Type 1 and Type 2 Diabetes treatments: Conventional and the Alternative

Type 1 and Type 2 Diabetes Treatments: Conventional and the Alternatives

An accidental discovery of a potential type 1 and type 2 diabetes treatment found by a Chinese translator through the translation of a paper from Chinese to English.

Diabetes is a condition in which the body does not produce enough, or properly respond to, insulin, a hormone produced in the pancreas. According to American Diabetes Association, diabetes symptoms may include frequent urination, excessive thirst, extreme hunger, unusual weight loss, increased fatigue, irritability, and blurry vision.

For conventional treatment of diabetes, many websites including the website of American Diabetes Association have listed various conventional treatments for Type 1 Diabetes and Type 2 Diabetes. Recently, Australia’s Dr. Dorota Pawlak, research development manager at the Juvenile Diabetes Research Foundation, raised hope for a possible Type 1 Diabetes cure. The research, led by institutions across Europe and the US, shows mice that had chemically-induced diabetes could be cured of the condition through the manipulation of a single gene (Pax4). The research is published in the international journal Cell. In the US, Onglyza was also approved by FDA for Type 2 Diabetes Treatment.

In terms for the alternative treatments for diabetes, according to the National Center for Complementary and Alternative Medicine, Alpha-lipoic acid (ALA, also known as lipoic acid or thioctic acid), Chromium, Omega-3 fatty acids, and polyphenols in dietary supplements are shown to improve the conditions of type 2 diabetes patients, while other ingredients in dietary supplements may need additional research to verify their efficacies.

However, accidentally, through the translation of a research report from Chinese to English, translators at Abacus Chinese Translation Services have found an additional piece of information that might give hopes to millions of diabetes patients around the world. According to a preliminary double blind, randomized controlled animal study conducted at the Stanford University School of Medicine in the 1990’s for the application of a research grant from the National Center for Complementary and Alternative Medicine, Yu Xiao San 8805, a dietary supplement in the US but a traditional Chinese medicine used in China used for the treatment of diabetes, has shown statistically significant effect on the increase in triglycerides (TG) in these streptozotocin-induced insulin resistant diabetic rats. Although it has yet to shown its effectiveness for diabetes, clinical trials in China have just proved that.

Immune drug linked to cancer

Immune drug linked to cancer

This week WebMD, a medical and health news source, and several other internet news sources have reported that the US Food and Drug Administration has updated its warning for a group of drugs called TNF blockers, which it says may cause lymphoma and other cancers in children and adolescents. The drugs include infliximab and etanercept, which are used for the treatment of juvenile rheumatoid arthritis (JRA), Crohn's disease and other inflammatory diseases. Licensing of the drugs in the

What is the basis for these current reports?The Food and Drug Administration (FDA) in the US is responsible for the regulation of foods, dietary supplements, drugs, vaccines and medical devices, and for ongoing safety monitoring. In June last year thADVERTISEMENT

e organisation announced that it was investigating the possible association between drugs to block tumour necrosis factor alpha (TNF-alpha), a protein involved in mediating the immune and inflammatory response, and the development of lymphoma (cancer of the lymph system), plus other cancers in children and young people.

Over a 10-year period the FDA received some 30 reports of these types of cancer in young people taking TNF blockers alongside other immune-suppressive medicines to treat JRA, Crohn’s disease or other conditions. They called for manufacturers to submit information on cancers in children also taking these drugs.

When the FDA began its investigation of these reports it stated that the potential benefits of the use of TNF blockers outweigh the potential risks in certain children and young adults. It called for manufacturers to submit reports on any cancer cases, which they included in their investigations.

On August 4 2009 the FDA released a follow-up report requesting a change to the labelling of TNF blockers. They concluded that, based on analysis of 48 childhood cancer cases, “there is an increased risk of lymphoma and other cancers associated with the use of these drugs in children and adolescents”. There is also an increased risk of new psoriasis.

Manufacturers must now add this information to drug literature in the form of a warning on the leaflet inserted into the medicines’ packaging. Patients and professionals are encouraged to report any adverse effects of TNF blockers to the FDA through the MedWatch reporting system they have implemented.

Which cases were the FDA investigating?The FDA reviewed case reports of 48 childhood cancers in young people also taking TNF blockers. Half of these were lymphomas, including both Hodgkin’s and non-Hodgkin’s lymphoma. Other cancers included leukaemia and melanoma. Some rare cancers, including renal cell carcinoma, liver cancers and leiomyosarcoma (a soft tissue cancer starting in the smooth muscle tissue), were also reported. Unfortunately, 11 of these 48 children died.

