Saturday, 9 June 2007

Like vultures on Dick Cheney's hunting trip (safe)

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House Calls, a popular newsletter written by the prestigious Dr. Inglis, highlights a very important question in light of the Avandia mishap: how many other potential whistle-blowers are out there that have been silenced into submission before the Big Pharma vultures?

A medical expert testified that he agreed to sign a statement that was meant to appease the company's investors. This is not the type of behavior anyone should expect or dismiss of a doctor, entrusted with a patient's life. In his defense, he did forward a letter with his concerns to the FDA- which means they also were aware of the same threat. This same doctor is the President-elect for none other than the American Diabetes Association. Isn't that special? The ADA - my friend, my confidant, my utter supporter of the C-peptide crusade...sense the sarcasm? So much for advocacy, when the president-elect of this organization so willingly swept those safety concerns under the table, when he should have been throwing a tantrum on top of it! And all over the threat of litigation from a drug company more concerned about its investors than patients.

The closing comments in Dr. Inglis' newsletter say it all. There are so many vultures out there waiting to pick the bones of the American public, it disgusts me. This example goes to show why I always recommend to you-and to all of my patients-that you always question everything when it comes to your health. I don't care if it's your doctor you've had for 50 years or one of these nonprofit organizations-give them all hell.

Warning signs of type 1 diabetes emerge over days or weeks

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The recent post about the death of the little girl in Wales from undiagnosed diabetes gave me a heavy heart. It also sparked a memory of the weeks leading up to my brother's type 1 diagnosis.

I actually profited from my brother's warning signs. In the six weeks or so leading up to his diagnosis, he was devoid of energy. He was also incredibly thirsty, trying to satiate a steadily rising blood sugar wracking his teenage body. I was only nine years old, but recall delivering gallons of ice cold water to him as he lethargically lay on the couch. For each gallon, he paid me $1.00. He proposed the deal out of desperate thirst. I only thought it an oddly-made fortune, and happily watched the rising stack of dollars bills.

As my brother's symptoms worsened, my mom's worry and frustration rose. A eureka moment arrived when she watched my brother drag his feet while playing ping-pong with my dad. Suddenly a thought popped in her head -- could it be diabetes? She called a doctor friend, only to have her notion dismissed. Stubbornly suspicious, she headed to a pharmacy to pick up a urine test strip to measure blood glucose ... this was back in the 1970s, remember those? The pharmacist steered her away from the test strips and recommended my brother get a blood test. Long story short, he was tested the next day. His blood sugar was off the charts. The lab had to dilute his blood three times to finally measure a 990 mg/dl blood sugar. After two weeks in the hospital, he was stabilized and sent home on a new regimen for life.

This article in WebMD clearly outlines the warning signs of type 1 diabetes. Early symptoms include frequent urination, extreme thirst, weight loss,and increased hunger (not always) over a few days or weeks. Rapidly rising blood sugar can also result in ketoacidosis, a deadly condition characterized by flushed/hot/dry skin; loss of appetite/abdominal pain/vomiting; strong, fruity breath; rapid, deep breathing; and possible coma.

Spread the word, we need more awareness on early warning signs of type 1 diabetes.

Sweet as a daisy

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Stevia is a member of the daisy family, and Coca Cola teamed with Cargill to bring it onboard as a new sweetener in their family of products.

According to reports in the Wall Street Journal, Coca-Cola has filed 24 patent applications for the product, which has been tentatively named Rebiana. It plans to use the sweetener in some of its beverages. Stevia is only approved in the United States as a dietary supplement, not as a food additive. The extract is claimed to be the world's only all-natural sweetener with zero calories, zero carbohydrates and a zero glycemic index.

Extracts are said to have up to 300 times the sweetness of sugar. As a sweetener, Stevia's taste has a slower onset and longer duration than that of sugar. Lower-calorie sodas are made with artificial sweeteners such as saccharin, aspartame and sucralose. A recent report revealed that the US sweetener market is poised to increase 4% annually, to reach over $1 billion in 2010. A company that could offer a natural alternative to artificial sweeteners may have found a new sweet spot this growing market.

Courtney Love forced to give up smoking

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A few little bumps in the throat may have saved Courtney Love's health. Jonathon at That's Fit recently reported that the singer was recently forced to quit smoking by her doctor, who found benign nodules in her throat, caused by her daily cigarette habit. Though the nodules are benign, they could require surgery if Love doesn't stop smoking. I can only imagine that throat surgery would have a big impact on someone who sings for a living.

Not only will Love hopefully enjoy a long music career now that she's given up cigarettes, she'll also quickly improve her cardiovascular health. And research shows that parents who quit smoking are less likely to pass the the bad habit on to their kids, so she's doing her daughter a favor as well.

This summer, choose cherries for the heart

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For me, freshly-picked cherries are synonymous with summer. Eating those sweet morsels of goodness on a hot summer's day is about as perfect as it gets. If you love cherries as much as me, there's good news -- They're great for you, especially your heart. There's a downside to this news though -- Sour cherries are better for you than those of the sweet variety. Tart cherries are associated with a lower risk of metabolic syndrome and cardiovascular disease, more so than sweet cherries like Bing cherries. The reason that tart cherries are more beneficial than sweet ones if that tart cherries have more antioxidants, and we all know antioxidants are great for whatever ails you.

I'm not a fan of tart any type of tart fruit self can't see myself buying them for the antioxidant value. What about you?

Thought for the Day: Who is going to handle communication?

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playing telephoneMy husband and I have a friend who was recently diagnosed with a sarcoma. I don't have more specific details about what kind of cancer it is than that, except that he went to the emergency room with groin pain and the doctors found a mass. Our friend is being treated at the Mayo Clinic, but he and his wife return on weekends, and we have dinners with our large extended family of friends, all together, every Friday night. We have been having these Friday night dinners for years now. We call them Friday Night Literary Society as many of the friends teach in the English department at the local university, or used to, as I did.

The point of these dinners, though, is to have fun. It is not to mention cancer, treatment, or anything else. Our friend doesn't want to talk about it, doesn't need the reminder. I'm sure it's never far from his thoughts. I sat next to his wife tonight, and she talked about how well he was responding to treatments, how he wasn't nauseaus from the chemo. The doctors say he will need surgery in August, and will probably have to have his right leg amputated. It's stark and horrible, and we are all affected by it.

