Our local pumper’s club had its annual ADA scientific meeting update
by one of the local endocrinologist last night. A couple of the
highlights. This is based on my inadequate notes and faulty memory of
what is always a session punctuated with many questions that tends to
interrupt narrative clarity.
For the type 2s – Progress continues apace on the analogs to GLIP-I
(Glucagon Like Peptide I). GLIP-I increases insulin output,
regenerates damaged beta cells, slows glucose absorption into the
blood, and causes weight loss. Diabetics show loss of production of
GLIP-I. The down side of GLIP-I is that it is short lived. A shot
starts working in 10 minutes and it is gone in an hour. Everybody and
their grandmother are looking for long acting analogs. Farthest in
the pipeline is Exenatide (the famous lizard spit peptide) for which
phase 3 trial data was released at the meeting. The results include
reductions in A1c of 1 to 1.5 points, continued weight loss through 52
weeks, no additional hypoglycemia, and beta cell regeneration.
Treatment requires 2 subcutaneous shots/day. Roll out is expected in
June 2005. Wide use in the type 2 community is expected. Several
other analogs are starting trials including one that binds to albumin
but remains active and one with a few amino acids switched that
doesn’t break down. Others are working on inhibiting the breakdown
mechanism with some success.
Type 1 & 2 – Many (most?, all?) complications appear to ultimately
result from oxidation problems in the mitochondria. New very powerful
antioxidants are in the works. Vitamin C and E are useless in this
regard. In fact, they are strongly contraindicated in diabetics
taking statins. Prospective trials have shown C and E to counter the
secondary beneficial actions of statins.
Type 1 & 2 – DIAD Trial (Detection of Ischemia in Asymptomatic
Patients With Diabetes) 75-80% of diabetics die of adverse
cardiovascular events. 50% of those have no chest pain to trigger
emergency call. For 1/3, death is the result of their first
cardiovascular event. DIAD is an attempt to find those at risk who
are missed because they do not show symptoms. The diagnostic test is
a stress heart scan. 20% of those scanned have a clear cardio
vascular problem. 1/3 of those have a major problem which requires
treatment, e.g. stent placement. There will be 4 more years of follow
up to see if the detection and treatment result in improvements in
mortality. The presenter is screening all his 50+ year old diabetics
every 2 years. If you are clear in the stress heart scan, you have a
very low chance of a problem in the following 2 years.
–
——-
Charly Coughran
ccough…@DELETE-TO-RESPOND-UCSD.EDU
Thanks for a very interesting post!
–
Ed
T2 04/99 Starlix & Glucophage
Edward Rutter Jr. <ed….@verizon.net> quoth:
>Thanks for a very interesting post!
I second the gratitude! Very helpful.
Priscilla
On Tue, 10 Aug 2004 18:01:21 +0000 (UTC), Charly Coughran
- Hide quoted text — Show quoted text -
<ccough…@REMOVE-TO-DELETE-UCSD.EDU> wrote:
>Our local pumper’s club had its annual ADA scientific meeting update
>by one of the local endocrinologist last night. A couple of the
>highlights. This is based on my inadequate notes and faulty memory of
>what is always a session punctuated with many questions that tends to
>interrupt narrative clarity.
>For the type 2s – Progress continues apace on the analogs to GLIP-I
>(Glucagon Like Peptide I). GLIP-I increases insulin output,
>regenerates damaged beta cells, slows glucose absorption into the
>blood, and causes weight loss. Diabetics show loss of production of
>GLIP-I. The down side of GLIP-I is that it is short lived. A shot
>starts working in 10 minutes and it is gone in an hour. Everybody and
>their grandmother are looking for long acting analogs. Farthest in
>the pipeline is Exenatide (the famous lizard spit peptide) for which
>phase 3 trial data was released at the meeting. The results include
>reductions in A1c of 1 to 1.5 points, continued weight loss through 52
>weeks, no additional hypoglycemia, and beta cell regeneration.
>Treatment requires 2 subcutaneous shots/day. Roll out is expected in
>June 2005. Wide use in the type 2 community is expected. Several
>other analogs are starting trials including one that binds to albumin
>but remains active and one with a few amino acids switched that
>doesn’t break down. Others are working on inhibiting the breakdown
>mechanism with some success.
>Type 1 & 2 – Many (most?, all?) complications appear to ultimately
>result from oxidation problems in the mitochondria. New very powerful
>antioxidants are in the works. Vitamin C and E are useless in this
>regard. In fact, they are strongly contraindicated in diabetics
>taking statins. Prospective trials have shown C and E to counter the
>secondary beneficial actions of statins.
>Type 1 & 2 – DIAD Trial (Detection of Ischemia in Asymptomatic
>Patients With Diabetes) 75-80% of diabetics die of adverse
>cardiovascular events. 50% of those have no chest pain to trigger
>emergency call. For 1/3, death is the result of their first
>cardiovascular event. DIAD is an attempt to find those at risk who
>are missed because they do not show symptoms. The diagnostic test is
>a stress heart scan. 20% of those scanned have a clear cardio
>vascular problem. 1/3 of those have a major problem which requires
>treatment, e.g. stent placement. There will be 4 more years of follow
>up to see if the detection and treatment result in improvements in
>mortality. The presenter is screening all his 50+ year old diabetics
>every 2 years. If you are clear in the stress heart scan, you have a
>very low chance of a problem in the following 2 years.
Thanks so much for that Charly.
Cheers, Alan, T2 d&e, Australia.
Remove weight and carbs to email.
—
Everything in Moderation – Except Laughter.