In their analysis the FDA concludes that, overall, cases of lymphoma and malignancies in children and young people taking infliximab were higher than would be expected. Children taking etanercept had higher than expected rates of lymphomas, but overall rates of cancer were as expected. The TNF blockers adalimumab and certolizumab were not included in their analysis because these drugs are not often used in children.

The FDA says that, in the cases of childhood cancer that they investigated, the majority of the patients (88%) were also taking other immunosuppressive medicines such as azathioprine or methotrexate, which themselves carry warnings about increased cancer risk. It is, therefore, difficult to determine the possible causes of these cancers, but the role of TNF blockers cannot be excluded.

What are TNF blockers?TNF blockers work by suppressing the immune system through blocking TNF, a substance that causes inflammation, which can lead to bone and tissue damage. This action makes them useful for treating immune-related disease. The prescribing guidelines for the four TNF blockers that are currently available in the USA (Remicade, Enbrel, Humira and Cimzia) already contains a warning about the possible risk of cancer.

The FDA reports that manufacturers of these drugs are required to report any cases of cancer in children using these medications, so that the FDA can monitor the situation. In addition, the manufacturer of Cimzia will conduct a 10-year study starting in 2009 that will assess the impact of the drug, with particular reference to new cancers.

Are TNF blockers used in the UK?In the UK, the licensed TNF-alpha blockers are

adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade). The only drug that may be prescribed for children is etanercept, which is licensed for use in juvenile arthritis only. NICE guidance (2002) advises that this drug be used only in children aged four to 17 years who have had an inadequate response to, or been intolerant of, methotrexate (a disease-modifying antirheumatic drug).

Etanercept is licensed for prescription, in accordance with the British Paediatric Rheumatology Group, by a consultant who regularly sees the child and who registers the child with the Biologics Registry, where all details of dosage, response and toxicity are regularly reported.

Infliximab and adalimumab are not licensed for use in children with arthritic diseases. Regarding inflammatory bowel disorders, infliximab is licensed for the treatment of only adult cases of Crohn’s disease. Adalimumab may also be used in adults with Crohn’s disease, but its use for this condition is currently undergoing NICE review, as is infliximab. Neither drug is licensed as a treatment for children or adolescents under 18 years.

What specific changes has the FDA called for?The FDA has specifically requested that manufacturers:

Update their boxed warning on prescribing information to ensure healthcare professionals are alerted to the association between use of TNF blockers and increased risk of lymphoma and other malignancies. Update the adverse events section of the drug information sheets to include information on possible new-onset psoriasis. Revise the medication guide section to reflect this new information.

What is the advice for patients?The FDA has said that patients should:

Be aware that taking TNF blockers may increase the risk of developing lymphoma, leukaemia and other cancers. Be aware that taking TNF blockers may increase the risk of developing psoriasis or worsen pre-existing psoriasis. Pay close attention for any signs or symptoms of new-onset psoriasis or worsening psoriasis, such as red scaly patches or raised bumps on the skin that are filled with pus. Review the printed medication guide that comes packaged with TNF blockers. Not stop or change their use of medicines that have been prescribed without first talking to a suitable healthcare professional. Pay close attention for any signs or symptoms of cancer, such as unexplained weight loss or fatigue, easy bruising or bleeding, or swollen lymph nodes in the neck, underarms or groin. Any possible signs or symptoms should be promptly discussed with a healthcare professional. In the face of overwhelming evidence that the drugs cause cancer, the FDA would withdraw them from use. However, this is not the current view of the FDA. The FDA is now working with manufacturers to find ways to understand and quantify the association between cancer and treatment with TNF blockers. Based on these new recommendations of the FDA, patients should not change their own medication without speaking to their doctor.

James Watson and winning the war on cancer

James Watson and winning the war on cancer

Picture: Edmond Terakopian/PA

To celebrate the 40th anniversary of the Moon landings, The Times last month cast around for a project that would be a worthy contemporary successor to the Apollo programme: a great scientific initiative that might be achievable, given the right support, on a decade-long timescale like the one President Kennedy set out back in 1961.

Our chosen target, set out in a leading article, was cancer. While the challenge of curing the "big C" in all its forms may well be too great, there is a very real prospect that its treatment could be comprehensively transformed within 10 years. As the leader put it:

"We may soon come to see this dread disease largely as a manageable and chronic condition. Within ten years or so, many scientists believe it could become more usual to die with cancer than of it."

