Monthly Archives: August 2010

Depression Sufferers Live With Higher Risk of Diabetes

Depression can heighten the risk of developing type 2 diabetes as the mental illness also increases the likelihood of obesity and failing to take enough exercise, a study carried out by the German Diabetes Association (DDG) has shown, reports DPA.

Bouts of depression can also lead to higher levels of the stress hormone cortisol in the blood. Cortisol, also known as hydrocortisone, counteracts insulin and contributes to type 2 diabetes, which is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.

It is recommended that those suffering from depression undergo tests for the disease as they are 11 times more likely to suffer vascular complications than people battling diabetes alone. The risk of damage to arteries, which could lead to a heart attack, is between two and five times as high.

According to the DDG, not only are people with depression at increased risk of developing type 2 diabetes, those with diabetes are also at increased risk of developing depression.

The consequences can be serious as treatment for diabetes requires the active involvement of the patient. “Depression is a major barrier in such instances,” explains Bernhard Kulzer, chairman of the DDG’s psychology council.

Complications that can result from improperly managed type 2 diabetes include renal failure, blindness and arterial disease, including coronary artery disease. The DDG recommends that diabetics suffering from depression undergo psychological treatment.

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Are You Diabetic? It May be Time for Insulin!

If you have type 2 diabetes and have had difficulty achieving blood sugar control, it may be time to find out if insulin is right for you.

Why Consider Insulin
Insulin is proven to lower blood sugar levels when used as part of an overall diabetes treatment plan. In fact, over 5 million people take insulin every day.

Adding insulin replaces what your body isn’t making naturally to help control blood sugar. Insulin is a hormone that is naturally produced in the body that helps convert your blood sugar (or blood glucose) into energy.

When you have diabetes your body doesn’t make enough insulin and/or your body doesn’t properly use the insulin it does make. As diabetes progresses it can get harder to manage your blood sugar.

Insulin should not necessarily be viewed as a sign of personal failure, or viewed as a last resort.

When diet, exercise, and oral diabetes medications alone don’t bring your blood sugar levels under control, insulin may be an effective tool to help with uncontrolled blood sugar. Do not take insulin if you are allergic to insulin or any of its ingredients. You must test your blood sugar levels when using insulin.

Choose To Know More About Insulin & Overcome Common Fears

Many people, including you, may be afraid of insulin. However, insulin may help you achieve better blood sugar control.

It is important to talk to your doctor about the potential benefits and realistic risks associated with insulin use. Hypoglycemia is the most common side effect of insulin therapy, which may be serious.

Some fears of insulin may be based on misperceptions. Do any of these concern you?

  • It’s painful. Today’s insulin needles are smaller and thinner than in the past. Generally injections cause little discomfort. You may be surprised by how soon you get used to injections.
  • It’s a sign of failure. Adding insulin does not necessarily mean that you failed with your current diabetes treatment plan. Over time, your body may have trouble producing what it needs to lower blood sugar.
  • It’s a “last resort.” Insulin should not be seen as a “last resort.” With diabetes, your doctor may change your treatment plan over time to find what works best for you. Controlling your blood sugar is what’s most important.
  • It’s a lifestyle change. Insulin is an effective option that you can add to your diabetes treatment plan to help you reach your daily blood sugar goals and lower your A1C. Most people find that insulin becomes a part of their routine.
  • It’s forever. Insulin is not physically addictive or habit-forming. Many patients stay on insulin because they see the effect it has on lowering blood sugar.
Talk to your doctor sooner, rather than later, if you have uncontrolled blood sugar. Together you can decide if insulin is right for you. Insulin works as part of an overall diabetes treatment plan, which includes diet, exercise and other diabetes medications, to help control blood sugar.

Remember, controlling blood sugar may help reduce the risk of developing diabetes-related complications.

Diabetes: Shortage Of Vascular Surgeons In India Costs 80,000 Limbs Every Year

India has less than 100 vascular surgeons since the establishment of the first department of vascular surgery in 1978. The states of Orissa, Madhya Pradesh, Bihar and Manipur don’t have any vascular surgeon.

