Type 2 diabetes in newly diagnosed 'can be reversed'

An extreme eight-week diet of 600 calories a day can reverse Type 2 diabetes in people newly diagnosed with the disease, says a Diabetologia study.

Newcastle University researchers found the low-calorie diet reduced fat levels in the pancreas and liver, which helped insulin production return to normal.

Seven out of 11 people studied were free of diabetes three months later, say findings published in the journal.

More research is needed to see whether the reversal is permanent, say experts.

Type 2 diabetes affects 2.5m people in the UK. It develops when not enough insulin is produced in the body or the insulin that is made by the body doesn't work properly.

When this happens, glucose - a type of sugar - builds up in the blood instead of being broken down into energy or fuel which the body needs.

The 11 participants in the study were all diagnosed with Type 2 diabetes within the previous four years.

They cut their food intake drastically for two months, eating only liquid diet drinks and non-starchy vegetables.

Fat loss

After one week of the diet, researchers found that the pre-breakfast blood sugar levels of all participants had returned to normal.

MRI scans of their pancreases also revealed that the fat levels in the organ had decreased from around 8% - an elevated level - to a more normal 6%.

Three months after the end of the diet, when participants had returned to eating normally and received advice on healthy eating and portion size, most no longer suffered from the condition.

Professor Roy Taylor, director of Newcastle Magnetic Resonance Centre at Newcastle University and lead study author, said he was not suggesting that people should follow the diet.

"This diet was only used to test the hypothesis that if people lose substantial weight they will lose their diabetes.

"Although this study involved people diagnosed with diabetes within the last four years, there is potential for people with longer-standing diabetes to turn things around too."

Susceptibility question

Dr Ee Lin Lim, also from Newcastle University's research team, said that although dietary factors were already known to have an impact on Type 2 diabetes, the research showed that the disease did not have to be a life sentence.

"It's easy to take a pill, but harder to change lifestyle for good. Asking people to shift weight does actually work," she said.

However, not everyone in the study managed to stay free of diabetes.

"It all depends on how much individuals are susceptible to diabetes. We need to find out why some people are more susceptible than others, then target these obese people. We can't know the reasons for that in this study," Dr Lim said.

Professor Edwin Gale, a diabetes expert from the University of Bristol, said the study did not reveal anything new.

"We have known that starvation is a good cure for diabetes. If we introduced rationing tomorrow, then we could get rid of diabetes in this country.

"If you can catch people with diabetes in the early stages while beta cells are still functioning, then you can delay its onset for years, but you will get it sooner or later because it's in the system."

But Keith Frayn, professor of human metabolism at the University of Oxford, said the Newcastle study was important.

"People who lose large amounts of weight following surgery to alter their stomach size or the plumbing of their intestines often lose their diabetes and no longer need treatment.

"This study shows that a period of marked weight loss can produce the same reversal of Type 2 diabetes.

"It offers great hope for many people with diabetes, although it must be said that not everyone will find it possible to stick to the extremely low-calorie diet used in this study."

Dr Iain Frame, director of research at Diabetes UK, which funded the study, said the diet was not an easy fix.

"Such a drastic diet should only be undertaken under medical supervision. Despite being a very small trial, we look forward to future results particularly to see whether the reversal would remain in the long term."

Cancer May Be Linked To Chronic Illnesses.

People With High Blood Pressure, Diabetes, Heart Attack More Likely to Have Cancer
By Jennifer Warner
WebMD Health NewsReviewed by Laura J. Martin, MDApril 2, 2010 --

Having a heart attack or chronic illness may raise the risk of being diagnosed with cancer, according to a new survey.

Researchers found that people with high blood pressure, high cholesterol, or diabetes were about twice as likely to have cancer as healthy people without these chronic illnesses.

In addition, the survey found that people who had suffered a heart attack were nearly three times more likely to have a cancer diagnosis than those who hadn't.

The survey was conducted as part of the Gallup Healthways Well-Being Index and based on telephone interviews with more than 350,000 adults in the U.S. conducted between Jan. 2- Dec. 30, 2008, and Jan. 2- Dec. 29, 2009. It has a sampling error of no more than 1 percentage point.

The survey showed the relationship between a cancer diagnosis and the following health conditions:



Health Condition % Diagnosed With Cancer

High blood pressure 11.8

No high blood pressure 5.0

High cholesterol 11.7

No high cholesterol 5.3

Diabetes 12.7

No diabetes 6.4

Heart attack 18.1

No heart attack 6.5

The risk of developing any of these chronic illnesses increases with advancing age, but researchers say the link between these illnesses and cancer remained significant within every age bracket. The relationship between cancer and some of the conditions, such as heart attack, were especially pronounced under age 45.

Researchers point out that the results do not necessarily mean any of these chronic illnesses cause cancer, but they do show that cancer and chronic conditions share many risk factors and may be interrelated.

For example, smoking cigarettes is a risk factor for both heart attack and lung cancer, and cholesterol itself is not a cancer-causing substance but can enhance the effects of other carcinogens in the body.

