Sometimes it may persist after birth and is associated with increased maternal disorders (hypertension or high blood pressure, vaginal infections and urinary tract, premature delivery and caesarean) and serious harm to the baby (macrosomia fetal death, ie overgrowth of the product because it is exposed to more glucose than usual this is because it stimulates your pancreas secretes insulin abundance increases their development, which can lead to injury at the time of passing through the birth canal .)

Pregnancy is a metabolic stress on the body of the mother because the baby uses their bodies for food (energy), oxygen and eliminating waste. For this reason, the woman who becomes pregnant is more likely a deficiency of the hormone that allows sugar or glucose is used by the cell (insulin), causing difficulty breathing.

The type 2 diabetes
Type-2 diabetes have a resistance of body cells to the biological effects of insulin. Once this so-called insulin resistance is too strong, does the injected insulin in a diabetes therapy is not effective enough. Be increased in these cases, the insulin sensitivity by insulin sensitizers. These sensitizers are firstly used for type-2 diabetes with marked insulin resistance, ie, in patients in whom insulin alone is insufficient. On the other hand in diabetic patients who are not the standard combination of insulin and metformin because of contraindications or intolerance can take.

To date, registered in Germany, two insulin sensitizers: Pioglitazone and rosiglitazone. These drugs increase insulin sensitivity of liver cells, muscle, and adipose tissue. The cells absorb more sugar by these substances, the liver, however, limits their glucose production. The result: the blood sugar level falls, both fasting and after meals.

The study
In the current study for three years more than 4000 patients taking part. All will be treated with the combination of insulin and pioglitazone. The first interim analysis of data from 2086 patients from 408 different diabetological study centers appears very positive. The blood glucose levels of the test subjects fell by nearly one percentage point. As an ultimate goal, the leaders recommend a percentage of 6.5%. In addition, the interim results showed that 22% of patients required less insulin. Blood pressure and blood lipid values of study participants also improved.

Possible side effects
The compatibility ratio of this therapy was quite good and was 97.7%, which was tolerated in most patients, the combination without major problems. One in seven patients, there was water retention in the legs. Through a diuretic these unwanted side effects, however, were already resolved during therapy. Encouraging, the researchers expressed the fact that no patient had to discontinue the therapy and already well-known complications with pioglitazone were observed.

Treatment Information
In patients receiving the combination therapy for the first time it is very important that the physician individually reduces the insulin dose to prevent hypoglycaemia. Those in charge of the study suggest, therefore, patients in the first few weeks follow closely, especially with regard to the occurrence of Herzinsuffiziensymptomen. Particularly crucial to a problem-entry into this type of therapy is the continuous adjustment of insulin dose.

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In contrast to the insulin-dependent type 1 diabetes produce humans with type 2 diabetes, even a small amount of endogenous insulin. This amount is often small, that they no longer sufficient to adequately regulate the blood sugar. In addition, the metabolism of a type-2 diabetics often speaks to the existing insulin significantly less responsive than in perfectly healthy people would be the case. In this problem, so-called “oral agents” to correct the situation. These tablets increase the effects of the existing residual insulin and stimulate the pancreas to pour out to, for example at meals sufficient endogenous insulin. In the tablets even no insulin is included because it would be destroyed by stomach acid. In Germany, a type-2 diabetes is usually treated with oral antidiabetic agents. Only when the excess of regular long-term blood sugar levels (HbA1c), despite all efforts, the level of 7% are type 2 diabetics treated with insulin.

Texas study examines the advantages and disadvantages of diabetes therapy
A team of endocrinologists in the United States had now for three years, recently published study examined the self-treatment of people with type 2 diabetes. The study involved about 58 people had taken part with a newly diagnosed diabetes who were assigned randomly to one of two groups. One group was treated during the three-year observation period with insulin and the drug metformin, the other group received a combination treatment with the antidiabetic metformin, pioglitazone, and glyburide.

Insulin and combination tablets are equally good
The result: The HbA1c of both groups differed at the end of the study, only 0.1 percent. The insulin group had reached an average of 6.1%, the tablet group had the slightly better value of 6%. Weight gain was observed in both groups. Surprisingly, participants had risen kg in the insulin group, however, only about 4.5, while the tablet group average of 7.2 kg with a lot more put on the scales. Hypoglycemia occurred during the study in both groups rarely, and usually, these were not severe hypoglycemia. The self-discipline and the satisfaction with the therapy in both groups were also roughly equal.

