Thursday
Bristol Diabetes Pill Faces Safety Hurdle After Early Drugs Tied to Risks
EAV_BLOG_VER:79843941c6db5c8a
Bristol Diabetes Pill Faces Safety Hurdle After Early Drugs Tied to Risks
Bristol-Myers Squibb Co. (BMY) and AstraZeneca Plc. (AZN)’s new diabetes pill will probably face increased scrutiny from regulators and doctors after two rivals were tied to cancer and heart risks.
The drug, dapagliflozin, works differently than Takeda Pharmaceutical Co.’s Actos, linked to cancer last week, and GlaxoSmithKline Plc (GSK)’s Avandia, tied to heart risks in 2007. While those drugs adjust the hormone that regulates sugar, the new pill helps patients excrete sugar through their urine.
“Increasingly, people are on the lookout for problems with these drugs,” said Laurence Kennedy, chairman of Cleveland Clinic’s department of endocrinology, diabetes and metabolism, in a telephone interview. “There will always be a market for finding newer and different ways to help control blood sugar, but the newest ways will be under increasing scrutiny.”
Some analysts say they won’t project sales for dapagliflozin because of the risks posed by Avandia and Actos. Even if approved after a regulatory panel next month, doctors say they will be slow in using the new drug until more is known about long-term safety. A one-year study reported last year found no cancer or heart risks. Two years of data will be reported June 26 at the American Diabetes Association meeting.
An estimated 25.8 million Americans have diabetes, mostly the Type 2 variety linked to being overweight and sedentary, according to the National Institutes of Health. The disease is caused by an inability to use insulin to break down blood sugar into energy and can increase the risk of heart disease, stroke and kidney damage. Medicines are used to lower sugar levels.
Patients Lost Weight
The new drug is being developed jointly by New York-based Bristol-Myers and London-based AstraZeneca. The earlier trial showed it worked better than insulin plus a placebo, and that patients using it lost weight. This is particularly noteworthy because insulin drugs frequently trigger weight gain.
If approved, dapagliflozin would be the first in a new class of medications, called SGLT2-inhibitors. Similar drugs are also being developed by Johnson & Johnson, of New Brunswick,New Jersey, Indianapolis-based Eli Lilly & Co. (LLY) and the German drugmaker Boehringer Ingelheim GmbH, Tokyo-based Astellas Pharma Inc., Isis Pharmaceuticals Inc., based in Carlsbad, California, and Lexicon Pharmaceuticals Inc., of The Woodlands, Texas.
The companies, analysts and investors will be closely watching the safety results and a panel of Food and Drug Administration advisers that is set to review dapagliflozin on July 19, said Les Funtleyder, a portfolio manager at Miller Tabak in New York, in a telephone interview.
No Modeling
Concerns about potential side effects of all diabetes medications leave analysts little room to assess the sales potential of dapagliflozin, he said.
“With these type of drugs, we don’t model until they’re approved because so much can go wrong,” Funtleyder said. “We know it’s a new class in diabetes, which is often not well- controlled. The downside is people are nervous about possible infections and other side effects, and you have to take the good with the bad.”
Bristol-Myers referred comment to AstraZeneca. AstraZeneca’s spokeswoman Kirsten Evraire declined to comment.
In May, U.S. regulators restricted use of London-based Glaxo’s Avandia, ordering the drug to be pulled from pharmacy shelves and made available only through a special program. Sales of Avandia fell to $680 million last year from $1.8 billion in 2007 after a study that year showed a 43 percent increased risk of heart attacks among patients taking the medicine.
On June 15, a five-year analysis from a decade-long company-sponsored study of Takeda’s Actos showed an increased risk of bladder cancer. Actos is the world’s biggest-selling diabetes drug. The FDA had required the study under new guidelines for diabetes drug approvals.
$1.6 billion by 2017
Bristol-Myers’s and AstraZeneca’s Onglyza and Kombiglyze, a version of the drug combined with metformin, a standard treatment, generated $158 million last year. Those two drugs are projected to make $1.6 billion by 2017, according to estimates from Seamus Fernandez, an analyst for Leerink Swann.