Because we are a tight-knit bunch, we all talked among ourselves because we didn't want to ask the family too many questions, didn't know what they needed from us. We all wanted details, but we didn't know how to get them. The family wanted us to know details, but didn't really want to contact everyone individually. Fortunately, or unfortunately, we are a group who has known tragedy. Another friend died of cancer a few years ago. Yet another was covered yesterday in the Survivor Spotlight. There are more. So, the solution to the communication problem is this: Select a point man. Select one person who is responsible for updating everyone else on what is going on.

Think about this:If you have selected someone to give the news, field the questions, arrange to have the lawn and the cats taken care of and the house keys delivered, meals coordinated, etc., then you will have much less that you have to think about. Also? You don't have to convey the same information multiple times and wonder who knows what. You authorize information to go out, and ask someone to take care of it for you.

I have been the point man before, and group emails work wonderfully. Of course, you will need to make sure your point person knows the emails of family and out-of-state friends who will want updates. It is also very simple and easy to go to blogger and create a free blog with the purpose of updating people on the situation. We set one up when another friend had a double brain stem stroke at age 35, and successfully raised money for the family to help offset costs, medical, transportation, lodging, and other.

The simple fact is: Nobody is an island. Even though the cancer may be happening to YOU, your friends and family need a way to talk about it, they need to know what is happening, and they need to know how best to help you. So, consider, early after your diagnosis, assigning a point person to handle communication with the rest of the world. It can make a huge difference to your peace of mind.
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Worthy Wisdom: Carbs against cancer

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In today's world, we worry about carbohydrates. We monitor them, count them, obsess about them, and pare them down to just about nothing in order to lose weight. Yet quality carbs have a fierce power in the fight against disease. They are packed with vitamins, minerals, antioxidants, and fiber. They absorb slowly and stabilize blood sugar, appetite, even mood. Carbs don't have to be avoided. In fact, they should be embraced -- in their most healthy forms.

While at the Canyon Ranch resort in Tucson this past April, I observed that all meals are balanced with small to moderate portions sizes of carbohydrate foods. Canyon Ranch is all about health and healing. If the experts here say carbs can be good for us, I believe them.

They key to carb management is knowing which ones keep cancer and other disease at bay. It's simple, really. Just think whole fruit, vegetables, beans, and modest amounts of whole grains.

If you must rid your diet of carbs, focus on the unhealthy variety -- chips, cookies, large servings of pasta and bread.
Just be sure to keep the cancer-conquering kind.

Thanks Canyon Ranch for the carbohydrate clarity!

Tamoxifen induced hot flashes cut breast cancer recurrence

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Now here's some good news for Tamoxifen-taking, hot-flash suffering women. A new study finds women who have lots of hot flashes during treatment with the breast cancer drug Tamoxifen have a lower risk of recurrence than women who don't suffer from the annoying waves of heat commonly associated with menopause.

"This study provides the first evidence that hot flashes may be an indicator of a better prognosis in women with early stage breast cancer," said study author John P. Pierce, Ph.D., from the University of California at San Diego. "Our data support the possibility of a significant association between hot flashes and disease outcome."

More study is necessary to determine whether or not hot flashes -- which may predict better outcomes than severity of cancer, hormone receptor status, and age -- are associated with Tamoxifen and breast cancer progression.

Dentists need to be more careful when screening for Oral Cancer

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.As part of the check-up your dentist probably screen you for oral cancer. Right? I know mine does. But apparently, some dentists are performing these checks as thoroughly as they should. It's not their fault though--their not given proper training, and don't really know what to look for. But seeing as dentists spend about a gazillion years in school, I'd like to think that cancer screening is on the curriculum. It is, after all, a matter of life and death. They also aren't too clear on the top risk factors for oral cancer -- smoking and alcohol. Come on, even I know those.

What do you think? Do you trust your dentist when it come to oral cancer, or has the article scared you?

Stand Up For Survival

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Join the Young Survival Coalition and Stand Up For Survival! as we take a virtual walk to raise money for programs and services dedicated to young women affected by breast cancer.

Help raise awareness that young women can and do get breast cancer by participating in this exciting online event without ever leaving home. Or, you can take an actual walk through your own community; you set the day, the time and the route.

As a special thank you for your participation, our top fundraisers will receive some very special prizes.

You can make a difference in the fight against breast cancer! Join individually or get your girls together and team up. Registration is simple and free, so click here to register today.

Too busy to participate? Click here to choose a participant and donate to their effort.

For more information, contact YSC Development Associate Alison Dichter at 646-257-3019 or donate@youngsurvival.org.

Friday, 8 June 2007

FDA slaps diabetes drugs Avandia and Actos with black box label

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Call the art director and the printer. It's time for a label redesign.

Glaxo just finished revving up the printing press for their aggressive PR campaign assuring us all Avandia is safe. Yesterday, the FDA ordered Glaxo to add their strictest warning to bottles of Avandia - the dreaded black box label. They also ordered the black box label be placed on Avandia's closest competitor, Actos, manufactured by Takeda Pharmaceuticals and Eli Lilly & Company.

This bomb was dropped by FDA commissioner, Dr. Andrew C. von Eschenbach, in the midst of a packed House hearing investigating the FDA's questionable handling of Avandia. In a written statement, he said the agency asked Avandia and Actos makers to add the more prominent black box warning of heart failure because the drugs were being prescribed to patients with significant heart failure, despite existing warnings on the bottle. Dr. Nissen's May 21 study, which sparked the controversy, revealed a 43 percent higher risk of a different side effect, heart attack.

Revealed to the public only yesterday, turns out the FDA had requested drug makers for the black box label on May 23, a mere two days following publication of Dr. Nissen's study in the New England Medical Journal.

Democrats on the House committee strongly criticized the FDA, while some Republicans challenged Democrats were drawing conclusions with uncertain data. Representative Virginia Foxx, Republican of North Carolina, questioned whether those researching the drug had spoken only to Democrats on the committee and not the FDA. She then called for the press to investigate if certain members of Congress conspired with a few FDA staffers to seriously embarrass the drug agency.