Results are not fully meaningful
As a result, the insulin / metformin therapy and the combination of three anti-diabetic agents also equal. However, a combination of three different anti-diabetic agents in Germany is practiced only in emergencies, because the blood glucose in most patients even with a tablet can be adjusted very well. In addition, a study with only 60 patients compared to the experience of millions of diabetics is not meaningful.

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The pancreas (in the lower part of the stomach) makes insulin and enzymes that food.Inside help the body process and use of the pancreas are clusters of cells called the islands of Langerhans.Islets are different types of cells, including beta-formed cells, the to make insulin. (National Diabetes Information Clearinghouse)

Research shows the first high-resolution map of the genomes in these cells, the majority is for the treatment and prevention of Type II diabetes is important. On balance, the discovery of the genetic changes that alter the genes disease.If may be, then the treatment and prevention can lead to change exponentially.

By narrowing the 80,000 vacancies detected within chromatin pancreatic islet cells to 3,300 clusters, the results of individual genes that are in islet cells, 20 of these genes harbor genetic types in patients with type II diabetes.This research are not limited to the treatment of diabetes, they are also interested in the discovery of genes associated with lymphocytes of the immune system associated with.

New research on diabetes daily.Just published yesterday, a story about the diagnosis of diabetes to the forefront that people will no longer have to undergo more rapid and invasive blood tests, a new option available. Living with diabetes is difficult, especially when you consider that millions of Americans, they suffer every day, new studies show that people do not feel they receive good treatment from their doctors.

Another interesting factor about the release of this new genetic evidence correlates, as it is released. Victoza with the new diabetes treatment drug, already approved, and Byetta, which are under review, will, intend, its future biotechnology -achieving companies millions of dollars in profits.

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Normally, when glucose exceeds 110 mg / dl is secreted insulin and low blood sugar to normal (80-110 mg / dl). When the blood sugar falls below 60 mg / dl, normal production slows insulin, which limits the use of glucose by the tissues and allows increased blood glucose to normal.

The body gets its energy in the form of carbohydrates, fats and proteins through the diet. This provides fuel for 4-8 hours of cell metabolism. After this period the body will draw on glucose produced by the liver primarily, but all controlled by the degree of insulin producing pancreatic cells.

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The device, produced through a collaboration of experts from Boston University, Massachusetts General Hospital and Harvard Medical School has two hormones that are deficient among Type 1 diabetic, insulin, which prevents levels blood sugar get too high after a meal, and glucagon, a hormone that occurs naturally that prevents blood sugar levels fall too far.

Because the device does not depend on a human will provide information, it is called a “closed loop.”

“A closed-loop system bihormonal is possible and can help maintain a good average blood sugar readings,” said Edward Damiano, one of the designers of the device, associate professor of biomedical engineering at Boston University and father of a child with type 1 diabetes.

“What we developed is an automated software that makes decisions and uses mathematical formulas to inject various amounts of insulin and glucagon when necessary,” he said.

Type 1 diabetes is a disease in which the body’s immune system that normally protects against infections and other diseases attacking healthy cells. In type 1 diabetes, the immune system attacks the pancreatic beta cells, which in effect destroys the body’s ability to produce insulin and control blood sugar levels.

However, many people do not know beta cells are not the only ones affected by the autoimmune attack. The alpha cells, which produce the hormone glucagon, also damaged. Dr. Steven Russell, of Harvard and Damiano colleague said “there is a deficiency in alpha-cell function in type 1 diabetes, so do not act as they should. No glucagon secreted properly, so you lose a level Additional safety and body compensates with hypoglycemia, a condition that can cause big scares and even put life at risk. ”

For that reason, decided to add artificial pancreas glucagon to provide an additional level of protection, said Russell.

In the current version of the device, the researchers tracked the blood glucose through a special sensor placed inside a vein. Future versions will use the device monitors blood glucose continuous (CGM, for its acronym in English) that are already available, but for this test, the researchers wanted an extremely accurate way to measure blood sugar levels, so the only variable was the mathematical formulation used to program the administration of insulin and glucagon.

Eleven people with type 1 diabetes participated in the initial tests and experiments were performed in 27 hours. During that time, were connected to artificial pancreas and ate foods high in carbohydrates (carbohydrates are converted into glucose in the body).
The device responded to the increase in blood sugar levels with insulin administration. In six, the device reached a level of average blood glucose of 140 milligrams per deciliter (mg / dl), which is within the range established guidelines for the care of the American Diabetes Association. However, five insulin absorbed much more slowly than expected, which led to severe drops in blood sugar, so it was necessary to use extra food.