Even after approval, “we still have an obligation to conduct studies carefully and properly just to make sure nothing major has been missed” said Kennedy, of the Cleveland Clinic.
Since its original warning on Avandia, the FDA has required an aftermarket study of heart risks for all diabetes drug applications, said Karen Riley, a spokeswoman for the FDA, in an e-mail.
‘New Lessons’
“Not all programs are identical and development isn’t static so as these data come in, we have to apply new lessons learned to the interpretation of risk assessment for subsequent programs,” she wrote.
The number of Americans with diabetes is expected to rise to as many as 1 in 3 adults if trends continue, according to the Atlanta-based Centers for Disease Control and Prevention.
This explosion in cases has spurred the development of at least nine classes of diabetes drugs, some oral and some injectable. Today there are more than 39 diabetes drugs on market, generating about $16.8 billion in U.S. sales in 2010, according to data from research firm IMS Health.
Only half of diabetes patients have their blood sugar under control, so there’s a need for new medications, said Martin Abrahamson, the chief medical officer of Joslin Diabetes Center, an affiliate of Harvard Medical School in Boston.
“Type 2 diabetes being a progressive disease, one drug, a single drug, is unlikely to be a control for glucose levels over many years,” Abrahamson said in a telephone interview. “Usually you add more medications to achieve glucose targets.”
First-Line Therapy
Metformin, approved for use in the U.S. in 1995, is almost universally accepted as a first-line therapy for diabetes, because it has a long safety record and is cheap, Abrahamson said. Often, though, it’s not enough.
Many people with Type 2 diabetes are overweight or obese, and have co-existing conditions such as heart disease and high blood pressure, Abrahamson said. Complications associated with the disease also make prescribing tricky, he said.
Given the difficulty in controlling the disease, doctors remain eager for new medications, even though they are “becoming more gun shy” as dangerous risks are uncovered after the drugs are approved, said Robert Rushakoff, medical director for inpatient diabetes at the University of California, San Francisco.
“Given the reality of diabetes and how difficult it is, endocrinologists will be using it right away,” he said in an interview. “I know I’ll be using it right away. It’s easier than teaching someone to inject a medication. It’s a matter of once the drug moves out of studies, how those side-effects appear. More common, more severe or not a big deal?”
Diabetes Association Meeting
The data presented at the American Diabetes Association meeting in San Diego is expected to provide new details on dapagliflozin’s safety profile, said Tony Butler, an analyst with Barclays Capital in New York. He, like Miller Tabak’s Funtleyder, is unwilling to project sales at this point.
In the one-year study, dapagliflozin was linked to an increased likelihood of urinary tract and genital infections. While that’s a lesser concern than heart or cancer, it has raised red flags.
Rita Rastogi Kalyani an assistant professor of medicine at Johns Hopkins University in Baltimore, said the infections probably occur because the urinary tract is a more hospitable environment for bacteria when patients excrete more sugar in their urine.
“I think as much as we’re excited about new classes of medications, we’re still looking at the older medications first because they’ve been tested over time,” Kalyani said, referring to metformin. “We’ve seen an explosion of classes but we still don’t know about long-term risks.”
WARNING
Dihydrogen monoxide:
- is called "hydroxyl acid", the substance is the major component of acid rain.
- contributes to the "greenhouse effect".
- may cause severe burns.
- is fatal if inhaled.
- contributes to the erosion of our natural landscape.
- accelerates corrosion and rusting of many metals.
- may cause electrical failures and decreased effectiveness of automobile brakes.
- has been found in excised tumors of terminal cancer patients.
- as an industrial solvent and coolant.
- in nuclear power plants.
- in the production of Styrofoam.
- as a fire retardant.
- in many forms of cruel animal research.
- in the distribution of pesticides. Even after washing, produce remains contaminated by this chemical.
- as an additive in certain "junk-foods" and other food products.
