[acb-diabetics] multiple articles

[Patricia LaFrance-Wolf]

1. Heartwire  Increased Risk of Diabetes Observed Among Statin-Treated
Patients 2/17/10  — New data from a large meta -analysis of major statin
trials

suggests the LDL-cholesterol–lowering drugs slightly increase the risk of
developing diabetes mellitus. Investigators stress, however, that clinical
practice

should remain unchanged in patients with moderate or high cardiovascular
risk, given the low absolute risk of developing diabetes, particularly when
when

compared with the benefit of statins. "We found that there was indeed a risk
of DMabout 9%, but it isn't a worrying increase as had been suggested by
other

studies," said co–lead investigator.Dr Steven Nissen  praised the
researchers and agreed with their conclusions, stating that the benefits of
statins exceed

the risk of diabetes and that physicians should not alter clinical practice
based on these findings. . "Whatever this effect is, it doesn't lessen the

favorable effect of statins on clinical outcomes. I don't think people
should hesitate to give prediabetic patients statins because they might
develop

diabetes a few weeks or a few months later and

deny them all the other benefits of these drugs."

 

2.%% Medscape Diabetes & Endocrinology - Re-thinking the Diagnosis of
Diabetes: Is A1C the Final Answer? 2/9/10 In July 2009, an international
expert committee

published a report that made the

case for using the hemoglobin A1C assay to diagnose T2DM. The committee
included members appointed by (ADA),  European Assoc for the Study of
Diabetes

(EASD), and the Internat  Diabetes Fed (IDF).  Summary, the expert panel has
suggested that the A1C assay be used to diagnose DM recommending 6.5% as the

diagnostic threshold, and the ADA has now accepted the suggestion. .in 2008,
another group suggested the very same thing.  If an expert panel wanted to

take on the topic of diagnosing DM, perhaps it is time to turn away from the
glucose-centric definition to one that more clearly represents the full
cardiometabolic

risk of the individual patient.

 

3.%% MW Monitoring Helps Stop Drug-Associated Hyperkalemia Events in
Diabetics ) Feb 10 - Angiotensin-converting enzyme inhibitors and other
agents that

block the renin-angiotensin -aldosterone (RAA) system are used to slow the
progression of renal disease in patients with T2 and hypertension. However,

these drugs can cause hyperkalemia. [high potassium] [27355 patients]
Overall, subjects with potassium monitoring were 50% less likely to have  a
hyperkalemia

event. For patients with chronic kidney disease, the risk reduction with
monitoring was -- 71%. "This study offers tangible evidence to support
published

guidelines that recommend monitoring serum potassium among patients with
these clinical characteristics who are started on RAA system inhibitors,"
the

authors conclude. J Gen Intern Med 2010.

 

4.%%  Exercise and Type 2 Diabetes 2/09/2010 Retinopathy. Although exercise
increases systemic and retinal blood pressures, there is no evidence that
physical

activity acutely worsens the retinopathy present in DM. Bernbaum et al found
that T1 & T2 individuals with proliferative retinopathy who engaged in a low

-intensity training program improved cardiovascular function by 15%. Thus,
in a well- supervised environment, low-intensity aerobic activity can be
safely

performed by persons with retinopathy. they need to be cautioned about
engaging in activities that cause blood pressure to increase dramatically,
such

as head-down or jarring activities or those with arms overhead... Physical
activity affords significant benefits for those with T2. . Several factors
including

muscle fiber composition, low capillary density, obesity, and older age
require that physical activity be initiated at lower intensity/ duration and
be

increased gradually to reduce risks and contribute to maintenance of
physical activity by those with T2..

 

5.%% Tailoring Treatment to the Individual in T2DM  2/11/10; Int J Clin
Pract. 2010;64(3): Abstract - Good glycaemic control continues to be the
most effective

therapeutic manoeuvre to reduce the risk of development and/or progression
of microvascular disease, and therefore remains the cornerstone of DM
management..

Our recently updated '10 steps to get more T2 patients to goal'  remains the
blueprint in terms of practical guidance for helping patients to achieve and

maintain their glycaemic targets. However, having reviewed the evidence, we
recognise that individualising targets and/or treatment according to patient

type is paramount. For example, while early intervention is preferred
wherever appropriate, certain high risk groups may not respond to overly
intensive

glucose- lowering regimens.  Table 1. Individualising the '10 steps to get
more T2 diabetes patients to goal' according to patient type..