The researchers were surprised by the significant difference in the rates of absorption of blood sugar, so turned back, the mathematical formula adjusted and re-test the device in a second experiment. This time, reached a level of average blood glucose of 164 mg / dl, which is slightly above the target of the ADA. However, there were no cases of hypoglycemia that needed intervention.

The researchers said that people who use the pump is freed from daily injections. On the other hand, might need to change the pump site every three days and the place of glucose monitoring once a week. Yet integration has been developed in one place for the administration of hormones and glucose monitoring, although the ultimate goal.
In the following essay, researchers hope to give at least some insulin before a meal, which is the standard treatment. Damiano noted that this could be achieved with a button before the meal and the user could choose whether the carbohydrate meal will be short, medium or large.

The next series of trials will also evaluate a device that includes only insulin, it is likely to be available faster. The reason is that now glucagon is only approved by the FDA in a freeze-dried injection as rescue medication. But not to be administered via an insulin pump in small doses, as in the case of the artificial pancreas. Both Damian and Russell believe it is possible to have a closed-loop system only insulin to patients within five years or so.

“The goal of artificial pancreas is to try to restore normal physiology as closely as possible to the real organ, and this study shows that this technology is a reality and it works on real people,” said Aaron Kowalski, assistant vice president for research Glucose Control and director of the Artificial Pancreas Project of the Juvenile Diabetes Research Foundation (JDRF). “Many years ago we talked about the theoretical potential of closed-loop system and now we see the real potential. These technologies will become real systems and have the potential to transform the management of diabetes.”

The study results are published in the April 14 edition of Science Translational Medicine.

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The Taiwanese doctors presented at a press conference the positive results of therapy in 60 cases of operated diabetic gastric surgery over a year ago.

Diabetes is really a gastrointestinal disease, resulting from problems with the gastrointestinal hormones that influence insulin production, so it can be treated with gastric surgery,” said a spokesman for the doctors, Li Wei-jie.

In an experiment with 60 patients, average age 45 years, found that one year after gastric bypass surgery, 93.3 percent had normal blood sugar level and in the case of gastric narrowing, the proportion was 46.7 percent.

Researchers at the Taiwan Normal University said that with current therapies and medication, a year, only 30 percent of patients achieved a normal level of sugar.

“”The success of gastric surgery to control diabetes is unclear, but it takes a longer-term follow-up to prove that the result holds,” said Li.

A third of patients had symptoms of anemia and osteoporosis after gastric surgery, while the risk of gastric perforations is less than one percent, said the Taiwanese doctor.

Bypass surgery and gastric narrowing side effect is thinning of the patients, so it is necessary prior review in order to avoid putting too thin, Li added.

The traditional treatment of diabetes is an appropriate plan of diet and weight control, physical activity plan and medication (if needed).

When we eat something, a lot of digested food is converted into glucose, the main energy source of the body. The pancreas then responds to blood sugar levels by secreting insulin in increasing the flow of blood. Most cells in your body contain insulin receptors that help insulin bind to the cell. Once insulin binds to the cell, activate other receptor sites, allowing glucose to enter the cell and provide energy for life.

Insulin also plays other vital roles in the body such as storage of excess food and magnesium, sodium retention and management of other hormones in the body including growth hormones, testosterone, and progesterone. Insulin is also responsible for stopping the liver to release fat, a potential metabolic fuel in the blood after a meal.

Insulin resistance occurs when even though the body produces insufficient amounts of insulin in the body cells become resistant to its effects. When this happens, the body requires more than the normal amount of insulin to take effect, and consequently, the pancreas produces more insulin.

While the pancreas can continue with the high demands of insulin, blood sugar levels remain normal, however, rising levels of insulin may have other negative health effects such as weight gain, high blood pressure, osteoporosis, fatty liver disease and hormone-related conditions such as polycystic ovarian syndrome (PCOS). If the pancreas can no longer continue with the demands of insulin, Type II diabetes can ocurrit.

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Scientists at the National Marine Mammal Foundation of America (NMMF) found that the bottlenose dolphin (Tursiops truncatus) is resistant to insulin, the hormone that regulates glucose levels in the blood-like people suffering type 2 diabetes .