No government-run hospital in the country’s capital New Delhi, including the premiere All India Institute of Medical Sciences, has a department of vascular surgery. Chennai and Bangalore in the southern states of Tamil Nadu and Karnataka respectively, with 20 surgeons each, are slightly better off.

Only last year, the number of seats for post-graduate degree in vascular surgery in the country was raised from four to eight in medical colleges. Including diploma holders, the country produces only 16 vascular surgeons yearly. This, experts feel, should be trebled in two years.

“A large number of people wheeled in for amputations are either trauma victims or long-term diabetics. At least 40% of people with decade-long diabetes develop vascular problems. In a country where more than 40 million people are estimated to have diabetes, the number of people estimated to have vascular problems is large. Add to this road accident victims day and you know why there is a need to produce a greater number of vascular surgeons,” says Dr Sekar, who is also the president of the Vascular Society of India. Though there are no clear statistics on amputations, it is estimated that at least one lakh people lose a limb every year. Of these, nearly, 80,000 amputations are avoidable.

Sakthiraj Ekambaram, 29, a chronic smoker, complained of pain every time he walked for more than 20 minutes. “I had to stop for a couple of minutes and walk again. The doctor sent me to the gym,” he said. Luckily, Sakthiraj, decided to consult a vascular surgeon for the wound that did not heal for long. “That is when I discovered that the blood supply to my legs was very low. My feet were cold unlike other parts where blood flowed and I did not have good sensation on my feet. I underwent a procedure that saved my legs,” he said. But not all patients are as lucky has Sakthiraj, says Dr Sekar.

Pulling out the case sheets of a 40-year-old patient, he continues, “A chronic diabetic, this patient had one of his limbs amputated last year. This year, he had his other leg amputated too. Almost 50% of diabetics who go in for amputation of one limb, lose their second limb in another year. A vascular disease is an indicator of a heart disease because if there are blocks in the leg, there can be blocks in the heart too,” says Dr Sekar.

“When people are disabled, the burden is high on the family and the government,” says Dr Ravul Jindal, the only qualified vascular surgeon in Chandigarh. “Some patients who can afford the treatment are referred to doctors in other states. The others undergo amputation surgeries. These are done by general surgeons or orthopedic surgeons to prevent infection from spreading to other parts of the body,” says Dr Jindal.

The society is now waging an aggressive war with the Union health ministry and at least ten state governments urging them to start new departments in vascular surgery. Vascular surgeons say they consider several options before deciding to remove a limb.

“The blood vessels in the legs and hands are just like arteries and veins in the heart. If there is a block in arteries of the heart, it can reduce supply of blood and cause heart attack, which is death of the heart muscle. When similar things happen on the leg, it leads to death of muscles in the leg. They begin to rot (gangrene). Just like the heart, we have options of using balloons to remove blocks by a procedure called angioplasty, place drug coated thin wires in the vessels to prevent clots or even do a by-pass graft,” says Dr Paresh Pai, consultant vascular surgeon at Mumbai’s Lilavati Hospital. “But on most occasions, patients are refered to us very late. We want to create awareness among doctors and patients on foot care. For instance, if a wound remains unhealed for long, doctors should first check if there is adequate blood supply and restore it. For this, the patient should come in early,” he says.

Representatives from the association would meet Union health minister Ghulam Nabi Azad and health secretary Sujatha Rao to discuss a road map. First, they want the ministry to increase the number of seats for post-graduate degree in vascular surgery. “At present, there are only seven training centers for vascular surgery, training 12 students every year. We want them to double the number of seats in a year and increase it by at least three times by 2012,” Dr Sekar said.

Thank you Pushpa Narayan/Times of India

Diabetes Can Cause A Sugar Coating That Smothers Body’s Immune Defences

Research led by the Warwick Medical School at the University of Warwick has found that unhealthy glucose levels in patients with diabetes can cause significantly more problems for the body than just the well-known symptoms of the disease such as kidney damage and circulation problems. The raised glucose can also form what can be described as a sugar coating that can effectively smother and block the mechanisms our bodies use to detect and fight bacterial and fungal infections.