You MUST avoid this dangerous substance. It is found in domestic kitchens and bathrooms, swimming areas and bathing locations, and also comes in bottles from shops and other retail outlets, rarely if ever is a caution label attached, it may be labelled as '"Sparkling", "Still", or "Flavoured".
Tuesday
Very Interesting topic reported by the BBC. Interestingly I had read reports that indicated that a lower blood glucose level was target to achieve. I think that this adds a bit od 'sense' - the right blood sugar level is what we should aim for. I aim for around 7, but achieve around 7.5
Diabetes sugar 'can go too low'
Diabetes disrupts blood sugar levels
Intense treatment to lower blood sugar in patients with diabetes could prove nearly as harmful as allowing glucose levels to remain high, a study says.
Cardiff researchers looked at nearly 50,000 patients with type 2 diabetes and found the lowest glucose levels linked to a heightened risk of death.
Significant differences in death rates between patients on insulin and those taking tablets are also flagged up.
But there could be various explanations for this, experts noted.
Patients taking insulin-based treatments have been urged not to stop taking their medication as a result of the Cardiff University study, which is published in The Lancet.
Changing treatments
Using data from GPs, the team identified 27,965 patients with type 2 diabetes whose treatment had been intensified to include two oral blood glucose lowering agents - metformin and sulphonylurea.
It is crucial to remember that blood glucose targets should always be agreed by the person with diabetes and their healthcare team according to individual needs and not according to a blanket set of rules
Dr Iain FrameDiabetes UK
A further 20,005 patients who had been moved on to treatment which included insulin were added to the study.
Patients whose HbA1c levels - the proportion of red blood cells with glucose attached to them - were around 7.5%, ran the lowest risk of dying from any cause.
For both groups this risk went up by more than half if levels dropped to 6.4%, the lowest levels recorded. For those with the highest levels the risk of death increased by nearly 80%.
But the risks appeared to be particularly pronounced among those on the insulin-based regimen than those on the combined treatment.
Irrespective of whether their HbA1c levels were low or high, there were 2,834 deaths in the insulin-taking group between 1986 and 2008, nearly 50% more than in the combined group.
'Don't stop'
The authors acknowledged there could be various factors associated with this, such as these being older patients with more health problems, who perhaps had had diabetes for a longer period of time. They also make reference to a possible link between use of insulin and cancer progression that had been reported in a different study.
"Whether intensification of glucose control with insulin therapy alone further heightens risk of death in patients with diabetes needs further investigation and assessment of the overall risk balance," wrote lead author Dr Craig Currie.
"Low and high mean HbA1c values were associated with increased all-cause mortality and cardiac events. If confirmed, diabetes guidelines might need revision to include a minimum HbA1c value."
Dr Iain Frame, head of research at Diabetes UK, described the study as "potentially important" but stressed it had limitations.
"It is not clear what the causes of death were from the results reported. Furthermore, when it comes to the suggestion made in this research that insulin could increase the risk of death, we must consider important factors such as age, the duration of their diabetes and how the participants managed their condition.
"It is crucial to remember that blood glucose targets should always be agreed by the person with diabetes and their healthcare team according to individual needs and not according to a blanket set of rules."
While people would be able to manage their condition for a period with diet, exercise and even tablets, many would eventually have to move on to insulin, he noted.
"We would advise people with type 2 diabetes who use insulin not to stop taking their medication. However, if they are worried about blood glucose targets, they should discuss this with their healthcare team."
Diabetes sugar 'can go too low'
Diabetes disrupts blood sugar levels
Intense treatment to lower blood sugar in patients with diabetes could prove nearly as harmful as allowing glucose levels to remain high, a study says.
Cardiff researchers looked at nearly 50,000 patients with type 2 diabetes and found the lowest glucose levels linked to a heightened risk of death.
Significant differences in death rates between patients on insulin and those taking tablets are also flagged up.
But there could be various explanations for this, experts noted.
Patients taking insulin-based treatments have been urged not to stop taking their medication as a result of the Cardiff University study, which is published in The Lancet.