 

6.%% Classification System for Diabetic Nephropathy May Advance Patient Care
2/18/10 An international group of physicians has designed a categorization

system for diabetic nephropathy (DN), the chief cause of kidney failure.
"DN is a complex condition with varying degrees of severity and varying
effects

on the kidneys," write the researchers. The team separated DN into 4
classes, based on biopsy findings. They range from the least severe (class
1) to the

most severe (class 4): ..The classification system will help scientists
discover more about the pathways of DN progression, and therefore improve
patient

care, the authors predict. They note  future research should focus on
evaluating clinical results.

 

7.%% MW Diabetes Drug Stinks, Doctors Find (Reuters) Feb 16 - Metformin
stinks, literally, and this may explain why many patients stop taking it a
group

of doctors wrote.. It smells like fish or dirty socks to some people, and
this could account for the well known side effects of the drug, which can
make

people nauseated. But the problem could be solved by coating the pills so
they do not smell or release the odor into the stomach, where it can be
burped

up. One patient  had taken brand-name metformin (Glucophage) before being
switched to an immediate- release, generic version which he refused to take.


An extended release generic version, coated to make it dissolve more slowly,
solved the problem. . "Trial of a film-coated, extended-release formulation

may be a reasonable approach in such cases." 

 

8.%% Dolphins have diabetes off switch  BBC News 2/19/10

A study in dolphins has revealed genetic clues  that could help medical
researchers to treat T2DM. Scientists said that bottlenose dolphins are
resistant

to insulin - just like people with DM. But in dolphins, this resistance is
switched on and off.  insulin - the hormone that  reduces the level of
glucose

in the blood - has  no effect on the dolphins when they fast. In the
morning, when they have their breakfast,  they simply switch back into a
non-fasting

state. . the  mammals may have evolved this fasting-feeding  switch to cope
with a high-protein, low-carbohydrate diet of fish. "Bottlenose dolphins
have

large brains that need  sugar, Since their diet is very low in sugar, "it
works to their advantage to have a condition that keeps blood  sugar in the
body


to keep the brain well fed". . other marine mammals, such as seals, do not
have this switch, and they think that  the "big brain factor" could be what

connects  human and dolphin blood chemistry. “And we have found changes in
dolphins that  suggest that [this insulin resistance] could get  pushed into

a disease state. "If we started  feeding dolphins Twinkies, they would have
diabetes."  They hope  to work with medical researchers to turn the
discovery

in dolphins into an eventual treatment for humans. 

 

9.%% NYTimes 2/20/10 Research Ties Diabetes Drug to Heart Woes

Hundreds of people taking Avandia, a controversial DM drug

needlessly suffer heart attacks and heart failure  each month, according to
confidential government reports that recommend the drug be removed from the

market. ..MedWatch 2/23/10  FDA Safety Information and Adverse Event
Reporting Program -  Avandia (rosiglitazone): FDA notified healthcare
professional

and patients that it is reviewing the primary data from a large, long-term
clinical study, RECORD, on possible cardiovascular [CV] risks with Avandia.

In addition to the clinical trial, a number of observational studies of the
CV safety of rosiglitazone have been published and FDA has been reviewing
these

on an ongoing basis. . no new conclusions or recommendations about the use
of [Avandia]  in the treatment of T2DM have been made at this time. .the
agency

will present the totality of new and existing CV safety data on Avandia  in
July 2010. FDA recommends that healthcare professionals follow the
recommendations

in the drug label.  Patients should continue taking rosiglitazone unless
told by their healthcare professional to stop. Patients who are concerned
about

the possible risks associated with using rosiglitazone should talk to their
healthcare professional.