The Times is in good company: no less a figure than James Watson, the co-discoverer of the double-helix structure of DNA,has this week also described beating cancer as a "realistic ambition", in an op-ed for the New York Times. The reason Watson cites is the same one highlighted by the Times leader: "at long last, we largely know its true genetic and chemical characteristics," he said.

As the excellent PolITigenomics blog points out, some of Watson's reasoning about the best way forward is a little confused. He seems, for example, to call at once for the US National Cancer Institute to focus more on basic research, and for accelerated patient trials of new drugs. But the timing of his intervention is interesting, for it coincided almost to the day with the publication of just the sort of study that is promising to drive a cancer revolution.

In this new research, published in the New England Journal of Medicine, a team led by Elaine Mardis, of Washington University in St Louis, has sequenced the entire genetic code both of cancerous cells from a patient with acute myeloid leukaemia, and of his healthy tissue. A comparison between the two revealed about 750 genetic mutations that have occurred in the cancerous cells.

Most of these mutations will be passenger mutations, symptoms of the disease rather than causes, if you like. The team, however, picked out 64 mutations that were more likely to be causal because of their position in the genome for further study, and looked for them in 187 samples of cancer cells from other leukaemia patients. One mutation, in a gene named IDH1, showed up in 16 per cent of these samples. It is highly likely to be a "driver mutation" -- one of the genetic errors that can actually cause leukaemia.

A more detailed summary of the paper is available atMassGenomics, a blog written by Daniel Koboldt, a member of the Mardis team. A commentary on the findings by James Downing, of St Jude's Children's Research Hospital in Memphis, Tennessee, also sums up nicely what such research means for medicine.

The results are significant because they represent a step towards the great goal of contemporary cancer genomics: to identify the precise mutations that drive the many different types of tumour, for clues to diagnosis and treatment.

Armed with this knowledge, it should eventually be possible to determine, by sequencing cells from a patient's cancer, how aggressive it is likely to be, and what will be the most effective approach to treatment. Such genomic insights will also identify new targets for medical research, bringing new drugs that are designed with the genomic architecture of particular tumours in mind.

It is studies of this sort that mean the war on cancer might plausibly be won.

POSTED BY MARK HENDE

Brain radiotherapy affects mind

Radiotherapy used to treat brain tumours may lead to a decline in mental function many years down the line, say Dutch researchers.

A study of 65 patients, 12 years after they were treated, found those who had radiotherapy were more likely to have problems with memory and attention.

Writing in The Lancet Neurology, the researchers said doctors should hold off using radiotherapy where possible.

One UK expert said doctors were cautious about using radiotherapy.

The patients in the study all had a form of brain tumour called a low-grade glioma - one of the most common types of brain tumour.

In these cases radiotherapy is commonly given after initial surgery to remove the tumour, but there is some debate about whether this should be done immediately or used only if the cancer returns.

“ It always depends on the patient, but if it is possible to defer radiotherapy, maybe people should ”

Dr Linda Douw, study leader

It is known that radiation treatment in the brain causes some damage to normal tissue and the study's researchers suspected it could lead to decline in mental function.

A previous study in the same patients done six years after treatment found no difference in aspects like memory, attention and the speed at which people could process information, in those who had received radiotherapy.

But the latest research, carried out more than a decade after original treatment, did find significant variation in the results of several mental tests between those who had had radiotherapy and those who had not.

In all, 53% of patients who had radiotherapy showed decline in brain function compared with 27% of patients who only had surgery.

The most profound differences were in tests to measure attention.

Delaying treatment

With an average survival of ten years for this type of tumour, the researchers said patients undergoing radiotherapy were at considerable risk of developing problem years down the road.

One option for doctors would be to delay when patients received radiotherapy, reserving it in case the tumour returned, they advised.

"It always depends on the patient, but if it is possible to defer radiotherapy, maybe people should," said study leader Dr Linda Douw, from the Department of Neurology at VU University Medical Centre in Amsterdam.

But she added that more research was needed and there were trials under way to look at other treatments such as chemotherapy.

In an accompanying article, experts from the Mayo Clinic in Rochester, USA, said it was hard to draw conclusions because radiotherapy had improved since the patients in the study had been treated, but agreed more studies were needed.