In diabetes, patients suffer a higher risk of chronic bacterial and fungal infections but until now little has been known about the mechanisms involved. Now new research led by Dr Daniel Mitchell at the University of Warwick’s Warwick Medical School has found a novel relationship between high glucose and the immune system in humans.

The researchers have found that specialized receptors that recognize molecules associated with bacteria and fungi become “blind” when glucose levels rise above healthy levels. The new research may also help explain why diabetic complications can also include increased risk of viral infections such as influenza, and also inflammatory conditions such as cardiovascular disease.

The researchers looked at the similarities in chemical structure between glucose in blood and body fluids, and two other sugar called mannose and fucose. These sugars are found on the surfaces of bacteria and fungi and act as targets for receptors in our body that have evolved to detect and bind to microbial sugars to then combat the infection.

The research found that high levels of glucose outcompetes the binding of mannose and fucose to the specialized immune receptors, potentially blocking these receptors from detecting infectious bacteria and fungi. Glucose also binds in such a way that it inhibits the chemical processes that would normally then follow to combat infections. If this happens it can inhibit a range of key processes including:

  • It can inhibit the function of immune system receptors called C-type lectins such as MBL (Mannose-binding lectin) which are known to bind to a sugar known as mannose that is present in the structure of infectious fungal bacterial cell walls. Unlike glucose, mannose does not exist in mammals as a free sugar in the blood.
  • The loss of MBL function may also predispose the body to chronic inflammatory diseases, since MBL is involved in the processing and clearance of apoptotic cells (dying cells).
  • A number of C-type lectins tat can be affected by raised , including MBL, but also including immune cell surface receptors DC-SIGN and DC-SIGNR, are found in key parts of our circulation and vascular system such as plasma, monocytes, platelets and endothelial cells that line blood vessels. Inhibiting the function of these key molecules in those settings could contribute to diabetic cardiovascular and renal complications.

Warwick Medical School researcher Dr Daniel Mitchell said: “Our findings offer a new perspective on how high glucose can potentially affect immunity and thus exert a negative impact on health. It also helps to emphasize the importance of good diet on preventing or controlling diseases such as diabetes. We will build on these ideas in order to consolidate the disease model and to investigate new routes to treatment and prevention.”

Provided by University of Warwick

How Long Does it Take to Lower Your A1C Levels?

Red blood cells and the hemoglobin they contain have an average life span of 120 days during which glucose molecules are exposed to the red blood cells and form glycated hemoglobin. Therefore, in theory, changes in your A1C levels won’t be apparent for at least the 120 days it takes for the affected red blood cells to complete a life cycle.

The amount of time it takes to lower your A1C depends on how big of a change you are trying to achieve. If your A1C is in the double digits, it may take a matter of 2 or 3 months to see a significant change if your diabetes management is consistent and tight. If your A1C is a point or two away from ADA/AACE recommendations, getting to goal may take a little longer.

“Lowering your HbA1c from a [high] number to an 8.0 or 7.5 is much easier than lowering it from a 7.5 to 6.5,” said dLife Expert CDE Claire Blum in response to a question about lowering A1C levels. “Tightening of control that occurs at the lower numbers takes a lot of fine tuning. Our bodies also require some time to adapt to the change of improved [levels].”

There are no special tricks to getting your A1C to a level more acceptable to you and your doctor. Lowering your A1C is doing just what your doctor has always told you was best for good diabetes management.

Insulin Dosage Tracking Device To Make Manual Recording Of Blood Glucose Redundant

Working toward the goal of unifying patients’ diabetic treatment information in a single place, the PositiveID Corporation hopes to patent a new device that monitors insulin pens.

The Insulin Tracker would attach to a user’s insulin pen and record the times and amounts of injections. That information would then be sent to a database that allows for comprehensive monitoring. Insulin pens come in disposable and cartridge-replaceable flavors; the tracker can be moved easily from one pen to another.