Changing treatments
Using data from GPs, the team identified 27,965 patients with type 2 diabetes whose treatment had been intensified to include two oral blood glucose lowering agents - metformin and sulphonylurea.
It is crucial to remember that blood glucose targets should always be agreed by the person with diabetes and their healthcare team according to individual needs and not according to a blanket set of rules
Dr Iain FrameDiabetes UK
A further 20,005 patients who had been moved on to treatment which included insulin were added to the study.
Patients whose HbA1c levels - the proportion of red blood cells with glucose attached to them - were around 7.5%, ran the lowest risk of dying from any cause.
For both groups this risk went up by more than half if levels dropped to 6.4%, the lowest levels recorded. For those with the highest levels the risk of death increased by nearly 80%.
But the risks appeared to be particularly pronounced among those on the insulin-based regimen than those on the combined treatment.
Irrespective of whether their HbA1c levels were low or high, there were 2,834 deaths in the insulin-taking group between 1986 and 2008, nearly 50% more than in the combined group.
'Don't stop'
The authors acknowledged there could be various factors associated with this, such as these being older patients with more health problems, who perhaps had had diabetes for a longer period of time. They also make reference to a possible link between use of insulin and cancer progression that had been reported in a different study.
"Whether intensification of glucose control with insulin therapy alone further heightens risk of death in patients with diabetes needs further investigation and assessment of the overall risk balance," wrote lead author Dr Craig Currie.
"Low and high mean HbA1c values were associated with increased all-cause mortality and cardiac events. If confirmed, diabetes guidelines might need revision to include a minimum HbA1c value."
Dr Iain Frame, head of research at Diabetes UK, described the study as "potentially important" but stressed it had limitations.
"It is not clear what the causes of death were from the results reported. Furthermore, when it comes to the suggestion made in this research that insulin could increase the risk of death, we must consider important factors such as age, the duration of their diabetes and how the participants managed their condition.
"It is crucial to remember that blood glucose targets should always be agreed by the person with diabetes and their healthcare team according to individual needs and not according to a blanket set of rules."
While people would be able to manage their condition for a period with diet, exercise and even tablets, many would eventually have to move on to insulin, he noted.
"We would advise people with type 2 diabetes who use insulin not to stop taking their medication. However, if they are worried about blood glucose targets, they should discuss this with their healthcare team."
Thursday
Obvious to some, but perhaps not to all. Here is some very good advice from Yahoo Health on handling illness when you already have diabetes
What happens when you are sick
When you are sick, your body reacts by releasing hormones to fight infection. But these hormones raise blood sugar levels and at the same time make it more difficult for insulin to lower blood sugar. When you have diabetes, even a minor illness can lead to dangerously high blood sugar. This may cause life-threatening complications, such as diabetic ketoacidosis or a hyperosmolar state.
Plan ahead
Work with your doctor to make a sick-day plan for you or your child with diabetes. Discuss your target blood sugar goal during an illness, how you should adjust your insulin dose and timing (if you take insulin), and when you need to contact your doctor for help. Also, make sure you know how often to check blood sugar and urine ketone levels. Keep your plan in a convenient place, and include contact information in case you need to reach your doctor at night or on the weekends.
Steps to take during an illness
Here are some general sick-day guidelines:
Continue taking your pills for diabetes (if you have type 2 diabetes) or insulin, even if you are vomiting and having trouble eating or drinking. Your blood sugar may continue to rise because of your illness. If you cannot take your medicines, call your doctor and discuss whether you need to adjust your insulin dose or other medicine.
Try to eat your normal types and amounts of food and to drink extra fluids, such as water, broth, carbonated drinks, and fruit juice. Encourage your child to drink extra liquids to prevent dehydration.
If your blood sugar level is higher than 240 milligrams per deciliter (mg/dL), drink extra liquids that do not contain sugar, such as water or sugar-free cola.