 

10.%% Diabetic Retinopathy and Blockade of the Renin–Angiotensin System: New
Data from the DIRECT Study Programme  2/17/10; Eye. 2010;24(1): %%In
summary,

we suggest that candesartan should be considered for all 'at risk patients'
with T1DM  those of more than 6-year duration of diabetes, especially if
there

is an indication for RAS blockade such as the presence of albuminuria or
hypertension. In T2DM, candesartan should be considered for patients with
early

stages of diabetic retinopathy, particularly if there is an indication for
RAS blockade.  Key points - Vascular risk factors must be addressed

Blood glucose, BP control, & lipid lowering are important * Caution and
counselling in women of child-bearing age, and this drug should be
discontinued

if planning for pregnancy or on the first notification of pregnancy.

 

11.%% MW Diabetes Slows Return of Continence After Laparoscopic
Prostatectomy 2/12/10— Patients with DM who undergo laparoscopic radical
prostatectomy

often experience a slower return of urinary continence than do men without
DM. study found that 43.7% of DM patients are continent within 3 months of
surgery

vs 57.8% of non-diabetics. .The findings also suggest that diabetics who've
had DM for 5 years or longer are nearly 5 times more likely to have post-
prostatectomy

incontinence than are those with a shorter disease duration. In addition, an
elevated HbA1c value was predictive of incontinence on long-term follow-up.

"Urinary incontinence remains a clinically important complication after
radicalprostatectomy and has a significant negative impact on patient
quality of

life," said the senior author [135 diabetics/ 135 controls.] J
Urol.2010;:Reuters Health 

 

12.%% Diabetes Feb 2010 vol. 59 no. 2   Duration of Lactation and Incidence
of the Metabolic Syndrome in Women of Reproductive Age According to
Gestational

Diabetes Mellitus *GDM) Status: A 20-Year Prospective Study in CARDIA
(Coronary Artery Risk Development in Young Adults) [1399 women 39% black age
18–30

years) Conclusions  Longer duration of lactation was associated with lower
incidence of the metabolic syndrome years after weaning among women with a
history

of GDM and without GDM, controlling for preconception measurements, BMI, and
sociodemographic and lifestyle traits. Lactation may have persistent
favorable

effects on women's cardiometabolic health.

 

13.%% Nat Rev Endocrinology 6 March 2010 | Type 1 diabetes mellitus (T1DM)
is a chronic condition characterized by autoimmune destruction of the
pancreatic

ß cells; as a consequence, affected individuals are unable to produce
insulin and maintain adequate glucose homeostasis. Daily administration of
exogenous

insulin has long been the mainstay of the clinical management of patients
with T1; however, therapeutic use of insulin has a number of drawbacks.
Although

efforts have been made to address at least some of these problems, novel
approaches to the treatment of T1DM are clearly warranted. Over the past
decade,

increased understanding of the pathogenesis of T1DM, at both the molecular
and cellular level, has aided the development of potential noninsulin-based

therapies for T1 

These therapies are diverse in nature and range from stem-cell
transplantation to replenish the damaged pancreatic ß cells to modulation of
the immune

response. Other approaches aim to prevent development of T1DM in the first
place. This Focus issue provides an expert overview of noninsulin therapies

currently in

development or clinical trials, all of which have been identified by leaders
in the field as promising strategies for the future management of patients

with T1DM.

 

14.%% Nature  Reviews Endocrinology  6, (Mar 2010) FOCUS ON:  Noninsulin
therapies for T1DM :[NRE 3/2010 T1] Immunomodulation with microbial vaccines
to

prevent T1 Abstract - Selected bacteria, viruses, parasites and nonliving,
immunologically active microbial substances prevent autoimmune DM in animal

models. Such agents might also have a protective effect in humans by
providing immune stimuli critical during childhood development. The 'hygiene
hypothesis'

proposes that reduced exposure to environmental stimuli, including microbes,
underlies the rising incidence of childhood autoimmune diseases, including

T1DM. This hypothesis is supported by data that highlight the importance of
infant exposure to environmental microbes for appropriate development of the

immune system.. This finding raises the possibility of using live,
nonpathogenic microbes (for example, probiotics) or microbial components to
modulate

or 're-educate' the immune system and thereby vaccinate against T1. Progress
has been assisted by the identification of receptors and pathways through

which gut microbes influence development of the immune system. 

