Diabetes

In patients with diabetes who have end-stage renal disease and CHF, the choice of oral medications is limited because metformin is contraindicated. Glipizide has a 5% renal clearance and is relatively safe. Studies suggest that glimepiride is the safest of the sulfonylureas.

MONTREAL -- A coronary artery calcium score, obtained via CT, can accurately predict the development of atherosclerotic and ischemic disease in asymptomatic patients with type 2 diabetes, according to a report at the American Society of Nuclear cardiology meeting here.

NEWARK, N.J. -- Race does not seem to substantially affect diabetic retinopathy in type 1 diabetes, according to a six-year study of African Americans here.

WASHINGTON -- The Physicians Committee for Responsible Medicine, a crusading group that has long ranked vegetarianism high on its agenda, has made a compelling case for a low-fat vegan diet to improve glycemic control.

COLUMBUS, Ohio -- One reason African Americans with type 2 diabetes tend to have comparatively poor clinical outcomes may be cultural, investigators here reported.

EXETER, England -- Children who need insulin injections because of a rare type of diabetes may be able to do well instead with an oral sulfonylurea, according to researchers here.

Is the weight gain associated with thiazolidinediones (TZDs) counterproductive to the treatment of diabetes?

PHOENIX, Ariz. -- The onset of type 2 diabetes before age 20 in Pima Indians, who are genetically prone to the disease, was associated with an increased risk of early kidney failure and death between ages 25 to 55, researchers reported.

BOSTON -- Two common genetic variants appear to contribute to the development of type 2 diabetes for some patients with impaired glucose tolerance, found researchers here. But lifestyle moves seem to be able to combat the enhanced risk.

BOSTON -- Women with type 2 diabetes have a nearly two-fold increased risk of developing primary open-angle glaucoma, the most common form of the disease, found researchers here.

Which medications should be stopped first when a patient starts using insulin? Are there any that should be continued?

TORONTO - Diabetes is the clinical equivalent of aging 15 years, thrusting men and women with the disease into a high-risk category for cardiovascular disease while still in middle-age.

BOSTON ? High levels of retinol binding protein 4 (RBP4), which transports vitamin A as its main job, may be an early warning sign for insulin resistance and type 2 diabetes, according to researchers here.

SCOTTSDALE, Ariz. - The two-hour oral glucose tolerance test - often avoided by busy physicians - should be part of the diagnostic work-up for patients with chronic idiopathic axonal neuropathy, researchers here contend.

WASHINGTON - Liraglutide, an investigational injectable drug for type 2 diabetes, has produced significant decreases in HbA1c levels, as well as significant and sustained weight loss, according to phase 2 studies.

WASHINGTON - Tight glucose control leading to episodes of hypoglycemia in patients with type 1 diabetes does not appear to lead to cognitive problems, as some had feared, researchers reported here.

WASHINGTON ? Among patients who live more than 50 years with type 1 diabetes, a significant proportion show evidence of a residual population of insulin-secreting beta islet cells, according to research presented here.

WASHINGTON ? Januvia (sitagliptin), an investigational oral agent for type 2 diabetes, appears to be effective when given as a monotherapy or as an adjunct to Glucophage (metformin) or Actos (pioglitazone), reported researchers here.

WASHINGTON ? If medications for four optimal therapeutic goals of diabetes could be combined into a single pill, the risk of diabetes related heart attacks could be cut in half over the next 30 years.

WASHINGTON ? Antidepressant medications appears to further increase the risk of developing type 2 diabetes in those with impaired glucose tolerance, researchers reported here.

WASHINGTON ? More than three hours a day would be required of patients with type 2 diabetes to follow to the letter all recommended tasks for home care, researchers reported here

WASHINGTON ? Preeclampsia is an independent risk marker for type 2 diabetes, even when gestational diabetes is taken into account, reported researchers here today.

WASHINGTON ? Postmenopasual women with high levels of estradiol and testosterone are at a greatly increased risk for developing type 2 diabetes, according to data from the reported Women's Health Study.

TEMPLE, Tex. - Diabetics who develop foot infections have a 55-fold greater risk of being hospitalized than diabetics without foot infections and a 154-fold higher risk of losing the affected foot, found a multicenter study.

Diabetic nephropathy, the leading cause of end-stage renal disease (ESRD) in the United States, affects 20% to 30% of patients with diabetes. Early diagnosis and aggressive treatment may delay the progression of kidney disease.

MANCHESTER, England ? An investigational gene therapy offers promise for diabetic neuropathy, investigators here reported.

My 46-year-old patient had a fasting plasma glucose level of 115 mg/dL; a followupfasting plasma glucose level was 116 mg/dL.

Diabetes is epidemic! The numbersare truly alarming. In 1997, official datashowed that 16 million people in theUnited States had diabetes. Approximately1 million had type 1 disease,and 10.4 million had type 2 disease; theremainder had undiagnosed diabetes.1If these numbers are projected outagainst an annual increase in diseaseprevalence of about 3.5%, it means thatby the year 2028, 50 million people willhave diabetes. However, the actual rateis closer to 7% each year. As such, approximately100 million Americans-roughly 1 of every 4-will have diabetesby 2028.

Have any specific genes been identified for type 1 or type 2 diabetes? If so, howmany genes are involved?

A 49-year-old man presents for a routine examination. He has a 15-year history of essential hypertension and a 7-year history of hypercholesterolemia and type 2 diabetes mellitus.