Democrats asked Dr. von Eschenbach if the FDA needed more authority to require drug safety studies or correct drug advertisements. He replied more money is needed, not authority. He also said separating the drug agency's safety and approval offices, suggested by some Congressional critics of the agency, was more destructive than constructive.

In a testimonial moment, Representative Diane E. Watson, Democrat of California, said her doctor ordered her off Avandia after she developed a heart murmur. She said Avandia should have heart attack on the label, and she thinks she was headed toward one at the time.

In an awkard moment for the FDA, Representative Stephen F. Lynch, Democrat of Massachusetts, asked the FDA officials to look at the current Avandia label and find the warning about heart attacks. As Representative Lynch repeatedly asked the officials if they had found the warning yet, one official eventually pointed to an embarrassingly small table in the labeling information. Dr. von Eschenbach explained the agency was working toward improving readability of all drug labels. Can you just see a spoof of this scene on NBC's Saturday Night Live? See the full story in the New York Times.

Get in the drug label printing business, there is a fortune to be made.

JDRF's kids online: Community of kids with diabetes

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The Juvenile Diabetes Research Foundation International (JDRF) was started in 1970 by a group of parents advocating for their children. JDRF has grown into a powerful research and educational force for juvenile diabetes -- nothing short of amazing!

Check out JDRF's Kids Online, a community of kids handling their disease with grace, humor and courage. Kids Online offers a variety of interactive zones to engage youth and teens with juvenile diabetes. Just a sampling, the Your Life link provides tips to manage the disease from a kid's point of view. Don't miss the Your Stuff link boasting an Idea Zone to share artwork and ideas; Kids Say for a give-and-take of opinions; and Pen Pals where kids can forge friendships with other juvenile diabetics across the globe.

Sneak a peek at Kids Online and be inspired by this on-line playground. If you know a child with juvenile diabetes, make sure to send them a hyperlink!

Non-prescription Diachrome(R) improves glycemic control for type 2 diabetics

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You don't even need a prescription for this one. Nutrition 21, Inc., a nutritional bioscience company, markets drugstore supplements such as selenium and omega-3 fish oil. They recently announced new published results of a clinical study of their patented product Diachrome(R), a combination of chromium picolinate and biotin (a B vitamin).

Here's the skinny on the study. In a 447 subject, randomized, double-blind, placebo-controlled study, type 2 diabetics taking Diachrome(R) realized significant improvements in glycemic control (an absolute decrease in A1C of 0.54%). More dramatic decreases were seen for type diabetics with terrible glycemic control levels (A1C levels equal or greater than 10%). These diachrome(R)-takers saw an additional absolute A1C decrease of 1.76%, and they were already taking one or more prescriptions to treat their type 2 diabetes. Improvements were also seen in fasting glucose levels and triglycerides to high density lipoprotein (HDL) ratios.

Is a nutritional supplement honestly going to help people with type 2 diabetes? I checked out the Diachrome(R) website and found the product has been around at least since 2004, possibly even longer. The FDA has deemed it safe. Perhaps it does enhance insulin function, but the website clearly states it should never replace medications already being prescribed to treat type 2 diabetes.

No kidding around -- kids hearts hurt by secondhand smoke

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Imagine being 11-years-old and already have artery damage from being exposed to secondhand smoke. That's what researchers from Finland's University of Turku found when they studied 402 children who had either had no exposure to secondhand smoke, light exposure, or heavy exposure.

When they did ultrasound testing on the children, they found that those who had been exposed to secondhand smoke had reduced artery function. The more exposed a child was, the greater the damage to their cardiovascular system. Though researchers aren't certain what this means for these kids in the long run, they say that research in adults suggests that this kind of damage is not reversible.

A whopping 60% of kids are exposed to secondhand smoke in the United States. Not only does living with a smoker increase the risk of health problems like asthma, ear infections, and cardiovascular damage, but kids who live with smokers are more likely to smoke themselves.

Soy nuts good for the heart?

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Soy is one of the more well-known health foods because it's high in protein and low in fat, particularly of the saturated variety. So it comes as little surprise that studies have shown that soy nuts are good for the heart -- specifically, they help lower blood pressure and bad cholesterol, especially in women.

Soy nuts are those tasty little things you find in the healthy section of your supermarket. I love them, and they make a great snacking substitution to chips and other junk food. I've even heard that some of them are coated in chocolate but I've yet to find those in my local grocery store.

What do you think of soy nuts?

Blood pressure: 20 ways to do something about it

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Who knows why so many people, men particularly, ignore their high blood pressure and don't make any moves to lower it -- only 1/3 of all patients with a diagnosis of hypertension have it under any kind of control at all. It's one of those illnesses that you can't necessarily feel doing damage, so it's easier to ignore. But whether you feel it happening or not, it is slowly killing you: among other things having high blood pressure increases your risk of heart attack by 4 times.

Msn has compiled this list of 20 different things you can do to help lower your blood pressure. Although the article is written for men specifically, many of the tips are good for all of us, man or woman. Some things, like inactivity and stress, affect us all!



Slow down, eat smaller bites for a healthier diet

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The above sounds like something I say to my children every night at the dinner table. However, it is an approach that if taken literally could help Americans with our ongoing obesity struggles. The French long ago adopted the eat slowly and carefully approach and their portion control, coupled with a leisurely dining pace, has helped to keep their population of obese adults to a mere 11%, compared to the American national average of 37% adult obesity.

In a society where we are so often on the go, it is hard to justify sitting down and slowly eating a meal when we could just as easily pack it in to plastic containers and munch away in the car while we run errands, pick up kids and multi task. And if we forget to bring a drink? No worries, we can stop at a drive thru and get a huge one for under two dollars. Or if we have been working all day, it is far easier to pile the kids in the car and have dinner at an all you can eat buffet. A buffet offers something for everybody and the plates are unlimited.

There is a lesson to be learned from the French. Smaller portions, spending a few extra minutes at the table and chewing our bites a few more times can help to give the feeling of fullness while still enjoying a meal. Being realistic about portions is another key to eating in moderation. The changes are small but key to reducing obesity and creating a healthy lifestyle. Click here to read more.