 

15.%% [NRE 3/2010 T1]] :Stem cell therapy for T1DM Abstract - The use of
stem cells in regenerative medicine holds great promise for the cure of many
diseases,

including T1 Any potential stem-cell-based cure for T1DM should address the
need for ß-cell replacement, as well as control of the autoimmune response

to cells which express insulin. The ex vivo generation of ß cells suitable
for transplantation to reconstitute a functional ß-cell mass has used
pluripotent

cells from diverse sources, as well as organ-specific progenitor cells from
the liver and the pancreas. The most effective protocols to date have
produced

cells that express insulin and have molecular characteristics that closely
resemble bona fide  insulin-secreting cells; however, these cells are often

unresponsive to glucose This Review focuses on current strategies to obtain
cells which express insulin from different progenitor sources and highlights

the main pathways and genes involved, as well as the different approaches
for the modulation of the immune response in patients with T1DM.

 

16.%% [NRE 3/2010 T1] Selective depletion of B lymphocytes with rituximab
preserves ß-cell function   Selective depletion of B lymphocytes could
represent

a novel approach to the management of patients with newly diagnosed T1
according to phase II data. “.. a treatment that specifically targets B
cells can

lead to preservation of insulin secretion,” explains a lead researcher.“It
now opens the field up to alternative therapies that target B cells, either

as single agents or perhaps combined with other agents.”  The progressive
autoimmune destruction of pancreatic ß cells characteristic of T1 is widely
believed

to involve T lymphocytes. However, studies of the nonobese diabetic (NOD)
mouse suggested that B lymphocytes might also play a part. . rituximab—a
chimeric

anti-CD20 monoclonal antibody developed to treat hematological neoplasias
-has shown promise for the treatment of autoimmune diseases, such as
rheumatoid

arthritis. [87 patients with newly diagnosed T1] results of this study
suggest that selective depletion of B lymphocytes can preserve ß-cell
function in

patients with new- onset T1. The next step is to optimize therapies that
target B lymphocytes.

 

17.%%[NRE 3/2010 T1] Immune therapy for T1DM what is unique about anti-CD3
antibodies?  T1 is a prototypic organ-specific autoimmune disease that
results

from selective destruction of insulin-secreting ß-cells by immune-mediated
inflammation (insulitis), that is, the infiltration of pancreatic islets by

autoreactive CD4 + and CD8+ T lymphocytes. Current treatment is substitutive
- chronic use of exogenous insulin -which, in spite of considerable
advances,

is still associated with constraints and lack of effectiveness over the
long-term in relation to the prevention of vascular and neurological
complications.

Finding a cure for T1DM is an important medical health challenge, as the
disease's incidence is steadily increasing in industrialized countries and
projections

of future prevalence are alarming. Crucially, as T1 mainly affects children
and young adults, any candidate immune therapy must be safe and avoid
chronic

use of immunosuppressants that promote sustained depression of immune
responses. The ideal approach would, therefore, involve induction or, in the
case

of established T1 restoration of immune tolerance to target autoantigens.
This Review presents, in particular, 2 strategies that are still in clinical

development but hold great promise - the use of candidate autoantigens and
anti-CD3 monoclonal antibodies.    Autoimmune diseases such as T1 ensue from

the rupture of tolerance to self antigens, which is usually maintained
through a variety of immune mechanisms.. it is well accepted that both
genetic and

environmental factors (with either a predisposing or a protective role) are
involved...T lymphocytes involved in T1DM are heterogeneous, and include
pathogenic

cells (both CD4 + and CD8+ T cells) and specialized subsets of regulatory T
cells (TREG) that play a key role in the control of disease progression.
Recent

studies also stress the role of inflammatory mediators in the amplification
of the immune reaction.Various candidate autoantigens have been identified

as possible triggers of T1DM, including the main ß-cell hormone insulin (or
proinsulin) itself,  glutamic acid decarboxylase (GAD),  a ß-cell-specific

protein phosphatase,  a peptide of heat shock protein 60 (hsp60),  IGRP
(also called glucose-6-phosphatase 2), and the most recently characterized
zinc

transporter, ZnT8, which is a preferential target of pathogenic CD8 + T
cells...Immune therapy represents the only sensible therapeutic option for
T1DM,

as it is the only way to tackle the causal pathogenic mechanisms.
Well-designed immune intervention trials have been conducted and from the
data recovered,

major proofs of concept have emerged. The aim of this Review is to outline
these strategies and their pros and cons. .[90pages +]© 2010 Nature
Publishing

Group, a division of Macmillan Publishers Limited. 

