The substance will also include anti-angiogenic drugs to prevent the blood vessels re-growing and the original damage re-occurring.”

Placing this artificial jelly into the damaged eye should certainly improve and potentially restore lost sight. Janine Morris says that the research, which is in the preliminary stages, is good news for diabetes sufferers who will be protected against recurring damage. “The idea that we can potentially improve and maintain sight for diabetes sufferers by replacing the vitreous humour is amazing,” she says.

The vitreous humour is a clear gel-like substance that fills the space between the lens and the retina of the eye. It is 99% water but also contains collagen fibres, inorganic salts, acids and sugar.

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Article adapted by MD Only Weblog from original press release.
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For further information please visit:
The University of East Anglia

Diabetes is the leading cause of blindness among people aged 20-74 in Minnesota. Each year, according to the Minnesota Department of Health (MDH), between 400 and 700 Minnesotans go blind due to diabetes complications. Even when blood sugar is controlled, 60% of those having diabetes for more than 15 years will experience some form of diabetic eye disease in their lifetime.November is American Diabetes Month. This is a good time to schedule your annual dilated eye exam, urges the Minnesota Optometric Association (MOA), because type 2 diabetes can be caught early with this exam, and treated. MDH statistics show that of the 276,000 Minnesotans who have diabetes, 96,000 are unaware that they have it.

Currently, only eight in 10 Minnesotans with diabetes have a dilated eye exam every two years. “Most people do not realize that diabetics are twice as likely to suffer from cataracts, diabetic retinopathy and glaucoma. People may have these diseases before they are aware of it,” said Dr. Dirk Colby, president of the MOA and a doctor of optometry with West Metro Ophthalmology, Golden Valley and Plymouth, Minnesota. “It is critical for diabetic patients to come in every year,” said Dr. Colby. “Waiting two years or even worse, not coming in at all, can have a catastrophic effect.”

Diabetes is taking its toll on Americans and Minnesotans with eye diseases and type 2 diabetes is increasing rapidly due to the increase in obesity and decrease in exercise. These two risk factors are the leading causes of type 2 diabetes.

Diabetic retinopathy, the most common diabetic eye disease, is the leading cause of blindness in Minnesota, and overall in the United States. Diabetic retinopathy is caused by changes in the blood vessels of the retina. In some people with diabetic retinopathy, retinal blood vessels may swell and leak fluid; in others, abnormal new blood vessels grow on the surface of the retina. These changes may result in vision loss or blindness.

Cataracts occur when the normally clear lens in the eye becomes cloudy, impairing vision. Clouded vision may make it more difficult to read, drive, or see clearly. Glaucoma, an increase in fluid pressure inside the eye, leads to optic nerve damage and vision loss.

To help prevent diabetic eye diseases, the American Diabetes Association recommends people suffering from diabetes should:

• Keep your blood sugar under good control. People who keep their blood sugar levels closer to normal are less likely to have retinopathy.
• Bring high blood pressure down. High blood pressure can make eye problems worse.
• Get a dilated eye exam by a family eye doctor every year. Your optometrist will use drops to enlarge your pupils to look inside your eyes.

The Minnesota Optometric Association (MOA) recommends you see your family eye doctor right way if you have any of the following problems:

• Your vision is blurry.
• You see double, spots or floaters
• One or both eyes hurt
• You feel pressure in your eye
• You can’t see things at the periphery as well as before
• You have trouble reading

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Article adapted by MD Only Weblog from original press release.
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Contact:
Jim Meffort-Nelson
minnesota.aoa.org

Scientist find way to prevent blindness in diabetes

University of Florida stem cell scientists reported this week (Jan. 3) that they have prevented blindness in mice afflicted with a condition similar to one that robs thousands of diabetic Americans of their eyesight each year.Writing in the current issue of the Journal of Clinical Investigation, researchers describe for the first time the link between a protein known as SDF-1 and retinopathy, a complication of diabetes and the leading cause of blindness in working-age Americans.

Scientists explain how they used a common antibody to block the formation of SDF-1 in the eyeballs of mice with simulated retinopathy, ending the explosive blood vessel growth that characterizes the condition.