Thought for the Day: Never stop trying to learn

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To those afflicted with cancer, sometimes life seems a little hard to completely hopeless. Many cancer survivors I have talked to tell me that a good attitude (even on the hard days) and a willingness to investigate, learn and grab hold of all cancer knowledge has made them better people. We're not just talking about disease battling here, but enjoying the mental rewards that come with the relentless acquisition of knowledge.

Think about this:

The ability of the human brain to learn, think, adapt and survive obstacles that would put many other species to shame is what makes people of all skin colors, ages, genders and educational levels special. Never stop trying to learn about the world around you.

The moment our mental outlook changes from one of "giving up" to one of "enjoying all the time available that is possible" makes for a better life, whether or not cancer claims you or whether you tell cancer to take a hike. Changing a mental mindset to one of pure human strength is the best and more rewarding challenge we can face in life -- in all areas.

Survivor Spotlight: Claire P. "I don't think of myself as a cancer survivor."

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Claire P.I have known my friend Claire for years (she asked that her last name not be used). So, I remember the shock I felt three years ago when I found out that she had breast cancer. Malignant breast cancer, we whispered to ourselves. Claire had been teaching English for Dole Fruit in Honduras. She came home that summer, and she never went back, even though she had another year left in her contract. Even though we have talked about her experiences over the years, we had never done so formally before she agreed to talk to me for this Survivor Spotlight. She came over and I poured her coffee (black) and we went out back to my studio/office to chat.

How did you find out you had breast cancer?

I went in for a routine mammogram. I had been having mammograms for about the past ten years or so. But I missed the previous year! So, after I found out that I had cancer, I was mortified that I had forgotten the previous year. But actually, I had a benign cyst years earlier, when I was younger and hadn't gone through as much. That was actually much scarier.

How did you find out it was malignant?

Needle biopsy. But I had warning-- the radiologist was pretty sure it was bad, so he gave me warning. The biopsy was just to make sure.

What were your treatments?

I had a lumpectomy. (She showed me her scar, which just looked like a little dent in her breast, at the top). Then I had a pretty standard treatment of two rounds of chemotherapy and radiation. Then, I did a year of Herceptin. I was really lucky because it was new then. In fact, my doctors didn't think my insurance company would go for it, but I had such good insurance. They said, "Absolutely, anything." I had a particularly aggressive type of cancer, and special receptors. The Herceptin goes right to the HER2 receptor and there are no side effects. We called it the Not-Chemo, because it doesn't break down your system. Though, I had Ativan for the nauseau for the chemo, and it worked great.

Did you smoke pot?

No.

So, how did you tell your family you had breast cancer?

(Laughs) Oh, the usual for me. I called them [her two sons, Logan and Morgan; Claire is a widow] on the phone and said, "Bad news, but not to worry!"

[Author's note: Claire is young to be a widow-- only 56-- but her husband had a serious double brainstem stroke years ago and eventually died from complications more than ten years ago. And her experiences dealing with her husband's illness definitely colored her experiences with breast cancer and her entire outlook.]

I think it affected Logan [Claire's younger son, both are in their twenties] more strongly than it affected you. I remember asking him how you were doing, and he responded with your family's typical optimism, but there was a definite edge to it.

Oh, definitely. Well, the kids were dealing with the fact that they had already lost one parent...

But again, I was really lucky. Dole bought my second year contract, and I had an income from them that entire year. Also, my kids were grown, I was single, and I really had no obligations or responsibilities to anyone. So, I didn't have to work that entire year I was on Herceptin.

So, what did you do that year?

I read mystery novels that friends gave me. And I just spent a lot of time on myself, with myself.

What kind of research did you do about breast cancer after you were diagnosed?

(Laughs) I didn't really do any research. I was really in denial. I had two friends who did research for me, and I just kind of listened to them. But also, I just really trusted my doctors and did everything they told me to do.

What kind of follow-up do you still have to do?

I am back on my regular mammogram schedule, but I have this blood anomaly (too many white blood cells), so I still see my doctor every 4 months, and he may do cancer checks. (Laughs) I don't really know. The survivor rate, they told me, was 90%. The cancer hadn't spread to my lymph nodes, and to tell you the truth? I really did all the chemo and radiation to humor my doctors. I think they got it all with the lumpectomy. My doctor may disagree with that.

What kind of advice would you give to other people who are diagnosed with cancer?

Find a doctor you can trust and get along with. Don't put up with someone you can't communicate with or don't like. Also, plan to spend a lot of time on yourself. Take time you need. Also, listen to people who are starting to say that cancer is curable or something that you live with. That is more and more true.

Of course, the week after a mammogram is tense. And waiting for diagnoses and tests is just one of the horrors of life, that we all go through. But I had gone through so much of that already with [my husband], and that was so much harder.

You shaved your head before you started chemo. Do you think that is typical? Who told you to do that?

They recommended at the doctor's office that I do it, because it's just too depressing and too awful to watch it fall out in the shower. I thought I would have a harder time with it than I did. I went in alone and told my hairdresser-- I think she had a hard time with it. She didn't let me watch. She kept my face away from the mirror. But when I finally saw, I thought, "Morgan [her oldest son." I didn't realize how much he looked like me before that! (Laughs).

You wore scarves a lot... Was that to make other people feel more comfortable?

Yes. I actually really liked being bald. Well, it was cold in the winter. I was bald for about 7 months. Some forms of chemo don't make you lose your hair, but the chemo for breast cancer is quite aggressive.

Did you lose weight?

Yes. About 17 pounds. At the time, people told me I looked awful, but I didn't feel like I did. You know, about the worse side effect is what some people call Chemo Brain. For about a year after I finished treatment, I couldn't make a coherent sentence, or remember the name of a book or a movie, so when I started teaching again, that was really noticeable. I thought I was just rusty after taking a year off, but now, looking back, I really think I had Chemo brain.

Do you think of yourself as a cancer survivor? Has this changed your outlook?

No, no, I really don't. I think it's denial again (laughs). Well, okay, not a single day goes by that I don't think that I could get cancer. But I was like that before I got cancer. But my mother had four different kinds of cancer, including breast, and she lived until she was in her eighties. My father had lung cancer, and I think that ultimately killed him... ten years later, at age 82. There's nothing you can do about it. You can't let it rule your life. It hasn't changed or defined me. I really think that I just have this... optimism that kind of permeates everything. And I think stress can just make it worse. It's more like something that happened and now? It's done.
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Left-handers have higher breast cancer risk

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Left-handed women under the age of 50 are more than twice as likely to develop breast cancer than those who are right-hand dominant.