Positive ID has already developed the iGlucose system, which will work with patients’ blood glucose meters to collect their test results. The information then goes through SMS text messaging to an online database. The Insulin Tracker data will add a critical component to the data, allowing for a wide-ranging view of a diabetic’s treatment regimen.

The company began working on the insulin-tracking device in the second quarter of this year. According to PositiveID chairman and CEO Scott Silverman, the goal is making it easier for diabetics to collect the broad swaths of data necessary for good control.

“Due to the cumbersome nature of manually recording blood glucose levels, insulin dosages and the appropriate dates and times for each, many patients’ diabetes logs are incomplete or even nonexistent, which directly impacts patient compliance,” Silverman said.

“We believe the addition of the Insulin Tracker functionality to the iGlucose system will enable us to provide a complete solution for insulin-dependent diabetics, helping them automate the time-consuming process of manually tracking insulin data and glucose levels, thereby providing more complete health records.”

The company’s data collection system works independently of any brand of glucose meter and does not require a computer, internet access or even a cell phone.

The company is keeping its eyes on Medicare requirements, too. According to its website, the iGlucose device “is the first of its kind to address the Medicare requirement for durable medical equipment manufacturers and pharmacies to maintain glucose level logs and records for the millions of high-frequency diabetes patients.”

What Is Prediabetes? Is It A Serious Condition?

Recently, a friend wrote saying she was “mildly diabetic“. I wrote back straight away saying: “There’s nothing like being ‘mildly diabetic’; you’re probably prediabetic…”

Anyway, that set me off on a hunt to find a precise definition of “prediabetes“. I got the most reasonable answer from Michael Dansinger, MD at WebMD. This is what he has to say:

Many folks come to the diabetes community upon being diagnosed with “prediabetes”. These people are usually concerned about progressing to type 2 diabetes and want to know how to delay or prevent such progression. The diagnosis of prediabetes also typically serves as a “wake-up call” to make healthier lifestyle choices.

Interestingly, the term “prediabetes” was recently discredited by the concensus panel of diabetes experts. The experts encouraged replacing “prediabetes” with the concept of “increased risk of diabetes” which is reflected by a continuum of risk ranging from A1c levels of around 5.8 to 6.5. The experts argued that not everyone in this range progresses to diabetes and it is more accurate to see it as a risk spectrum rather than as a category unto itself.

I personally favor the old system of calling it “prediabetes” rather than “increased diabetes risk”. I just like the name better. It used to be called “borderline diabetes”, but that name seems so outdated to me. In any case, I urge people to see this as a strong warning that diabetes is probably coming, and lifestyle changes are the main way to slow or stop the progression.

I, too, think “prediabetes” is a much more forceful term than “increased risk of diabetes” – the former rings alarm bells, as it should, while the latter seems like a problem that can be taken care of later after more pressing issues like planning a vacation or buying a new computer are taken care of. Bad idea.

Remember, prediabetes (technically “impaired glucose tolerance”) is a health condition with no symptoms. It is almost always present before a person develops the more serious type 2 diabetes. Million of people over age 20 have prediabetes with blood sugar levels that are higher than normal, but are not high enough to be classified as diabetes.

More and more, doctors are recognizing the importance of diagnosing prediabetes as treatment of the condition may prevent more serious health problems. For example, early diagnosis and treatment of prediabetes may prevent type 2 diabetes as well as associated complications such as heart and blood vessel disease and eye and kidney disease. Doctors now know that the health complications associated with type 2 diabetes often occur before the medical diagnosis of diabetes is made.

Who’s at Risk for Developing Type 2 Diabetes?
Those at risk for type 2 diabetes include:

  • People with a family history of type 2 diabetes.
  • Women who had gestational diabetes or have had a baby weighing more than 9 pounds.
  • Women who have polycystic ovary syndrome (PCOS).
  • African Americans, Native Americans, Latinos, and Pacific Islanders, minority groups that are disproportionately affected by diabetes.
  • People who are overweight or obese, especially around the abdomen (belly fat).
  • People with high cholesterol, high triglycerides, low good ‘HDL’ cholesterol, and a high bad ‘LDL’ cholesterol.
  • People who are inactive.