 

18.%%[NRE 3/2010 T1]: Blockade of interleukin 1 in T1DM  Abstract -
Interleukin 1 (IL-1) is a 17 kDa protein highly conserved through evolution
and is

a key mediator of  inflammation, fever and the acute-phase response. IL-1
has important functions in the innate immune defense against microbes,
trauma

and stress, and is also an effector molecule involved in tissue destruction
and fibrosis. The inhibition of IL-1 action has clinical efficacy in many
inflammatory

diseases, such as hereditary auto-inflammatory disorders, gout, rheumatoid
arthritis and T2DM - a common metabolic condition caused by insulin
resistance

and pancreatic ß-cell failure, the causes of both of which have inflammatory
components. IL-1 signaling has roles in [includes] ß-cell dysfunction..  In

addition, IL-1 acts on T-lymphocyte regulation. Genetic or pharmacological
abrogation of IL-1 action reduces disease incidence in animal models of
(T1DM)

and clinical trials have been started to study the feasibility, safety and
efficacy of IL-1 therapy in patients with T1 Here, we review the rationale
for

blocking IL-1 in patients with T1DM.

 

19.%% [NRE 3/2010 T1]:Stem cell and gene therapies for diabetes mellitus
Abstract - In this Perspectives article, we comment on the progress in
experimental

stem cell and gene therapies that might one day become a clinical reality
for the treatment of patients with diabetes mellitus. Research on the
ability

of human embryonic stem cells to differentiate into islet cells has defined
the developmental stages and transcription factors involved in this process.

However, the clinical applications of human embryonic stem cells are limited
by ethical concerns, as well as the potential for teratoma [tumor]
formation.

As a consequence, alternative forms of stem cell therapies, such as induced
pluripotent stem cells and bone marrow-derived mesenchymal stem cells, have

become an area of intense study. Finally, gene therapy shows some promise
for the generation of insulin-producing cells. Here, we discuss two of the
most

frequently used approaches: in vitro  gene delivery into cells which are
then transplanted into the recipient and direct delivery of genes in vivo.

 

20.%% .Excessive Weight Gain in Early Pregnancy Linked to Gestational
Diabetes (GDM) 2/23/10 The lead author( Kaiser Permanente Med Group
Oakland,) said

"Our research shows that weight gain in early pregnancy is a modifiable risk
factor for GDM. Randomized studies are needed to determine the feasibility

of this early intervention and the best methods to help women meet the
[Institute of Medicine] recommendations." [345 patients with GDM & 800
controls]

screened for GDM at 24 -28 wks of gestation. When compared with the lowest
[3rd] of rate of gestational weight gain < 0.60 lb/wk, higher rates of
weight

gain were associated with increased risks for GDM. The association was
stronger in obese or overweight  women & in nonwhite women. Obstet Gynecol
2010;115:

 

21.%% MW Walnuts Shown to Improve Endothelial Function in Diabetics 2/22/10
The daily consumption of walnuts has the potential to improve endothelium
function

and plasma lipids in patients with

T2DM  With a high polyunsaturated and monounsaturated fat content, many
types of nuts have gained favor as a healthy addition to any diet, and
walnuts,

in particular, have a high level of omega-3 fatty acids. Researchers
theorized that the addition of walnuts could provide cardiovascular [CV]
benefits

to diabetics. "We know nuts are rich in fiber, and have a variety of
micronutrients, minerals, B vitamins, magnesium, and a number of properties
that make

them a likely candidate for benefits in people with CV risk," a coauthor
said. [randomized controlled crossover trial - 24 T2 subjects]The primary
outcome

measure for the study was a change in flow-mediated dilatation (FMD) after 8
weeks, and secondary outcome measures included changes in plasma lipids, 