What?

Yep, that's what a new study reveals.

This left-handed conclusion, published in the journal Epidemiology, comes from the study of 12,000 women in the Netherlands whose medical histories were followed for 13 years. Discounting all other factors -- lifestyle, environment, and other disease -- left-handers came up with a risk of breast cancer 1.39 times that of right-handers. For pre-menopausal women, the figure climbed to 2.41.

When considering all sorts of illness, left-handed women had a 70 percent higher chance of contracting any cancer and a 30 percent higher chance of a fatal disease of the circulatory system. It's not just breast cancer -- it's any number of health conditions that may be linked to regular use of the left hand.

Scientific reactions on this topic are mixed.

One doctor says there are generally few left-handers in the older population sector, explaining the higher incidence among younger women.

Another doctor, scientist Olga Basso, herself a left-hander, has this to say: "I am not alone in thinking that the literature on handedness suffers from a number of ills. Having successfully dodged a number of disorders, I doubt that my left hand is prematurely pulling me toward my grave."

Diagnosis: Benign

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There's nothing like a little benign news to start the day, nothing like a voice on the other end of the phone saying, "the pathology on your biopsy came back and everything is benign. We'll see you in one year for your next appointment."

While my dermatologist was freezing the pre-cancerous actinic keratoses lesions on my nose last week, she decided to cut out a suspicious chunk of skin on my hand. It was much worse than the freezing. She gave me a shot and numbed the area and then literally dug a hole into the skin just below the pinkie finger on my right hand. For days now, I've been applying antibiotic ointment, bandaging the wound, and whining about the twinges of pain that shoot through my hand.

My hand is still sore today. But I don't have skin cancer. And that makes the pain a whole lot more tolerable.
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New drug found to boost survival of adrenal cancer patients

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Cancer of the adrenal glans does not get the kind of press coverage as other types of cancer, but it can be just as deadly. Adrenal cancer, although one of the rarest forms of cancer, is being shone in a brighter light, though, as a new drug may be able to buy time for those stricken with it.

A new study out of Europe concluded that Mitotane (a drug for adrenocortical cancer) can give patients months of additional life without severe side effects. Although adrenocortical cancer is rare, the standard treatment involves surgery -- but with many patients seeing multiple relapses. With Mitotane being used in large doses during those relapses (to try and stop them), the most significant side effect is exhaustive fatigue -- the the point of some patients losing all quality of life. I'd consider that a severe side effect, but it does depend on the dose given (fatigues is only caused by very large doses).

The good news is that recurrence-free adrenocortical cancer cases saw patients with 42 month periods of survival without a relapse compared to 10 and 25 months in two control groups. I'd say that is pretty significant.

Oncotype test for breast cancer influences treatment choices

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Women with hormone receptor positive breast cancer that have negative lymph nodes can take advantage of a test known as OncotypeDX. This test is used to estimate the risk of cancer recurrence in women diagnosed with early stage breast cancer. Results presented at the 2007 annual meeting of the American Society of Clinical Oncology said that the test results changed the oncologist's treatment decisions in about 31 percent of cases.

The test is useful in determining which patients are likely to benefit from chemotherapy in addition to hormonal therapy. It can predict the risk of a patient experiencing a recurrence up to ten years following diagnosis. The patient receives a Recurrence Score that ranges from 0 to 100, the higher the score -- the greater risk of recurrence.

This a great way for oncologists to be able to give individualized treatment -- instead of one size fits all. Its important to get chemotherapy if needed but physicians don't want to over-treat and have the unnecessary risk of side effects from chemotherapy treatment if its not warranted.

Folic acid might not lower, but raise cancer risk

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Many Americans have begun taking folic acid supplements thinking that it can protect against colon cancer and also cut a person's risk of stroke and heart disease.

In the past, animal studies led researchers to believe that folic acid had these beneficial effects. The National Institutes of Heath funded a clinical trial that enrolled more than 1,000 men and women who previously had polyps removed from their colons.

Those in the study were randomly assigned to take daily pills containing either 1 milligram of folic acid or a placebo. The study showed that those who took the folic acid got just as many new colon polyps as those who took the placebo pills.

Robert Sandler, M.D., chief of the division of gastroenterology and hepatology told WebMD "We are disappointed and surprised that it didn't work. In fact, there was some evidence that folic acid increased cancer risk."

Thursday, 7 June 2007

Charges dropped against Mr. Universe

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Last week Amy Tenderich, creator of Diabetes Mine and co-author of Know Your Numbers, Outlive Your Diabetes, sent out an email asking us to speak out on behalf of Mr. Universe. I remembered the gist of the story when it first happened, back in April. What I didn't realize was the ensuing atrocities for Mr. Burns after the event.

Back in April, Doug Burns was maced by police during a hypoglycemic event at a movie theater. During the episode, the police assumed he was intoxicated, despite a bystander's insistence that it might be a diabetes issue. He was handcuffed, thrown into a car, and driven to a nearby ER without proper treatment for his hypoglycemia. Officers arrested him for assault and resisting arrest. Prosecutors initially insisted Burns needed to provide more medical evidence that he was a Type I diabetic suffering from insulin shock at the time. For some unknown reason -- a blood sugar of 40 isn't proof enough? The records from the event show that Doug never struck anyone, and in fact, he was the only party injured in the incident. However, the case was raised to assault and resisting arrest when one of the policemen suddenly reported an injury -- week-and-half later.

Turns out the county prosecutors have dropped misdemeanor charges against Mr. Universe. Ladies and gentleman, this is proof of how misinformed the general public is of the hurdles diabetics must overcome to continue life, uninterrupted. I'm proud to say that when issues are raised, awareness prevails. Thanks to everybody who called into the DAs office last week and thanks to Amy for calling out for the help.

Diabetics taking Avandia caught in volley of debate

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For those of you following the Avandia story in the news, you're probably wondering how the patients currently taking Avandia are feeling. Are they flushing the pills down the toilet? What about the patients enrolled in GlaxoSmithKline's current Avandia clinical trial -- are they dropping out like flies? If you are unfamiliar with the Avandia debate, news broke last week that Avandia, a popular diabetes drug, may increase the risk of heart attack. A 43% higher risk.