Older people. As people age they are less able to process sugar appropriately and therefore have a greater risk of developing type 2 diabetes.

What Are the Symptoms of Prediabetes?
Although most people with prediabetes have no symptoms at all, symptoms of diabetes may include unusual thirst, a frequent need to urinate, blurred vision, or extreme fatigue.

A medical lab test may show some signs that suggest prediabetes may be present.

Who Should Be Tested for Prediabetes?
You should be tested for prediabetes if:

  • You’re over 45 years of age.
  • You have any risk factors for diabetes.
  • You’re overweight with a BMI (body mass index) over 25.
  • You belong to a high risk ethnic group.
  • You were known to previously have an abnormal glucose tolerance test (see below) or have an impaired fasting glucose level (see below).
  • You have a history of gestational diabetes or delivering a baby that weighed more than 9 pounds.
  • You have clusters of problems seen in the metabolic syndrome. These problems include high cholesterol and triglycerides, high LDL cholesterol and low HDL cholesterol, central obesity, hypertension, and insulin resistance.
  • You have polycystic ovary syndrome.

How Is Prediabetes Diagnosed?
To determine if you have prediabetes, your doctor can perform two different blood tests – the fasting plasma glucose (FPG) test and the oral glucose tolerance test (OGTT).

During the FPG blood test your blood sugar level is measured after an 8 hour fast. This laboratory health screening can determine if your body metabolizes glucose correctly. If your blood sugar level is abnormal after the fasting plasma glucose (FPG) test, you could have what’s called “impaired fasting glucose,” which suggests prediabetes.

Understanding the FPG Test Results

  • Normal: Less than 100 mg/dL (milligrams per deciliter)
  • Prediabetes: 100 mg/dL – 125 mg/dL
  • Diabetes: Greater than 126 mg/dL on two or more tests

The other laboratory health screening test your doctor can perform is the oral glucose tolerance test (OGTT). During this test, your blood sugar is measured after a fast and then again 2 hours after drinking a beverage containing a large amount of glucose. Two hours after the glucose beverage, if your glucose is higher than normal, you have what’s called “impaired glucose tolerance,” which suggests prediabetes.

Understanding the OGTT Test Results

  • Normal Less: than 140 mg/dL
  • Prediabetes: 140 mg/dL to 199 mg/dL
  • Diabetes: Greater than 200 mg/dL

Why Is It Important to Recognize and Treat Prediabetes?
By identifying the signs of prediabetes before diabetes occurs, you can prevent type 2 diabetes altogether and lower your risk of complications associated with this condition, such as heart disease.

A large 3-year medical study in patients at risk of developing type 2 diabetes found that lifestyle changes with exercise and mild weight loss, and treatment with medications that work to sensitize a person to the actions of insulin, can decrease the chance that a person with prediabetes will get type 2 diabetes by up to 60%.

Changing a person’s lifestyle habits with increased physical activities and mild weight loss was more effective than medications at reducing the risk of developing type 2 diabetes. For some people with prediabetes, intervening early can actually return elevated blood sugar levels to the normal, healthy range.

What’s the Treatment for Prediabetes?
To successfully treat prediabetes:

Eat a heart healthy diet and lose weight. A 5% to 10% weight loss can make a huge difference.
Exercise. Try to exercise 30 minutes a day, 5 days a week. The activity can be split into several short periods: 3 sessions of 10 minutes. Select an activity that you enjoy such as walking. In the study mentioned above, the total amount of exercise per week was 150 minutes.
Stop smoking.
Treat high blood pressure and high cholesterol.

Diabetic Diet: Black Rice – One Of The Greatest ‘Superfoods’

Black rice – revered in ancient China but overlooked in the West – could be one of the greatest “superfoods”, scientists believe.

The cereal is low in sugar but packed with healthy fibre and plant compounds that combat heart disease and cancer. It was known as “forbidden rice” in ancient China because only nobles were allowed to eat it. Today black rice is mainly used in Asia for food decoration, noodles, sushi and desserts.