(HbA1c), fasting glucose, insulin sensitivity. There was a significant
improvement in FMD among the participants consuming the walnut-enriched
diet, compared

with those not consuming diets with walnuts "We did not see significant
improvement compared with placebo in a variety of the other cardiac risk
factors

we measured as secondary outcomes, but when it comes to endothelial
function, I'm reminded of The Lord of the Rings. It's the 1 ring to rule
them all,"

he said. "What it tells us is how the blood vessels are feeling in light of
everything that is flowing by. You can measure everything you can think of

that is flowing by, such as LDL cholesterol, triglycerides, or stress
hormones, or you can simply ask the blood vessels, in essence: 'Given
everything

that is floating by, how are you feeling today?' " "And the blood vessels in
this study said, 'we feel better after we've been fed walnuts daily.'" The

results showed no significant weight gain among subjects receiving

walnut supplementation. “..our study suggests you can make room for a highly
nutritious food in your diet, particularly if it tends to fill you up, as

nuts do."

Almonds, too, appear to have their own unique benefits for diabetes, he
added. "Omega-3 fatty acids that are mostly in walnuts are very good for
nerve

development and the brain, and also the heart, but some research suggests
that almonds have specific sugar-control qualities." American Academy of
Pain

Medicine (AAPM) 26th Annual Meeting: Poster abstract 212645.

 

22. %%Are Different Oral Antidiabetics Associated With Different Adverse
Outcomes?  2/16/2010 Risk of Cardiovascular Disease and All-Cause Mortality
Among

Patients With T2DM Prescribed Oral Antidiabetes Drugs: BMJ. 2009;  Summary
study used UK Database to investigate the risk for incident myocardial
infarction

(MI), congestive heart failure (CHF), and all- cause mortality associated
with prescription oral antidiabetic agents. [5 million people].. The higher
mortality

risk associated with sulfonynureas (SUs) reported in the current study
further suggests that SU therapy should perhaps be used sparingly, as
suggested

by recent guidelines.

 

23. %%MW  Depression Linked to Increased Risk of Diabetes Mellitus in Older
Individuals 2/18/10  Nonsevere, persistent, and untreated depression may
lead

to the development of diabetes in people older than 55 years. In addition,
clinically significant depression was linked to a 65% increased risk of
incident

diabetes mellitus, writes the team   The aim of the study was to examine the
association between clinically significant depression (not limited to major

depression disorder - MDD) and risk of diabetes development. The
investigators also examined DM risk with respect to nonsevere depression,
first- -ever

depression, persistent depression, and untreated depression. [3521 subjects
+ 55 yrs]  Results showed that "the risk of incident DM was higher among
those

with depression when compared with nondepressed subjects, The incidence rate
was 19.70 per 1000 person-years for the depressed patients compared with
12.36

per 1000 person-years for the nondepressed patients.  "the estimated rate of
diabetes mellitus attributable to depression was 6.87%."

 

24.%% JH Is Diabetes in Your Genes? In the US, nearly 10% of adults age 20
and older have diabetes.  If you’re in this huge group, you may wonder if
you

inherited your DM.  Scientists are still sorting out how heredity influences
the risk of diabetes, but there is no doubt that the genes we receive from

our parents play a vital role. It's important to keep in mind, though, that
inheriting a given gene or set of genes does not guarantee you will develop

DM. Instead, certain genes increase the susceptibility for developing the
disease. Environment -- your eating habits, activity levels, stress, etc. --

also plays a significant role. Genes are units of biochemical information
found in the nucleus of every cell that dictate how the body appears and
functions.

.. "variations" in certain genes seem to increase the risk of many diseases,
including both major forms of diabetes. For instance, studies show that
people

with T1DM tend to have variations in genes that carry the code for producing
immune system proteins. Variations in a number of genes appear to increase

the risk of T2DM. However, genes alone do not cause DM in most cases.
Something in the environment must "trigger" onset of the disease in people
whose

genes make them susceptible. While several theories attempt to explain what
triggers T1, most evidence suggests that a high-fat Western diet and lack of

exercise interacts with a person's genes to cause T2.

 

25.%% Oph 117,3 Mar 2010 OphSource In Vivo Retinal Morphology after Grid
Laser Treatment in Diabetic Macular Edema  Conclusions - Spectral domain OCT
provides

new insight into the immediate morphologic changes after laser treatment
using the PASCAL laser system. Standardized grid photocoagulation induces
characteristic

homogenous alteration in the neurosensoric retinal layers. Biometric
changes, indicating an immediate effect, were observed within 1 day after
treatment.