If you cannot eat the foods in your regular diet, drink extra liquids that contain sugar and salt, such as soup, sports drinks, or milk. You may also try eating foods that are gentle on the stomach, such as crackers, gelatin, or applesauce. Try to eat or drink 50 grams (g) of carbohydrate every 3 to 4 hours. For example, 6 saltine crackers, 1 cup (8 fl oz) of milk, and ½ cup (4 fl oz) of orange juice each contain approximately 15 g of carbohydrate.
Check your blood sugar at least every 3 to 4 hours, or more often if it is rising quickly, even through the night. If your blood sugar level rises above 240 mg/dL and your doctor has told you to take an extra insulin dose for high blood sugar levels, take the appropriate amount. If you take insulin and your doctor has not told you to take a specific amount of additional insulin, call him or her for advice.
If you take insulin, do a urine test for ketones every 6 to 12 hours, especially if your blood sugar is higher than 300 mg/dL. Call your doctor if you have more than 2+ or moderate ketones in your urine. Check your child's urine for ketones at least every 6 hours, even through the night.
Weigh yourself and check your temperature, breathing rate, and pulse frequently if your blood sugar is higher than 300 mg/dL. If you are losing weight and your temperature, breathing rate, and pulse are increasing, contact a doctor. You may be getting worse.
Don't take any nonprescription medicines without talking with your doctor. Many nonprescription medicines affect your blood sugar level.
When to call your doctor
Minor illnesses in people with diabetes—especially children with type 1 diabetes—can lead to very high blood sugar levels and possible emergencies. When children are sick, watch them closely for signs that they need immediate medical attention. Call 911 or other emergency services if you or your child has:
Symptoms of diabetic ketoacidosis (DKA), such as abdominal pain, vomiting, rapid breathing, fruity-smelling breath, or severe drowsiness.
Symptoms of dehydration, such as a dry mouth and very yellow or dark urine. Dehydration is particularly dangerous in children and may be caused by vomiting and diarrhea.
A low blood sugar level that continues.
It may not be necessary to call your doctor every time you or your child with diabetes has a mild illness, such as a cold. But it is a good idea to call for advice when you are sick and:
Your blood sugar level is higher than 240 mg/dL after taking the adjusted amount of insulin in your sick-day plan.
You take oral diabetes medicine and your blood sugar level is higher than 240 mg/dL before meals and stays high for more than 24 hours.
You have more than 2+ or moderate ketones in your urine.
You still have a fever and are not feeling better after a few days.
You are vomiting or having diarrhea for more than 6 hours.
When you are sick, write down the medicine(s) you have been taking and whether you have changed the dosage of your diabetes medicines based on your sick-day plan. Also note changes in your body temperature, weight, blood sugar, and urine ketone levels. Have this information handy when you talk to your doctor.
Credits
Author
Caroline Rea, RN, BS, MS
Editor
Susan Van Houten, RN, BSN, MBA
Associate Editor
Tracy Landauer
Associate Editor
Pat Truman, MATC
Primary Medical Reviewer
Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer
Stephen LaFranchi, MD - Pediatrics and Pediatric Endocrinology
Last Updated
December 3, 2008
What happens when you are sick
When you are sick, your body reacts by releasing hormones to fight infection. But these hormones raise blood sugar levels and at the same time make it more difficult for insulin to lower blood sugar. When you have diabetes, even a minor illness can lead to dangerously high blood sugar. This may cause life-threatening complications, such as diabetic ketoacidosis or a hyperosmolar state.
Plan ahead
Work with your doctor to make a sick-day plan for you or your child with diabetes. Discuss your target blood sugar goal during an illness, how you should adjust your insulin dose and timing (if you take insulin), and when you need to contact your doctor for help. Also, make sure you know how often to check blood sugar and urine ketone levels. Keep your plan in a convenient place, and include contact information in case you need to reach your doctor at night or on the weekends.
Steps to take during an illness
Here are some general sick-day guidelines:
Continue taking your pills for diabetes (if you have type 2 diabetes) or insulin, even if you are vomiting and having trouble eating or drinking. Your blood sugar may continue to rise because of your illness. If you cannot take your medicines, call your doctor and discuss whether you need to adjust your insulin dose or other medicine.
