Can This Drug Reverse Diabetes?

6 Nov

What a thought. A common drug, already on the market to treat a different disease, may be able to reverse the course of diabetes for millions of people.

pancreas-showing-diabetes

In type 1 diabetes, beta cells in the pancreas are attacked by the immune system.

We all know the stats behind diabetes: it’s the 7th leading cause of death in the U.S. and contributes to heart disease, kidney disease, eye disease, neuropathy, and a host of other conditions. But researchers at the University of Alabama’s Comprehensive Diabetes Center will soon begin human trials to determine if a common drug prescribed for high blood pressure, verapamil, can stop the progression of diabetes and in some cases reverse it.

More than a decade of research

In 2002, Anath Shalev, M.D., a diabetes researcher at the University of Wisconsin – Madison, started investigating what genes in the human pancreas responded greatest to high levels of blood glucose. In type 1 and type 2 diabetes, certain beta cells in the pancreas – known as islet beta cells – are gradually lost to genetically programmed cell death, for reasons unknown. As these beta cells are lost, diabetes becomes much worse. Shalev’s research on islet beta cells revealed that a gene in these cells was producing a protein called TXNIP, which previous studies showed is overproduced in beta cells in the presence of high blood sugar. Too much TXNIP causes beta cell death and inhibits the body’s natural production of insulin.

For 12 years Shalev continued her research, eventually leaving the U of Wis to head the UAB’s Comprehensive Diabetes Center. Using cell cultures, mouse models, and pancreatic islet cells from humans, Shalev eventually showed that manipulating TXNIP could protect mice against diabetes or make it much worse.

In 2012, building on research from other teams, Shalev started testing verapamil on human islet beta cells. She discovered that the drug reduced TXNIP, and halted the death of beta cells. Shalev also discovered that mice which were fed verapamil in their drinking water actually reversed the course of their diabetes, and the drug protected other mice against diabetes. The following year, Shalev’s team discovered that high levels of TXNIP actually blocked insulin production in beta cells.

Clinical trials begin in 2015

In a recent press release Shalev stated that, “We have shown that verapamil can prevent diabetes and even reverse the disease in mouse models and reduce TXNIP in human islet beta cells, suggesting that it may have beneficial effects in humans as well. That is a proof-of-concept that, by lowering TXNIP, even in the context of the worst diabetes, we have beneficial effects. And all of this addresses the main underlying cause of the disease — beta cell loss.”

Clinical trials will begin soon to see if verapamil has the same effect on human type 1 diabetics as it does on mice. The three-year, $2.1 million trial will be conducted by the UAB Comprehensive Diabetes Center with funding from JDRF, the largest charitable supporter of type 1 diabetes research.

But Shalev expressed caution regarding the research results: “While in a best-case scenario, the patients would have an increase in beta cells to the point that they produce enough insulin and no longer require any insulin injections — thereby representing a total cure — this is extremely unlikely to happen in the current trial, given its short duration of only one year,” Shalev stated. But she also expressed optimism in regards to the research path. “Finally, we have reason to believe we are on the right track.”

This video simply explains what the UAB reserachers discovered and how dibetes effects beta cells in the pancreas.

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3 Resources For Diabetes Awareness Month in November

31 Oct

diabetes awareness month november

Among diabetes organizations, November is known as American Diabetes Month, Diabetes Awareness Month, and even National Diabetes Awareness Day (November 14). Regardless of the name, the purpose is to raise your awareness of this epidemic disease and its risk factors, and learn how you can avoid it or control it.

The startling facts about diabetes:

  • One in 12 Americans – more than 30 million – has diabetes
  • Diabetes is one of the leading causes of disability and death in the U.S. and worldwide
  • If not controlled, diabetes can cause blindness, nerve damage, kidney disease, heart disease, vascular problems, and foot and lower leg conditions, some leading to amputation
  • The American Diabetes Association estimates that the total national cost of diagnosed diabetes in the United States is $245 billion

Those statistics are nothing to take lightly. But if that weren’t bad enough, there’s a bigger crisis looming: Eighty-six million of us have prediabetes, which is chronic, elevated blood sugar levels which aren’t yet considered diabetic, but can quickly become so. Just a little bit of education however, can help you avoid developing diabetes and its many complications. For those already diagnosed with type 1 or type 2, use November to educate yourself about lifestyle changes you can make to control your disease, and schedule appointments with your physicians for an annual screening.