 

26.%% Oph 117,3 Mar 2010 High-Resolution Imaging of the Human Retina In Vivo
after Scatter Photocoagulation Treatment Using a Semiautomated Laser System


Results - At day 1 after PRP, the photocoagulation effects were sharply
delineated from the

surrounding unaffected retina and all spots seemed to be identical in size
and location. The area of tissue destruction was confined to the outer
retinal

layers, extending from the outer nuclear layer (ONL) to the retinal pigment
epithelium (RPE). At 1 week, images showed a progressive loss of the
affected

outer retinal layers,..The ONL recovered partially, but the PRL inner and
outer segments remained absent. During the long-term follow-up, RPE cells
migrated

to the center of the lesion, forming a hyperplastic scar. Conclusions - The
characteristic morphology of retinal photocoagulation effects in vivo and
over

time was identified for the first time in human eyes using SD-OCT.

 

27.%% MNTD VEGF Trap-Eye Shows Positive Results In A Phase 2 Study In
Patients With Diabetic Macular Edema 2/19/10   "The magnitude of the gain in
visual

acuity achieved with VEGF Trap-Eye in this Phase 2 study demonstrates the
biologic activity of VEGF Trap-Eye in treating diabetic macular edema, a
disease

in which high levels of vascular endothelial growth factor (VEGF) are
present," said the Principal Investigator for the study.The adverse events
reported

were those typically associated with intravitreal injections or the
underlying disease. Including: conjunctival hemorrhage, eye pain, floaters
(myodesopsia),

ocular redness (hyperemia), and increased intraocular pressure.

 

28.%% MedWatch - The FDA Safety Info.. Adverse Event Reporting Program
OneTouch SureStep Test Strips (LifeScan): Recall

LifeScan and FDA notified healthcare professionals of a voluntary recall of
eight lots of OneTouch SureStep Test Strips which are being recalled because

they may provide falsely low glucose results when the glucose level is
higher than 400 mg/dL. If patients use the falsely low test results to
determine

their insulin dose, they may give themselves too little insulin, which could
result in poor blood glucose

control. The 8 lots of Test Strips being recalled are identified in the
firm's press release. Lot numbers  are located on the outer carton and test
strip

vial. LifeScan estimates approximately fourteen thousand packages  were
distributed nationwide between August 1, 2009 and January 28, 2010. It is
important

that patients with recalled test strips continue to test their blood
glucose. Patients with access to a meter that does not use OneTouch SureStep
Test

Strips should use this other meter to test their blood glucose until
replacement product from LifeScan arrives. If an alternate meter is not
available,

patients may continue to test using the recalled OneTouch SureStep Test
Strips. However, if patients obtain results above  400 mg/dL, they should
contact

their healthcare professional for further instructions because their glucose
may be significantly higher. Read the complete MedWatch 2010 Safety summary

& link to the firm's press release, at: 

www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalPro
ducts/ucm202254.htm

 

- Abbreviations:  DM - diabetes Mellitus;T1DM - type 1 diabetes mellitus
T2DM - type 2; DME - diabetic macular edema; GDM - gestational diabetes; FPG
-

fasting plasma glucose BP - blood pressure; CVD - cardio-vascular disease;
MI -myocardial infarction or heart attack ;HTN - hypertension or high BP;
OCT

- optical coherence tomography; VA - visual acuity  -ADA - Amer Diabetes Ass
& ADA Professional Resource Online; FDA Federal Drug Adm. JHA - Johns
Hopkins

Alerts ; MW Medscape Web MD; NIH - National Institutes of Health;  MNTD-
Medical News Today  Definitions via online Medical dictionaries.
Disclaimer,

I am a BSN RN but not a diabetic or diabetic educator. Reports are excerpted
unless otherwise noted. This project is done as a courtesy to the
blind/visually

impaired and diabetic communities. Dawn Wilcox BSN RN Coordinator The Health
Library at Vista Center; an affiliate of the Stanford Hospital Health
Library.  

contact above e-mail or 

thl at vistacenter.org     

            

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