Try to eat your normal types and amounts of food and to drink extra fluids, such as water, broth, carbonated drinks, and fruit juice. Encourage your child to drink extra liquids to prevent dehydration.
If your blood sugar level is higher than 240 milligrams per deciliter (mg/dL), drink extra liquids that do not contain sugar, such as water or sugar-free cola.
If you cannot eat the foods in your regular diet, drink extra liquids that contain sugar and salt, such as soup, sports drinks, or milk. You may also try eating foods that are gentle on the stomach, such as crackers, gelatin, or applesauce. Try to eat or drink 50 grams (g) of carbohydrate every 3 to 4 hours. For example, 6 saltine crackers, 1 cup (8 fl oz) of milk, and ½ cup (4 fl oz) of orange juice each contain approximately 15 g of carbohydrate.
Check your blood sugar at least every 3 to 4 hours, or more often if it is rising quickly, even through the night. If your blood sugar level rises above 240 mg/dL and your doctor has told you to take an extra insulin dose for high blood sugar levels, take the appropriate amount. If you take insulin and your doctor has not told you to take a specific amount of additional insulin, call him or her for advice.
If you take insulin, do a urine test for ketones every 6 to 12 hours, especially if your blood sugar is higher than 300 mg/dL. Call your doctor if you have more than 2+ or moderate ketones in your urine. Check your child's urine for ketones at least every 6 hours, even through the night.
Weigh yourself and check your temperature, breathing rate, and pulse frequently if your blood sugar is higher than 300 mg/dL. If you are losing weight and your temperature, breathing rate, and pulse are increasing, contact a doctor. You may be getting worse.
Don't take any nonprescription medicines without talking with your doctor. Many nonprescription medicines affect your blood sugar level.
When to call your doctor
Minor illnesses in people with diabetes—especially children with type 1 diabetes—can lead to very high blood sugar levels and possible emergencies. When children are sick, watch them closely for signs that they need immediate medical attention. Call 911 or other emergency services if you or your child has:
Symptoms of diabetic ketoacidosis (DKA), such as abdominal pain, vomiting, rapid breathing, fruity-smelling breath, or severe drowsiness.
Symptoms of dehydration, such as a dry mouth and very yellow or dark urine. Dehydration is particularly dangerous in children and may be caused by vomiting and diarrhea.
A low blood sugar level that continues.
It may not be necessary to call your doctor every time you or your child with diabetes has a mild illness, such as a cold. But it is a good idea to call for advice when you are sick and:
Your blood sugar level is higher than 240 mg/dL after taking the adjusted amount of insulin in your sick-day plan.
You take oral diabetes medicine and your blood sugar level is higher than 240 mg/dL before meals and stays high for more than 24 hours.
You have more than 2+ or moderate ketones in your urine.
You still have a fever and are not feeling better after a few days.
You are vomiting or having diarrhea for more than 6 hours.
When you are sick, write down the medicine(s) you have been taking and whether you have changed the dosage of your diabetes medicines based on your sick-day plan. Also note changes in your body temperature, weight, blood sugar, and urine ketone levels. Have this information handy when you talk to your doctor.
Credits
Author
Caroline Rea, RN, BS, MS
Editor
Susan Van Houten, RN, BSN, MBA
Associate Editor
Tracy Landauer
Associate Editor
Pat Truman, MATC
Primary Medical Reviewer
Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer
Stephen LaFranchi, MD - Pediatrics and Pediatric Endocrinology
Last Updated
December 3, 2008
Monday
Don't lose your feet! A report from the BBC shows that there is an increase in the number of amputations through diabetes type 2. It is so important to keep on top of your diabetes and to get your blood sugar and cholesterol under control. If you don't then you are at best self mutilating or at worst committing very slow suicide.
It seems that just a few cups of tea or coffee a day can help stave off diabetes.
This is from the BBC
Tea and coffee drinkers have a lower risk of developing type 2 diabetes, a large body of evidence shows.