Senate report links diabetes drug Avandia to heart attacks

February 20, 2010 4:39 p.m. EST
CNN's Lisa Desjardins, Saundra Young, Miriam Falco and Arthur Brice contributed to this report.

(CNN) -- The diabetes drug Avandia is linked with tens of thousands of heart attacks, and drugmaker GlaxoSmithKline knew of the risks for years but worked to keep them from the public, according to a Senate committee report released Saturday.

The 334-page report by the Senate Finance Committee also criticized the Food and Drug Administration, saying that the federal agency that regulates food, tobacco and medications overlooked or overrode safety concerns found by its staff.

"Americans have a right to know there are serious health risks associated with Avandia and GlaxoSmithKline had a responsibility to tell them," said U.S. Senator Max Baucus, a Democrat and committee chairman. "Patients trust drug companies with their health and their lives and GlaxoSmithKline abused that trust."

The bipartisan report also was signed by Sen. Chuck Grassley, the top-ranking Republican on the committee.

GlaxoSmithKline rejected any assertions Saturday that the drug is not safe.

"We disagree with the conclusions in the report," company spokeswoman Nancy Pekarek told CNN. "The FDA had reviewed the data and concluded that the drug should be on the market."

Seven clinical trials on the drug prove that it is not linked to heart attacks, Pekarek said.

"None of that data shows a statistically significant correlation between Avandia and myocardial ischemia or myocardial infarction [heart attack]," she said.

Ischemia is a condition in which blood flow and oxygen are blocked from going to certain parts of the body.

The Senate committee investigation stems from concerns that Avandia and other high-profile drugs put "public safety at risk because the FDA has been too cozy with drug makers and has been regularly outmaneuvered by companies that have a financial interest in downplaying or under-exploring potential safety risks," the report states.

FDA Commissioner Margaret Hamburg said she is waiting for the recommendations of an advisory committee that will hear reports on the drug this summer.

"Meanwhile," Hamburg said in a statement, "I am reviewing the inquiry made by Senators Baucus and Grassley and I am reaching out to ensure that I have a complete understanding and awareness of all of the data and issues involved."

The Senate report was developed over the past two years by committee investigators who reviewed more than 250,000 pages of documents provided by GlaxoSmithKline, the FDA and several research institutes. Committee investigators also conducted numerous interviews and phone calls with GlaxoSmithKline, the FDA and anonymous whistleblowers.

According to the Senate report:

• FDA scientists estimated in July 2007 that Avandia was associated with approximately 83,000 heart attacks since the drug came to market.

"Had GSK considered Avandia's potential increased cardiovascular risk more seriously when the issue was first raised in 1999 ... some of these heart attacks may have been avoided," the report states.

• GlaxoSmithKline undertook attempts to undermine information critical of Avandia.

"GSK executives attempted to intimidate independent physicians, focused on strategies to minimize or misrepresent findings that Avandia may increase cardiovascular risk and sought ways to downplay findings that a competing drug might reduce cardiovascular risk," the report says.

As an example, committee investigators say they found that GlaxoSmithKline experts verified an outside study showing the cardiac problem, but the company publicly attacked the findings as incorrect.

• Two FDA safety officials sounded a clear alarm in October 2008 writing, "There is strong evidence that rosiglitazone [Avandia] confers an increased risk of [heart attacks] and heart failure compared to pioglitazone [rival drug on market]." They concluded and trials comparing the two would be "unethical and exploitive." Yet, the trial is still under way, the senators say.

GlaxoSmithKline counters that the Senate report relies on outdated information.

"In essence, the report is a compilation of information and events that took place years ago," spokeswoman Pekarek said. "There's no new data there."

The FDA has evaluated at the drug, Pekarek said, and updated product labeling in 2007 to say information on Avandia's relationship to myocardial ischemia is inconclusive.

"The FDA exists to ensure patient safety," she said. "That is their purpose."
Avandia has been under scrutiny for years. The New England Journal of Medicine called the drug's safety into question in 2007. The Journal of the American Medical Association also questioned whether Avandia was safe in 2007.

"Among patients with impaired glucose tolerance or type 2 diabetes, rosiglitazone use for at least 12 months is associated with a significantly increased risk of myocardial infarction and heart failure, without a significantly increased risk of cardiovascular mortality," the AMA journal wrote, adding that the "findings have potential regulatory and clinical implications."

"Regulatory agencies ought to re-evaluate whether rosiglitazone should be allowed to remain on the market," the report said. "Health plans and physicians should not wait for regulatory actions. They should avoid using rosiglitazone in patients with diabetes who are at risk of cardiovascular events, especially since safer treatment alternatives are available."

Read the report

In 2007, an FDA panel recommended by a vote of 22-1 that Avandia should remain on the market despite an analysis showing links to increased risk of heart attack. The vote was not binding, but a suggestion to FDA regulators.

The panel also voted 20-3 at the same meeting in support of data that showed Avandia increased the risk of cardiac ischemia in patients with the most common type of diabetes.

The Senate report does not address the issue of whether Avandia should be removed from the market.