Dr Jeremy Rees, a Cancer Research UK scientist at the National Hospital for Neurology and Neurosurgery Honorary said they would usually try to avoid giving radiotherapy to patients with low-grade glioma, unless the tumour was progressing or the patient had epilepsy not controlled on standard medication.

"Surgery is generally a preferred option with chemotherapy or radiotherapy coming into play at a later stage, if the glioma progresses.

"Continued research and increased knowledge about the disease is enabling us to treat it increasingly effectively while reducing side effects."

Colon Cancer - Concerned About Protecting Yourself from One of America’s Most Fatal Diseases?

Colon Cancer - Concerned About Protecting Yourself from One of America’s Most Fatal Diseases?

Healthcare

Also known as colorectal cancer, Colon cancer is a malignant tumor of the large intestine. Each year over 150,000 Americans, over 10,000 of those Pittsburgh residents are diagnosed with this deadly disease. However, according to Dr. David Blumberg, a colorectal surgeon in Pittsburgh and founder of Bandaid Surgery, “with early detection, proper colon cancer treatment with surgery and routine check-ups, Colon Cancer has a 100% lifetime cure rate.

While Colon cancer is most prevalently diagnosed in people over age 40, the disease can be present at an early age and lay dormant in the colon as a form of colon polyps for many years before it becomes a malignant cancer.

The American Cancer Society and the Cancer Research and Prevention Foundation say, “There are many factors that help lower a person’s risk. These include maintaining a healthy weight; consuming a low fat diet rich in fruits, vegetables, whole grains, nuts and beans; refraining from tobacco usage and exercising regularly”. “However, the most important factor in preventing colon cancer according to Dr. David Blumberg “is to get an annual Colonoscopy starting at age 40 if you have a family history of colon polyps or colon cancer and at age 50 if you have no risk factors”. “This simple test, says Dr. Blumberg, allows the colon surgeon to examine inside the entire large intestine, detect inflamed tissue, abnormal growths, ulcers and diagnose early signs of cancer in the colon and rectum. “Even if you don’t have symptoms,” says Dr. Blumberg, “upon examination of the colon, a diagnosis can be determined and a treatment plan can be prescribed. If the findings are colon cancer, the best surgical option is laparoscopic surgery”. “This minimally invasive colon surgery technique, according to Dr. Blumberg and the Society of American Gastrointestinal and Endoscopic Surgeons uses tiny incisions, minimizes pain and promotes shorter hospitalization and early recovery!

“Getting tested has been proven to saves lives” and if you are diagnosed with colon cancer, find out if laparoscopic colon surgery is an option for you”. Laparoscopic colon surgery is now been proven safe for colon cancer treatment so why undergo an open operation with a big cut when it so much more painful and recovery takes months says Dr. Blumberg. Dr. Blumberg a colorectal surgeon in Pittsburgh has recently pioneered a new laparoscopic colectomy technique that reduces the size of incisions and allow a 95% success rate of completing a colon cancer operation via a laparoscopic or minimally invasive approach (www.mmdnewswire.com/laparoscopic-colon-surgery-5454.html)

About Dr. Blumberg:

Dr. David Blumberg is a Board Certified General and Colorectal Surgeon with special training in colorectal cancer, inflammatory bowel disease (Chrohn’s & Colitis), and diverticulitis and Laparoscopic colon surgery. Dr. Blumberg is a fellow of the American College of Surgeons and American Society of Colon and Rectal Surgeons. He has been recognized by his peers for clinical excellence as a surgeon at the University of Pittsburgh Medical Center (UPMC) since 1999. Prior to this, Dr. Blumberg was a fellow in Surgical Oncology at the world-renowned Memorial Sloan-Kettering Hospital in Manhattan and a fellow in Colon and Rectal Surgery at the prestigious Ochsner Clinic in New Orleans. Dr. Blumberg is a recognized national leader in the area of colorectal cancer. He is the author of over 40 articles and has lectured at multiple national meetings. Dr. Blumberg has been recognized as a Top Doctor in Pittsburgh by Castle Connelly for two consecutive years. Dr. Blumberg has been performing Laparoscopic colon operations since 2000 and has a proven track record of expertise in this highly specialized field with multiple publications and innovations. If you have concerns about colon cancer or a colonoscopy call Bandaid Surgery, PC at 412-682-3333 for more information.

