Tag Archives: Diabetes

New drugs help treatment of diabetes 2

STOCKHOLM, Oct. 31(Greenpost)–A new combination of drugs can help individuals with complex type 2 diabetes lower their blood sugar levels, reducing their weight and use fewer insulin doses. This is shown in a study published in The British Medical Journal.

According to a press release reaching here from Gothenburg, individuals with type 2 diabetes who are treated with basal and mealtime insulin injections have few treatment options if their blood glucose is increased, other than increasing insulin doses. This often leads to a downward spiral with increased weight, which can have a negative effect on blood glucose.

In this study Swedish researchers have evaluated the effect of adding liraglutide, a drug that can be used along with oral antidiabetic drugs and basal insulin that has shown positive effects on blood glucose levels, to individuals with type 2 diabetes treated with basal and mealtime insulin.

The study was performed at 14 clinics in Sweden and included 124 participants with type 2 diabetes, overweight and increased blood glucose levels in spite of treatment with basal and mealtime insulin. Participants were randomly assigned to liraglutide or placebo (an inactive substance), and used their assigned drug/placebo for 24 weeks without making other changes to their treatment regimen.

Among all participants, 122 had enough data to be analysed. The main focus was the effect of liraglutide on HbA1c, weight and insulin doses. HbA1c is a test used to indicate blood glucose levels over the last three months. Results after 24 weeks showed that the liraglutide group reduced their HbA1c much more than placebo, with an average difference of 12.3 mmol/mol.

– In earlier studies, an Hba1c reduction of this magnitude has been shown to be associated with a considerablipal investigator Dr. Marcus Lind.

Results also showed that the liraglutide group had weight reductions averaging 3.8 kg, while there was no change in the placebo group. The liraglutide group also had insulin doses that were lowered by 18.1 units, as compared to only 2.3 units in the placebo group.

These results are positive news for people with type 2 diabetes, as it provides another treatment option for those using a complex regimen consisting of basal and mealtime insulin injections. Treatment alternatives conforming to international clinical diabetes guidelines for these types of complex patients are sparse today, according to Dr Lind.

-In contrast to many other studies of novel glucose lowering agents, this study was performed independent of the manufacturer. Study coordination was performed by the NU Hospital Group in Uddevalla, according to study coordinator Sofia Dahlqvist.

The article Liraglutide in people treated for type 2 diabetes with multiple daily insulin injections: randomised clinical trial (MDI Liraglutide trial) was published in BMJ 28 October.

Diabetes medication could be used to treat alcohol dependence

By Xuefei Chen Axelsson

Stockholm, Sept. 12(Greenpost)–A new study on mice and rats at Sahlgrenska Academy shows that a medication used for diabetes and obesity also could be a valuable tool for the treatment of alcohol dependence.

gothenburg-sweden Alcohol dependence causes morbidity as well as mortality and is –major health problem in today’s society. The costs for alcohol dependence in Sweden are estimated to be around SEK 45 billion per year. Nearly 5 percent of the adult population in Sweden have been diagnosed with alcohol dependence, which corresponds to approximately 300 000 people. Even more Swedes have harmful alcohol consumption. Indeed, approximately 15 percent consume more than 14 standard drinks per week (men) or more than nine standard drinks per week (women).

images (1)A new study at Sahlgrenska Academy, University of Gothenburg, shows that interfering with the hormone GLP-1 could be a target for treating alcohol dependence, which is an entirely novel aspect.

Researchers have found that a medication that resemble GLP-1, which is used to treat type 2 diabetes as well as obesity, also could be used to treat alcohol dependence.

Usually, dopamine is released in the brain’s reward center in response to drinking alcohol, which leads to a sense of euphoria. The GLP-1-like substance prevents the ability of alcohol to increase dopamine in reward areas in the mice, suggesting that they no longer experience a reward from alcohol. In addition the diabetes medication caused the rats to decreases their alcohol intake, as well as reduced the motivation to drink alcohol in rats that were bred to drink a lot of alcohol. The medication also prevents relapse drinking in rats, which is major problem for alcohol dependent individuals.

“The GLP-1-like substance reduced the alcohol consumption by 30-40 percent in rats that drank large quantities of alcohol for several months” says Elisabet Jerlhag, researcher at Sahlgrenska Academy.

imagesSimilar mechanisms appear to regulate alcohol dependence and binge eating. The hormone GLP-1 is released from the intestines when we eat and causes satiety. It is also released in the brain and thereby reduces food intake.

“The results of the present study suggest that the physiological role of GLP-1 extends beyond glucose homeostasis and food intake regulation and includes modulation of development of alcohol dependence. In addition we suggest that medications that resemble GLP-1 could be used to treat alcohol dependence in humans. This will now be studied further,” says Elisabet Jerlhag at Sahlgrenska Academy.

The article The glucagon-like peptide 1 receptor agonist liraglutide attenuates the reinforcing properties of alcohol in rodents was published in the journal Addict Biology on August 25.

Link to article: http://www.ncbi.nlm.nih.gov/pubmed/26303264

 

Insulin pump reduces mortality from cardiovascular disease by almost 50%

Insulin pump reduces mortality from cardiovascular disease by almost 50%

Stockholm, July 6(Greenpost)–People with type 1 diabetes who use insulin pump therapy face almost 50% less risk of dying from cardiovascular disease than those who take insulin by multiple daily injections, according to a statement reaching here from Gothenburg.

The British Medical Journal has published the study conducted at Sahlgrenska Academy.

Based on the Swedish National Diabetes Register, researchers monitored 18,168 Swedes with type 1 diabetes from 2005 to 2012. While 2,441 of the subjects used insulin pump therapy, the others relied on multiple daily injections.

The study found that insulin pump users had a substantially lower risk of dying of cardiovascular disease than the daily injection group. The correlation was statistically certain.

“We carefully analyzed the findings to eliminate the risk of bias or confounding and concluded that the effect had been fully verified,” says Isabelle Steineck, researcher at Sahlgrenska Academy.

The next step will be to identify the mechanisms that explain the extra benefits of insulin pump therapy. Dr. Steineck believes that one reason for the difference between the two therapies is that the insulin pump method is accompanied by more extensive patient training and more frequent blood glucose monitoring.

”There is a rationale for insulin pump treatment resulting in more stable blood glucose concentrations than multiple daily injections” she says. ”Previous studies have shown that insulin pump can reduce the frequencies of severe hypoglycemic episodes. Severe hypoglycaemia can be a risk factor for cardiovascular events, particularly among high risk individuals.”

”We evaluated the patients who used insulin pump therapy and do not know if the observed effect is attributable to continuous infusion of insulin or that some of the effect is attributable to intensified glucose monitoring, increased motivation to control blood glucose, or a better knowledge about having diabetes type 1”says Isabelle Steineck.

The researchers have concluded that insulin pumps not only make life easier for patients, but represent a safe and effective treatment method.

“This is good news for anyone with type 1 diabetes,” says Soffia Gudbjörnsdottir, diabetologist and director of the Swedish National Diabetes Register. “But not everybody wants to use a pump, and the biggest priority is still to optimize blood glucose monitoring.”

Approximately 20% of Swedish type 1 diabetes patients have access to insulin pump therapy. But earlier studies at Sahlgrenska Academy have demonstrated that hospitals vary greatly – anywhere from 12% to almost 30% of patients may receive pumps.

The article “Insulin Pump Therapy, Multiple Daily Injections and Cardiovascular Mortality in 18,168 People with Type 1 Diabetes: Observational Study” was published online by the British Medical Journal on June 22.

Link to article: http://www.bmj.com/content/350/bmj.h3234