And the protection may not be down to caffeine since decaf coffee has the greatest effect, say researchers in Archives of Internal Medicine.
They looked at 18 separate studies involving nearly 500,000 people.
This analysis revealed that people who drink three or four cups of coffee or tea a day cut their risk by a fifth or more, say researchers.
The same amount of decaffeinated coffee had an even bigger effect, lowering risk by a third.
Type 2 diabetes usually starts after the age of 40 and develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly. Type 2 diabetes is treated with a healthy diet and increased physical activity. In addition to this, medication and/or insulin is often required.
The identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus
The study authors
If the findings prove true, doctors may well start advising people to put the kettle on as well as take more exercise and watch their weight, say the researchers.
When the authors combined and analysed the data, they found that each additional cup of coffee consumed in a day cut diabetes risk by 7%.
Lead researcher Dr Rachel Huxley, from the University of Sydney in Australia, said because of the finding with decaffeinated coffee, the link is unlikely to be solely related to caffeine.
Instead, other compounds in coffee and tea - including magnesium and antioxidants known as lignans or chlorogenic acids - may be involved.
Special brew
"The identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus.
"If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes mellitus, or who are at future risk of developing it, would be substantial."
Dr Victoria King, of Diabetes UK, said: "Without full information about what other factors may be influencing the type 2 diabetes risk of the studies' participants - such as their physical activity levels and diet - as well as what the active ingredient in tea or coffee appears to be, we cannot be sure what, if anything, this observed effect is down to.
"What we can be sure of is that the development of type 2 diabetes is strongly linked to lifestyle, which means that many cases could be prevented by keeping active and eating a healthy balanced diet that is low in fat, salt and sugar with plenty of fruit and vegetables."
This press release is an announcement from the Archives of Internal Medicine
CHICAGO - Individuals who drink more coffee (regular or decaffeinated) or tea appear to have a lower risk of developing type 2 diabetes, according to an analysis of previous studies reported in the December 14/28 issue of Archives of Internal Medicine. A previously published meta-analysis suggested drinking more coffee may be linked with a reduced risk, but the amount of available information has more than doubled since.
By the year 2025, approximately 380 million individuals worldwide will be affected by type 2 diabetes, according to background information in the article. "Despite considerable research attention, the role of specific dietary and lifestyle factors remains uncertain, although obesity and physical inactivity have consistently been reported to raise the risk of diabetes mellitus," the authors write.
Rachel Huxley, D.Phil, of The George Institute for International Health, University of Sydney, Australia, and colleagues identified 18 studies involving 457,922 participants and assessing the association between coffee consumption and diabetes risk published between 1966 and 2009. Six studies involving 225,516 individuals also included information about decaffeinated coffee, whereas seven studies with 286,701 participants reported on tea consumption.
When the authors combined and analyzed the data, they found that each additional cup of coffee consumed in a day was associated with a 7 percent reduction in the excess risk of diabetes. Individuals who drank three to four cups per day had an approximately 25 percent lower risk than those who drank between zero and two cups per day.
In addition, in the studies that assessed decaffeinated coffee consumption, those who drank more than three to four cups per day had about a one-third lower risk of diabetes than those who drank none. Those who drank more than three to four cups of tea had a one-fifth lower risk than those who drank no tea.
"That the apparent protective effect of tea and coffee consumption appears to be independent of a number of potential confounding variables raises the possibility of direct biological effects," the authors write. Because of the association between decaffeinated coffee and diabetes risk, the association is unlikely to be solely related to caffeine. Other compounds in coffee and tea-including magnesium, antioxidants known as lignans or chlorogenic acids-may be involved, the authors note.
"If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes mellitus, or who are at future risk of developing it, would be substantial," they conclude. "For example, the identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus. It could also be envisaged that we will advise our patients most at risk for diabetes mellitus to increase their consumption of tea and coffee in addition to increasing their levels of physical activity and weight loss."