It may depend on the specialty of your doctor. BusinessWeek has reported endocrinologists tend to be more skeptical of the study, noting its weaknesses compared to original, more rigorous clinical trials. Many cardiologists and drug safety experts give the study more weight, and remain worried about Avandia's potential cardiac danger. Doctors on the frontline are concerned patients may stop taking the drug without medical consultation as many are confused and frightened.

Dr. Nissen, the whistle-blower on Avandia and leader of the fight to withdraw Merck's arthritis drug Vioxx due to safety issues, acknowledges there are real limitations in his analysis, but he points out Glaxo's own data found a 30% increase in the risk of heart attack from Avandia. Nissen was alarmed enough to release his meta-analysis showing a 43% increased risk versus waiting for the results of Glaxo's 4,400-patient, eight-year clinical trial named RECORD, which is specifically measuring cardiovascular outcomes of Avandia.

Critics say Nissen went too far out on a limb this time as a meta-analysis examining 42 Avandia trials with varying research methodologies is not terribly reliable.

How many heart attacks did Nissen's meta-analysis reveal? Among 15,560 Avandia-takers, 86 had a heart attack and 39 died of cardiovascular origin. This compares to 72 heart attacks and 22 deaths from cardiovascular causes of 12,283 diabetics taking drugs other than Avandia. Critics point out Nissen did not include six trials of Avandia that showed zero -- yes, ZERO -- heart attacks. If you wrap those six trials into the mix, critics contend, Nissen's statistical significance is null and void.

Nissen says Avandia's only proven benefit is controlling blood sugar levels and many safer drugs are available. Endrocrinologists want a wide variety of drugs to prescribe in case a patient is resistant to one.

The back-and-forth news on Avandia reminds me of watching a long baseline rally in professional tennis before powerful graphite racquets entered the scene. But this is hardly a recreational moment for diabetics taking Avandia -- it must an unsettling time.

Avandia latest: Glaxo fights back

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GlaxoSmithKline has its hands full right now big-time, defending its conduct over the ever-deepening Avandia scandal. But the big-name pharma company isn't giving up the fight. (No surprise there...) Today Glaxo ran full-page advertisements in a number of prominent US newspapers. The move is described by Britain's Guardian as the launching of a major PR war. The ads are featured in fifteen major newspapers, says the Guardian, including The New York Times, The Washington Post, The Wall Street Journal, and the LA Times. The ad is a direct appeal to patients, taking the form of an open letter from Glaxo's chief medical officer, Dr. Ronald Krall. (Guess he's working some late nights at the moment, huh?)

The ads were timed to appear one day before the congressional hearing on the US Food and Drug Administration's work on Avandia and consumer safety, which is scheduled for tomorrow. Another Glaxo-penned letter defending Avandia was also published in the medical journal the Lancet. Said a company spokesman of today's ads: "We are determined to make sure the science we feel backs us up is heard."

This article also notes that weekly prescriptions for Avandia have fallen by sixteen percent since the recent publication of a damaging article by Dr. Steven Nissen in the New England Journal of Medicine. Nissen asserted that Avandia could increase the risk of heart attack by forty-three percent and the risk of cardiac-related death by sixty-four percent.

By the way, it is worth checking out the Wikipedia entry on Glaxo for a brief rundown of the company's history, including previous wrangles with the media and the law over its products. Note, though, the entry has not yet been updated in the wake of the Avandia scandal.

Mary Tyler Moore champions research for kids with type 1 diabetes

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I have always loved Mary Tyler Moore. I remember snuggling on the couch with my mom one night a week to watch the Mary Tyler Moore show. I don't know what was more comical -- the humor of the storyline or hearing my mom's roaring laugh each Saturday.

I found out years ago Moore has type 1 diabetes. Right away, it comforted me. Maybe it was because I admired her acting skills and love her warm smile. My young brain logic went something like this, "If Mary Tyler Moore has type 1, then maybe it's not so bad my older brother has juvenile diabetes." Whatever the reason, I did some research to catch up on Moore's activities these days.

Born in 1936, Moore turns 71 this year. Her activism in support of the Juvenile Diabetes Research Foundation International (JDRF) is remarkable. As JDRF's International Chairman, Moore has regularly testified before Congress for juvenile diabetes research. She is heading to Washington D.C. later this month to testify once again at Children's Congress 2007. Moore and over 100 kids with type 1 diabetes will meet with top U.S. Government officials to advocate for the cause. These pioneering delegates represent all 50 states and the District of Columbia.

I applaud Mary Tyler Moore for her efforts on behalf of type 1 diabetics worldwide. Watch for future posts on Children's Congress 2007 -- this influential event only comes around every two years.

Magic mushrooms to combat syndrome X

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Looks like 'shrooms might become a swanky and healthy thing to do! The fungi is affectionately called the Maitake mushroom, and literally means "dancing mushroom. Research has found it lowers blood pressure, abdominal obesity, and lipids in the blood.

Maitake Products plans to target the maitake (grifola frondosa) mushroom to treat metabolic syndrome. Metabolic syndrome is a common precondition for both coronary disease and type 2 diabetes. The condition is characterized by a group of metabolic risk factors including: abdominal obesity, atherogenic dyslipidemia, high blood pressure and insulin resistance. With the growing number of people affected by these conditions, Maitake claims there is significant market potential for its drug, SX-Fraction.

A preliminary clinical study was conducted among 19 patients with type 2 diabetes. Patients taking 9 tablets of SX-Fraction (per day) for 2 months found that it significantly reduced fasting blood glucose, triglycerides, and body weight. The possibility of maitake mushroom as a safe, natural agent for treatment of type 2 diabetes, Syndrome X and insulin resistance has been examined for the past several years and will soon prove to be a therapeutic dancing mushroom in days to come. Yeah man.

Glaxo spins the Avandia RECORD study: Critics disagree

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Glaxo is turning up the volume. Thanks to this post yesterday, we are all aware Glaxo's media department has been busy spinning the news on Avandia. Now they are spinning the RECORD study -- quite differently from critics. Preliminary results of the study were released today via an editorial in the New England Medical Journal, one day before today's Congressional investigation of the FDA. Opponents contend the FDA ignored heart risks associated with Avandia.