For Additional Information regarding Colon Resection surgery for Polyps and Colon Cancer Treatment or to make an appointment contact:

Contact Information

Dr. David Blumberg, M.D., FACS, FASCRS

Bandaid Surgery, PC

The Coronado Medical Building

500 South Aiken Ave, Suites 107-110

Pittsburgh, PA 15232

Phone: (412) 682-3333

FAX: (412) 682-3335

Visit us on the web http://www.bandaidcolonsurgery.com/

Email: davidsurg@aol.com

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Ovarian Cancer surgery doesnt have to end fertility

Ovarian cancer surgery doesn't have to end fertility

By Shari Roan

Young women diagnosed with an early stage of ovarian cancer may be able to have surgery for the disease without losing their fertility.

Traditionally, treatment of ovarian cancer involves removal of both ovaries and the uterus, which puts younger women into menopause and ends their chances of bearing a child. But a study published today in the journal Cancer, by researchers at Columbia University College of Physicians and Surgeons, showed that five-year survival rates for stage 1 ovarian cancer patients were the same for patients who had both ovaries removed and women who had only the cancerous ovary removed.

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The five-year survival rates were similar among patients who had the uterus removed compared with those who didn't.

"If the woman is young, premenopausal and is considering future childbearing, she does not need a hysterectomy and she does not to be completely castrated," said Dr. Beth Y. Karlan, director of the Women's Cancer Research Institute at Cedars-Sinai Medical Center. Karlan was not involved in the research. "It is safe to do a conservation procedure and still effect cure and allow the woman to appreciate her life goals. We're seeing more women cured of ovarian cancer. With stage 1, cure is a very realistic goal."

Other research on fertility-preserving surgery shows that most patients can become pregnant safely, even after chemotherapy.

Ovarian cancer, the fifth leading cause of cancer deaths in women, occurs most often in postmenopausal women and is often detected only at advanced stages.

However, up to 17% of ovarian cancers occur in women 40 or younger, a rate believed to be rising. So doctors are paying more attention to options that don't cause menopause.

Removal of both ovaries and the uterus, which produce hormones, is unappealing for reasons other than fertility, too, said Dr. Jason Wright, lead author of the study and an assistant professor of women's health.

"If the other ovary is preserved, that essentially means women don't go through the menopause. They don't experience hot flashes, vaginal dryness, osteoporosis. There is additional data that women who undergo the removal of their ovaries before age 55 are also at increased risk for cardiovascular disease, earlier death and dementia."

That means organ-preserving surgery could benefit premenopausal cancer patients even when fertility is not an issue.

But "for postmenopausal women, the risks may outweigh the benefits," Wright said.

The retrospective study focused on 1,186 patients diagnosed between 1988 and 2004, of whom 36% had one ovary conserved.

Further research, such as a randomized, controlled trial, is needed to test whether the procedure should be recommended to all younger women with early-stage ovarian cancer, Wright said. But for now, he said, it's a "reasonable" option that doctors should discuss with patients.

Karlan added: "It is important to ensure they are stage 1. Part of that includes sampling the lymph nodes and making sure the cancer hasn't spread to the nodes or upper abdomen."

Wright also reported earlier this year that removing the ovaries had no effect on five-year survival rates of early-stage endometrial cancer in women age 45 and younger.

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Supplements may help protect against Alzheimer’s

A new study has found a combination of supplements containing vitamin D3 and curcumin, a compound found in turmeric, may help shield the brain from the ravages of Alzheimer’s disease.

Turmeric is a perennial herb related to ginger which can be found throughout tropical South Asia. It has been known by alternative medicine practitioners for its antiseptic and antibacterial properties.

A team of scientists from UCLA, UC Riverside and the Human BioMolecular Research Institute found the combination acts by stimulating the immune system to remove amyloid beta from the brain.

Amyloid beta is a peptide that forms the plaques found in the brains of Alzheimer’s patients and is thought to be responsible for the neurodegeneration that accompanies the disease.

The researchers analyzed blood samples from Alzheimer’s patients and from healthy control subjects to isolate monocyte cells, which transform into macrophages that spearhead the immune system’s waste removal process.

Their results suggest curcuminoids boosted the surface binding of amyloid beta to macrophages, and vitamin D stimulated the absorption of amyloid beta in macrophages in a majority of patients.

Dr. Milan Fiala, a researcher at the David Geffen School of Medicine at UCLA expressed hope these natural compounds may open new possibilities in the treatment and prevention of Alzheimer’s disease.

He added, "since vitamin D and curcumin work differently with the immune system, we may find that a combination of the two or each used alone may be more effective, depending on the individual patient."