This is from the BBC
Tea and coffee drinkers have a lower risk of developing type 2 diabetes, a large body of evidence shows.
And the protection may not be down to caffeine since decaf coffee has the greatest effect, say researchers in Archives of Internal Medicine.
They looked at 18 separate studies involving nearly 500,000 people.
This analysis revealed that people who drink three or four cups of coffee or tea a day cut their risk by a fifth or more, say researchers.
The same amount of decaffeinated coffee had an even bigger effect, lowering risk by a third.
Type 2 diabetes usually starts after the age of 40 and develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly. Type 2 diabetes is treated with a healthy diet and increased physical activity. In addition to this, medication and/or insulin is often required.
The identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus
The study authors
If the findings prove true, doctors may well start advising people to put the kettle on as well as take more exercise and watch their weight, say the researchers.
When the authors combined and analysed the data, they found that each additional cup of coffee consumed in a day cut diabetes risk by 7%.
Lead researcher Dr Rachel Huxley, from the University of Sydney in Australia, said because of the finding with decaffeinated coffee, the link is unlikely to be solely related to caffeine.
Instead, other compounds in coffee and tea - including magnesium and antioxidants known as lignans or chlorogenic acids - may be involved.
Special brew
"The identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus.
"If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes mellitus, or who are at future risk of developing it, would be substantial."
Dr Victoria King, of Diabetes UK, said: "Without full information about what other factors may be influencing the type 2 diabetes risk of the studies' participants - such as their physical activity levels and diet - as well as what the active ingredient in tea or coffee appears to be, we cannot be sure what, if anything, this observed effect is down to.
"What we can be sure of is that the development of type 2 diabetes is strongly linked to lifestyle, which means that many cases could be prevented by keeping active and eating a healthy balanced diet that is low in fat, salt and sugar with plenty of fruit and vegetables."
This press release is an announcement from the Archives of Internal Medicine
CHICAGO - Individuals who drink more coffee (regular or decaffeinated) or tea appear to have a lower risk of developing type 2 diabetes, according to an analysis of previous studies reported in the December 14/28 issue of Archives of Internal Medicine. A previously published meta-analysis suggested drinking more coffee may be linked with a reduced risk, but the amount of available information has more than doubled since.
By the year 2025, approximately 380 million individuals worldwide will be affected by type 2 diabetes, according to background information in the article. "Despite considerable research attention, the role of specific dietary and lifestyle factors remains uncertain, although obesity and physical inactivity have consistently been reported to raise the risk of diabetes mellitus," the authors write.
Rachel Huxley, D.Phil, of The George Institute for International Health, University of Sydney, Australia, and colleagues identified 18 studies involving 457,922 participants and assessing the association between coffee consumption and diabetes risk published between 1966 and 2009. Six studies involving 225,516 individuals also included information about decaffeinated coffee, whereas seven studies with 286,701 participants reported on tea consumption.
When the authors combined and analyzed the data, they found that each additional cup of coffee consumed in a day was associated with a 7 percent reduction in the excess risk of diabetes. Individuals who drank three to four cups per day had an approximately 25 percent lower risk than those who drank between zero and two cups per day.
In addition, in the studies that assessed decaffeinated coffee consumption, those who drank more than three to four cups per day had about a one-third lower risk of diabetes than those who drank none. Those who drank more than three to four cups of tea had a one-fifth lower risk than those who drank no tea.
"That the apparent protective effect of tea and coffee consumption appears to be independent of a number of potential confounding variables raises the possibility of direct biological effects," the authors write. Because of the association between decaffeinated coffee and diabetes risk, the association is unlikely to be solely related to caffeine. Other compounds in coffee and tea-including magnesium, antioxidants known as lignans or chlorogenic acids-may be involved, the authors note.
"If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes mellitus, or who are at future risk of developing it, would be substantial," they conclude. "For example, the identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus. It could also be envisaged that we will advise our patients most at risk for diabetes mellitus to increase their consumption of tea and coffee in addition to increasing their levels of physical activity and weight loss."
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