Interim analysis of RECORD reports an 2.15 increase in heart failure for Avandia-takers, but no increased risk in the death rate for heart attack or stroke. Glaxo's Chief Medical Officer, Ron Krall, claims the results are reassuring and compares Avandia's safety profile to other type 2 medications on the market.

Critics have an entirely different opinion on the RECORD analysis (thank goodness someone else is weighing in). In the editorial, Dr. David Nathan, director of the diabetes center at Boston's Massachusetts General Hospital, states there is not enough evidence to implicate or clear Avandia and too many people have dropped out of the study. Nathan recommends doctors STOP prescribing Avandia as it might increase severe cardiovascular events and death by 8 percent. Did you hear that? Stop prescribing Avandia altogether.

New Avandia prescriptions from May 25-June 1 have dropped 16 percent, while total prescriptions have dropped 6 percent. No wonder Glaxo has jumped into the deejay booth, can you imagine the money at stake? Here is the full story in Bloomberg.

Foods that help control blood sugar

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It's not an oxymoron -- it's quite possible to control the rise of blood sugar with the foods you eat. This does not entail culinary tomfoolery, skipping meals or any shenanigans you ordinarily would expect from a quick fix. Many of these tips come from a fully certified dietician, Joy Bauer.

Joy suggests pairing every meal with a lean protein. Protein helps slow the absorption of carbohydrates, so include lean red meat, skinless turkey and chicken, egg whites, seafood, legumes or tofu with every meal. She also suggests you choose blood-sugar friendly carbs, such as those higher in fiber. Fiber is that part of the food that we cannot break down and absorb. As Americans looked for convenience, many people turned to processed foods and away from the fresh vegetables and fruits that could provide adequate fiber, which also slowed the absorption of sugar into the blood stream. If you must eat pasta -- cook your pasta al dente. The more pasta cooks, the more starch breaks down, making it easier and quicker to digest (thus, raising blood sugar faster). For those of you who are willing to give it a try, checkout Dreamfields pasta. It has only 5 grams of digestible carbs per serving and 5 grams of fiber.

Focus as much as possible on the fiber-rich foods. Joy suggests eating more legumes. This is accomplished by adding chickpeas to salads and stir-fry's, kidney beans to chili, and lentils to soups, or pureeing beans to make dips. One more little tip to reduce the sugar shock into the body: add acid to your meals! Vinegar, yogurt and lemon can each slow blood sugar response. Enjoy vinaigrette on salad, yogurt with fresh fruit, or fresh lemon juice on vegetables. If you'd rather eat your fiber in a good old fashioned muffin, check out Miracle Muffins. Just add water and bake. With approximately 100 calories per muffin and over 6 grams of fiber you can't go wrong. Bon appétit, everybody!

A death in Wales

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Trawling through the news, I came upon this awful story from Wales: a fourteen-year-old girl who died suddenly on November 30, 2006, turns out to have been diabetic ... only no one knew it when she was alive. An inquest by the Cardiff Coroner's Court concluded yesterday that the girl, Natasha Leigh Roberts, was suffering from pneumonia caused by undiagnosed diabetes. Her parents, Jenipher Perry and Stephen White, have said they encourage other parents to be vigilant for the disease now they have discovered the awful cause of Natasha's death.

Natasha was not diagnosed as diabetic even though she was clearly unwell in the months prior to her death. According to this article, Natasha's parents noticed the decline in their daughter's health. She had lost weight and was complaining of exhaustion in the weeks leading up to her death. Said her grandmother, Lily Ayres, "Natasha was always a healthy-looking plump girl until about a year ago. I reckon she would have only weighed about five or six stone [by the time of her death]." That would convert to about seventy to eighty pounds. Ayres went on to say that Natasha looked "awful" the day before she died. It is also reported that the girl had taken time off school due to feeling unwell and staff at her school were worried about her. Then, one morning, her mom went into her room to check on her and found her in bed, not breathing. Too late.

How disturbing and sad this story is. Was a doctor consulted? Did the teachers at school contact the parents? Why didn't the parents do something, for heaven's sake? Uh oh. There it goes: the so-human urge to play The Blame Game. Or ... maybe this impulse is a good one. If people can learn a lesson from the story by understanding why this child fell through the cracks and did not receive treatment, perhaps other lives can be saved.

Diabetic snack bars treat both hypoglycemia and hyperglycemia

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My family has type 1 diabetes, but when it comes to overnight hypoglycemia (low blood sugar), the similarity ends there. My mom's blood sugar level drops about 100 mg/dl overnight, so she makes sure her blood glucose level is around 180 mg/dl before hitting the pillow. My brother's blood sugar level never drops overnight; in fact, it oddly begins a steady rise upon awakening. Go figure. My dad has had many bouts with nighttime hypoglycemia and he often eats his favorite diabetic snack bar formulated to prevent a serious drop.

If there is one thing I have learned, diabetes is a complex disease and no diabetic is alike.

Diabetic snack bars is a growing market, with some designed to prevent hypoglycemia and others to reduce hyperglycemia (high blood sugar). Here is an article highlighting recommendations from diabetes specialists, along with a short list of products.

Snack bars with uncooked cornstarch (UCS), a slowly absorbed complex carbohydrate, aim to prevent hypoglycemia as the carbs act as a steady source of glucose. They are a good fit for diabetics on intensive insulin therapy with good control (more susceptible to hypoglycemia); as a bedtime snack; to avoid low blood glucose after consuming alcohol; or for those with hypoglycemia unawareness. Check out ExtendBar. My internet search uncovered Gluc-O-Bar and Nite Bites are no longer available.

Resitant starches and fiber reside in snack bars marketed to reduce hyperglycemia, as they dull the postprandial (after meal) glycemic response. They can be used to help prevent daytime hyperglycemia and are not suitable as nighttime snacks. Suggestions include Choice DM, Choice DM Crispy Bars or Ensure Glucerna.

It is important to note diabetic snacks bars should NOT be used to treat hypoglycemia, they do not act quickly enough. Pssst ... my dad loves those wild berry ExtendBars.