But this resistance in animals can turn on and off, the scientists reported in the Annual Conference of the American Association for the Advancement of Science (AAAS) held in San Diego, USA.

Researchers believe that this mechanism “on” works because of the diet of fish high protein and little sugar-feeding whales.

Scientists hope to collaborate with experts in diabetes to see if you can find even control an equivalent in humans.

The team, based in San Diego, took blood samples from trained dolphins consuming “snacks” continuously during the day and fasted overnight.

“The overnight changes in blood chemistry were equal to the changes occurring in human diabetics” he told the BBC Stephanie Venn-Watson, director of veterinary medicine of the Foundation.

“Some people with diabetes eat a diet high in protein to help control their disease, but the dolphins seem to have developed a condition similar to diabetes to consume a high protein diet.

This means, scientists say, that this mechanism allows the dolphins on simulate a state of diabetes when they fast without side effects.

In the morning, when the animals take their breakfast, simply revert to normal without diabetes.

Big brain
Just like humans, dolphins need sugar in the blood to their brains to function properly.

People with type 2 diabetes develops a resistance to insulin and thus loses the ability to control the levels of blood sugar.

Insulin Injection
People with diabetes need to inject insulin to control blood glucose.

If the condition is left unchecked can damage the heart, vision, kidneys and nervous system. According to the World Health Organization this disease causes 5% of all deaths that occur worldwide each year.

So with diabetes need to carefully control the levels of glucose and is often achieved with a diet low in sugar to avoid complications of the disease.

But dolphins insulin resistance seems to offer an advantage.

As explained by Dr. Venn-Watson, cetaceans appear to have evolved with the mechanism that allows them to simulate diabetes because it helps them maintain a high level of blood sugar when food is scarce.

“Bottlenose dolphins have large brains need sugar,” explains the researcher.

“Because his fish diet is low in sugar, the genetic mechanism allows them to keep blood sugar (even fast) to keep the brain well supplied.”

Among mammals, humans and dolphins have bigger brains and both have red cells that are exceptionally permeable to glucose and capable of carrying large amounts of it to the brain.

As already sequenced the genome of the dolphin, scientists hope to compare the genes of the whale with the human being to seek a similar mechanism in the latter.

According to Dr. Venn-Watson, “the fundamental difference so far is that dolphins are able to turn on and off the mechanism of insulin resistance, and humans do not”.

“But we hope that this discovery could lead to new ways to prevent, treat and perhaps even curing diabetes in humans” says the researcher.

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A type-1 diabetes develops when the immune system attacks a bad reaction in one’s own pancreas and destroys the insulin-producing cells. Due to an inflammatory reaction, which takes different lengths, the pancreas can no longer fulfill their function and diabetes becomes apparent. The onset of diabetes may last, depending on the injury, so that even ill babies or adults only. How it but at the slip of the immune system, so the exact cause of diabetes, occurs remains unclear.

Vaccination against type 1 diabetes?
If several relatives of a child have type 1 diabetes are affected, the genetic risk for the child greatly increases also suffer from diabetes too. Now by contrast, could potentially help the early administration of small doses of insulin as a kind of vaccination. Unlike type-1-Diabektikern with overt diabetes, the insulin for at-risk children do not serve to lower their blood sugar. It affects the immune system and prevent the fatal bad reaction to the pancreas in the long run. Two studies will now investigate in Austria, Italy, Britain, Canada, the USA and in Germany, how much insulin is suitable for the prevention and how it needs to be taken. The hormone could for example be administered in very small doses by mouth or as a nasal spray. When taken orally, insulin has no blood glucose-lowering effect, because it is ineffective by the stomach acid. With the hormone only children should be treated, although they are burdened with a high hereditary risk of diabetes, but still show no symptoms of the disease.

Who can participate in the prevention trial?
In Germany, experimental subjects aged 18 months to 7 years to be searched, where a family history is given with diabetes. Notes for a high risk of disease include pre-existing diabetes type 1 disease among siblings or their own parents. Before study participation, the individual risk of diabetes of the participating child is determined. The examinations and treatments during the studies are free of charge to participating families. The study is supported by the German Federal Ministry for Education and Research and the American Foundation for Diabetes Study. The study is called “pre-point” and is conducted in Germany by Professor Ezio Bonifacio at the TU Munich. For the 18-month study will be looking for a total of 40 children.

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