Researchers effectively silenced SDF-1’s signal to activate normally helpful blood stem cells, which become too much of a good thing within the close confines of the eyeball.

“SDF-1 is the main thing that tells blood stem cells where to go,” said Edward Scott, an associate professor of molecular genetics at the UF Shands Cancer Center and director of the Program in Stem Cell Biology and Regenerative Medicine at UF’s College of Medicine. “If you get a cut, the body makes SDF-1 at the injury site and the repair cells sniff it out. The concentration of SDF-1 is higher where the cut occurs and it quickly dissipates. But the eye is such a unique place, you’ve got this bag of jelly — the vitreous — that just sits there and it fills up with SDF-1. The SDF-1 doesn’t break down. It continues to call the new blood vessels to come that way, causing all the problems.”

Diabetic retinopathy causes 12,000 to 24,000 cases of blindness each year, according to the American Diabetes Association. What happens is high blood pressure and blood sugar levels associated with diabetes cause leaks in blood vessels within the eye and hinder the flow of essential chemicals. The eye compensates by growing new blood vessels, which clog the eye and cause even more leaks. Damage occurs to the retina, gradually destroying its ability to capture images.

UF researchers analyzed samples of the vitreous gel taken from the eyeballs of 46 patients undergoing treatment for diabetic eye disease, including 24 patients with retinopathy. They found SDF-1 in each of the patients, with the highest amounts detected in patients with the worst cases. No traces of SDF-1 were found in the vitreous samples of eight nondiabetic patients who were treated for other ailments.

With the hypothesis that SDF-1 is at the heart of the problem, scientists tested to see whether the addition of the protein would call stem cells and spur extraordinary blood vessel growth in the eyeballs of 10 laboratory mice. They succeeded, creating mice with retinopathy-like conditions. Then, as a treatment, scientists injected an SDF-1 antibody directly into the afflicted eyes. The antibody — which is simply another protein that binds to the SDF-1 — disabled SDF-1’s ability to summon stem cells, effectively halting the growth of almost all new blood vessels, said Jason M. Butler, a graduate student in the Interdisciplinary Program in Biomedical Sciences and a member of the research team.

Scientists next want to test the technique in monkeys, and if it continues to be successful, to test the therapy in human clinical trials, said Scott, the senior author of the paper. The National Institutes of Health funded the research in mice. The study in primates will involve support from RegenMed, an Alachua, Fla.-based company founded by Scott and other UF researchers to bring biomedical therapies to the marketplace.

“The scientific community and pharmaceutical companies have a long track record of being able to develop antibody-based therapy in things like snake anti-venoms,” Scott said. “This isn’t a new and unproven technology. This is something that can be rapidly adapted and brought to market.”

Scientists said they still need to find a way to anchor the antibody to a molecule large enough so it can do its SDF-1-blocking work in the vitreous but will be unable to penetrate the retina. They envision a therapy that will involve routine injections of the substance into a patient’s eye.

“It could potentially be a treatment option,” said Dr. Maria Grant, a professor of pharmacology and therapeutics in UF’s College of Medicine who participated in the research. “Current therapy for severe diabetic retinopathy is use of lasers that destroy parts of retina that are not needed for precise vision in order to improve oxygen delivery to the parts of the retina that are needed for detailed vision. Intraocular delivery of agents that block SDF-1 represent an excellent and less destructive alternative.”

The research sheds light on the mechanisms of diabetic retinopathy and the various functions of SDF-1, said Nadir Sheibani, an assistant professor of ophthalmology and visual science at the University of Wisconsin-Madison Medical School.

“Many factors are at work during retinopathy and it’s important to understand each of them,” Sheibani said. “It’s interesting that the researchers show how SDF-1 changes the levels of a protein called occludin, which affects junctions between cells that line the blood vessels. It helps explain why the blood vessels become leaky and edema develops during diabetic retinopathy.”

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Article adapted by MD Only Weblog from original press release.
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Contact: John Pastor
University of Florida