Victims of circumstance in hypoglycemic unawareness

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Lately the news has seen a lot of devastating diabetic events due to hypoglycemic unawareness. Hypoglycemic unawareness is commonly defined as an inability to recognize the symptoms (sweating, tremor, hunger, anxiety, and palpitations) of decreased blood sugar or a failure of the warning signs to occur before development of neuroglycopenia, which means a shortage of glucose in the brain. Curiously, this term was not coined for diabetes until 10 years after the introduction of genetically modified human synthetic insulin and insulin analogues.

I hate to say it but diabetes is a crapshoot. You never know what you are going to get, but you can sure try your best to keep your eye on the ball. Removing the inherent dangers of hypoglycemic unawareness would make me a happier diabetic, and improve the lives of all those I care about (diabetics like myself). The answer might lie in the only type of treatment available nowadays, insulin analogues. Diabetics who do not take any form of drug to control blood sugar do NOT have hypoglycemic unawareness.

It's called human but it is nothing like natural human insulin. It may be faster acting or longer lasting but I'm sure He didn't intend for insulin to break sound barriers or last three moons. If Big Pharmaceutical companies were asked to compare insulin analogues with natural human insulin you'd hear crickets. I promise you NO Big Pharma will fund a study that would become the antithesis of their marketing campaigns, human insulin is better. It's not better, it's just different -- totally different! Natural insulin is fat-loving. Insulin analogues are water-loving. The global command center of the body (the brain) is one big blob of fatty material. This means as your blood sugar is dropping, your brain is last fed, if it eats at all. Here in the United States we are victims of circumstance in hypoglycemic unawareness. Sorry brain, no soup for you.

Form and Function: Cellular transport mechanisms

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I am a Licensed Practical Nurse with five years' experience in this profession. I believe it is essential to go back to the basics in all things in order to really understand them. I am fascinated by how our bodies work and I hope I can get my readers to share my fascination. I hope we all learn new things and marvel again at the things we already know. This feature -- which includes a closing section on how disease affects the topic in question -- will run on The Cancer Blog on Wednesdays, and The Cardio Blog and The Diabetes Blog on Thursdays. [The contents in this post are for informational purposes only and should not be construed as medical advice or substitute for professional medical care.]

We start with the cell, because so much of what happens to us when we get sick, and how we get healthy again, can be explained by what happens on a cellular level. The cell is extremely complex and I will only touch on the basics in these posts, but at least we can have a rudimentary understanding.

We have discussed cell membranes (May 24), as well as cell organelles (May 31). Before we look at the nucleus of the cell, I would like to do a short post on some of the mechanisms for molecular movement across the cell membrane. Transport across the cell membrane is important to understand, because a lot of the newer research seems to focus on this aspect.

Living cells constantly interact with the external environment, like tissue or blood. In order to do that, materials must move through the plasma membrane, taking in some substances and secreting or excreting others. There are several methods by which movements can occur: diffusion, osmosis, facilitated diffusion, active transport, filtration, endocytosis and exocytosis. We will look at each of these briefly.

Diffusion: Movement of molecules from an area of greater concentration to an area of lesser concentration. An example would be the diffusion of oxygen from the lungs into capillaries.

Osmosis: The diffusion of water. The kidney tubules use osmosis to reabsorb water.

Facilitated diffusion: Diffusion assisted by a carrier protein. The carrier protein moves molecules across cell membranes. The intake of glucose by most cells happens by facilitated diffusion.

Active transport: Movement of molecules from an area of low concentration to an area of high concentration assisted by a carrier protein. Active transport requires ATP (Adenosine triphosphate- a specialized nucleotide that traps and releases biologically useful energy). An example of a process that uses active transport would be the absorption of amino acids and glucose from food by the cells of the small intestine.

Filtration: Movement of water and dissolved substances from an area of higher pressure to an area of lower pressure. This would be used in the first step in the formation of urine.

Endocytosis: The membrane engulfs something and draws it into the cell in membrane bound vesicles. An example of this would be white blood cells engulfing bacteria.

Exotysosis: Membrane bound vesicle fuses with the cell membrane, releasing it's contents outside the cell. An example of this would be the release of neurotransmitters by nerve cells or the cells of kidney tubules reabsorbing.


How does this affect you?

When insulin is released it proceeds by exocytosis to the plasma membrane. Studies are being done to determine if the transport mechanism plays a role in type 2 diabetes especially.
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TrialNet researching ways to prevent or delay type 1 diabetes

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Did you know type 1 diabetes can take months or even years to develop? It makes perfect sense considering my entire family developed type 1 diabetes at varying points in the life cycle -- teen, young adult and middle-age.

Research has shown the pancreas is stubborn and strong, requiring the loss of over half of the beta cells before symptoms of type 1 kick in. Researchers are taking the next logical step and enrolling relatives of type 1 diabetics in various studies to try and delay or even prevent the onset of the disease.

The University of Florida Health Science Center and Shands at UF are one of 14 centers nationwide dedicated to Type 1 Diabetes TrialNet, a research group dedicated to a host of prevention and early treatment studies.

Now here is a study I feel like enrolling in. TrialNet is testing whether a one-a-day oral insulin capsule can prevent or delay onset of type 1 in high-risk individuals. An earlier trial suggested oral insulin might delay type 1 diabetes up to 4 years in a portion of participants with islet cell autoantibodies in their blood. Makes me wonder if I have any autoantibodies swirling around in my blood.

Animal studies have suggested oral insulin can prevent type I, and some researchers believe oral insulin via the digestive tract can result in a more tolerant immune system.

UF's principal investigator, Dr. Desmond Schatz, explained that people with a strong genetic history and all three islet cell autoantibodies have a greater than 50 percent chance of developing type 1 within five years. Interestingly, these autoantibodies can be present up to 10 years before developing the disease.

TrialNet is also forging ahead on other studies: to retain insulin production in newly-diagnosed type 1 diabetics; to turn off the attack on beta cells with a rituximab, a monoclonal antibody; and an attempt to slow or stop the autoimmunity of type 1 with an FDA-approved drug combination normally used to prevent rejection after organ transplant. Finally, the TEDDY and TEDDY II studies are searching for type 1 genetic and environmental factors in newborns. See the recently published story in dLife or click here to read more aboutTrialNet. You can also call 1-800-HALT-DM1 to see if you are eligible to enroll in a TrialNet study.