“Just a spoonful of black rice bran contains more health-promoting anthocyanin antioxidants than are found in a spoonful of blueberries, but with less sugar, and more fibre and vitamin E antioxidants,” said Dr Zhimin Xu the food scientist who led the research.

“If berries are used to boost health, why not black rice and black rice bran? Especially, black rice bran would be a unique and economical material to increase consumption of health-promoting antioxidants.”

Bran is the hard outer coating of a cereal grain. When rice is processed, millers remove the outer layers of the grains to produce brown rice or more refined white rice.

Research suggests that plant antioxidants, which mop up harmful molecules, can help protect arteries and prevent the DNA damage that leads to cancer.

Food manufacturers could potentially use black rice bran or bran extracts to make breakfast cereals, beverages, cakes, biscuits and other foods healthier, said Dr Xu, from Louisiana State University in Baton Rouge, US.

The scientists presented their findings on August 26 at the 240th National Meeting of the American Chemical Society in Boston.

Thank you John von Radowitz/The Independent

Another Link Between Diabetes and Alzheimer’s Disease Established

Two of the most common and dreaded illnesses may share a connection, with new research suggesting that having insulin resistance or type 2 diabetes raises your risk of developing the brain plaques associated with Alzheimer’s disease.

After adjusting for other risk factors, the Japanese study found that people with the highest levels of fasting insulin had nearly six times the odds of having plaque deposits between nerves in the brain, compared to people with the lowest levels of fasting insulin.

Those with the highest scores on a measure of insulin resistance (where cells become less able to use insulin effectively) had about five times the odds of having brain plaques vs. those with the lowest scores on the insulin-resistance test, the study found.

In fact, “the risk of plaque-type Alzheimer’s disease pathology increases in a linear relationship with diabetes-related factors,” according to one study author, Dr. Kensuke Sasaki, an assistant professor in the department of neuropathology at Kyushu University in Fukuoka, Japan.

Results of the study appear in the August 25 online issue of Neurology.

Both type 2 diabetes and Alzheimer’s disease have been rapidly increasing in incidence, so much so that experts worry the illnesses may overwhelm the health-care system in the coming years if nothing is done.

While numerous studies have found a link between cognitive decline and dementia in people with type 2 diabetes, the current study sought to determine the reason for that link.

Using autopsies from 135 Japanese adults, the researchers were able to compare if different indicators of insulin resistance or type 2 diabetes correlated with the development of plaque deposits between the nerves in the brain (neuritic plaques) or neurofibrillary tangles, which are found in dying cells in the brain. Plaques and tangles are thought by many to be the two main causes of the destruction of brain tissue seen in Alzheimer’s disease.

All of those autopsied died between 1998 and 2003. In 1988, they had undergone numerous tests as part of an ongoing study on brain and heart health. The tests included an oral 2-hour glucose tolerance test, fasting blood sugar and insulin levels, and a measurement of insulin resistance using a test called homeostasis assessment of insulin resistance (HOMA-IR).

The researchers adjusted the data to control for age, sex, blood pressure, cholesterol, body-mass index, smoking, exercise and cerebrovascular disease.
They found no association between diabetes risk factors and the development of tangles.

However, higher levels of blood sugar two hours after eating, high fasting insulin levels and an elevated HOMA-IR score were associated with an increased risk of developing plaques. Fasting blood sugar levels were not associated with an increased risk of plaques, according to the study.

When the researchers compared varying levels of diabetes risk factors, such as fasting insulin, they found a linear association with the development of plaques. For example, fasting insulin was broken into three groups: low, medium and high.

The low group didn’t have an increased risk of plaques, while the medium group had more than twice the risk of brain plaques, and those in the high group had a six times higher risk of plaques than those in the low group.

The researchers also performed a separate analysis to see if the presence of a gene long implicated in Alzheimer’s disease (ApoE4) would have an effect on the association between diabetes risk factors and the development of plaques. It did: Those with the ApoE4 gene has the strongest association between high blood sugar levels, insulin resistance and fasting insulin levels and the development of plaques.

“Research has been linking diabetes to dementia, and probably to Alzheimer’s, and this study is one more bit of evidence to say that we’d better get a handle on this,” said Dr. Richard Bergenstal, president of medicine and science for the American Diabetes Association.

Bergenstal said this study’s findings are likely applicable to people with both type 2 and type 1 diabetes, and possibly to those with pre-diabetes, as well.

“This study fits into a body of literature looking at the relationship between diabetes and Alzheimer’s disease. This area is being pretty aggressively researched for a number of reasons. Would better control of type 2 diabetes improve the cognitive fate of those with the disease, and is there some way we can intervene in glucose metabolism that might affect Alzheimer’s?” said William Thies, chief medical and scientific officer for the Alzheimer’s Association.

“If you have diabetes, it’s certainly a good idea to keep it under control while we’re sorting out the research,” Bergenstal said.

“Although we don’t know anything that can prevent Alzheimer’s disease right now, I do think there are a lot of good reasons for people to try to prevent type 2 diabetes, much of which can potentially be avoided with regular physical activity and weight maintenance,” said Thies. “Preventing or controlling diabetes is good for all kinds of reasons, and also because it might contribute to your risk of Alzheimer’s disease.”

Thank you Serena Gordon/HealthDay

Insulin Users Have 50% Higher Cancer Risk?

Diabetics who take insulin have a higher risk of developing cancer, according to Danish researchers who say they can’t explain the link.

Patients on insulin were 50 percent more likely to get cancer compared with the general population, researchers led by Bendix Carstensen from the Steno Diabetes Center in Gentofte, Denmark, wrote in an abstract of the study posted on the website of the European Association for the Study of Diabetes. The findings will be presented next month in Stockholm at the EASD’s annual conference.

People with diabetes already have a higher risk of cancer, the researchers said, and the tumor development seen in this study may not be caused by insulin itself, according to Carstensen, senior statistician at the center. It may be the result of contributing causes common to cancer, diabetes and insulin use, such as obesity, he wrote in the abstract. The study, conducted on the Danish population, is the largest of diabetes and cancer incidence so far, Carstensen said.

“People who are on insulin have a higher risk of developing cancer,” Carstensen said in a telephone interview today. “But what the reason for that is, it’s not clear from this study nor from any other study.”

In order to follow diabetes patients and see how many of them developed cancer, researchers created links between the Danish National Diabetes Register and the Danish Cancer Register. They compared their findings with data on tumor occurrence among people not suffering from diabetes, according to the abstract. They observed a total of 30,000 cancer cases among diabetics, including tumors of the digestive tract, liver and pancreas.

Sanofi’s Lantus
Diabetes causes blood-sugar levels to be higher than normal. Insulin, a hormone made in the pancreas, helps convert blood sugar into energy. Diabetics either don’t produce enough insulin naturally or their bodies have trouble using it properly. Glucose-lowering therapies such as Sanofi-Aventis SA’s Lantus, the first once-a-day form of insulin, have become standard care for people who can’t control their blood sugar levels with healthy eating or exercise.

This is not the first time that researchers have sought to shed light on the possible link between insulin use and higher cancer risk.

Last year, Ralph DeFronzo, a researcher at the University of Texas Health Science Center, said on a conference call that studies would show Lantus was tied to cancer. Shares in Paris- based Sanofi slumped after that call. The research, published in the journal Diabetologia, delivered mixed results, and the US Food and Drug Administration said it didn’t prove a link.

Tumor Risk
Another study, based on 1,500 patients and published in June in the journal Diabetes Care, also tied insulin glargine, the chemical name for Lantus, to a higher tumor risk.

France’s biggest drugmaker remains confident on the safety of Lantus, Sanofi Chief Medical Officer Jean-Pierre Lehner said in a June 18 interview. The study in Diabetes Care is “unclear” and “lacks precision,” Lehner said during the interview. It can be “methodologically challenged,” Sanofi said at the time.

The Danish study will be presented on Sept. 23 in Stockholm, according to the EASD’s website.

Thank you Albertina Torsoli/Bloomberg

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