***All diabeteics should receive an annual screening from a podiatrist to look for early signs of numbness or hypersensitivity in the feet, which can be early warning signs of diabetic peripheral neuropathy. Visit our website to learn how to prevent diabetc complications in your feet.

Resource 1: The American Diabetes Association’s America Gets Cooking to Stop Diabetes

America Gets Cooking to Stop Diabetes is an initiative designed to engage and inspire people to live a healthier and more active lifestyle. The initiative encourages and empowers you to cook nutritious and delicious food and to be more active, with ideas like Get Moving Mondays and Tasty Tip Tuesdays. Get more info on America Gets Cooking to Stop Diabetes.

Resource 2: The National Diabetes Education Program

NDEP is a partnership of the National Institutes of Health, the Centers for Disease Control and Prevention, and more than 200 public and private organizations. Throughout National Diabetes Month, the NDEP will promote “Be Smart About Your Heart: Control the ABCs of Diabetes” to help people with diabetes learn they are at greater risk for heart disease, and how they can lower that risk by managing the diabetes ABCs: the A1C test, Blood Pressure, Cholesterol and Stop Smoking. Get more info on the National Diabetes Education Program.

Resource 3: JDRF and Thunderclap

JDRF, also known as the Juvenile Diabetes Research Fund, is an advocacy organization for raising awareness of Type 1 diabetes, the autoimmune disease one inherits from one or both parents. This November, JDRF is teaming with Thunderclap, a “crowdspeaking” social media platform that integrates with your facebook and twitter accounts. The concept behind Thunderclap is for everyone to share the exact same message on the same days on their social media accounts so that the JDRF posts have a chance to rise above the usual noise of cat memes and “5 Things You Can Do Right Now To…”  posts. Get more info on how you can help JDRF raise awareness for Type 1 diabetes.

Please join us in November in raising awareness of type 1 and type 2 diabetes.

Read our posts about diabetes

Schedule an appointment with one of our podiatrists for a diabetic foot exam.

Detroit’s Miguel Cabrera has surgery for bone spurs and stress fracture

27 Oct

cabrera hits a homer

Miguel Cabrera, legendary first baseman for the Detroit Tigers, surprised everyone – or no one at all, depending on who you ask – by announcing that he had right ankle surgery to remove the bone spurs which dogged him all season, and to repair a stress fracture of the navicular bone. The navicular bone lies on the top of the foot near the front of the ankle, and plays an important role in maintaining the arch of the foot.

If you’re a baseball fan, you no doubt heard that Cabrera struggled with these injuries the second half of the season this year, even though he hit .313 with 25 home runs, and 109 RBI’s (that’s a crap season for Cabrera, even though anyone else would be breaking out the Cristal and re-negotiating their contract with those numbers). By comparison, in 2013 Cabrera hit .348 with 44 home runs and 137 RBI’s, which won him his second consecutive American League Most Valuable Player award. By the end of this season however, Cabrera could barely run on the ankle due to the excruciating pain.

navicular bone fracture

Arrow points to the Navicular bone.

“It was a surprise, I’d say, for all of us,” team president Dave Dombrowski said. “We were not aware [the stress fracture] was there. I’m not sure how long it was there. He did have a couple of screws inserted. They cannot even believe once they went in there and looked at it that he could play with the ankle that he had. It’s worse than what we ever would have anticipated.”

Cabrera’s ankle will be reevaluated in 3 months, late in January, just a few weeks before the Tiger’s spring training is to begin.

Add Green Tea To Your Diet To Prevent Type 2 Diabetes

24 Oct

Tea, especially green tea, is the second-most popular beverage in  the world after water (take that, Coke and Pepsi!). You’ve probably heard that green tea has health benefits ranging from sharpening mental focus to helping to prevent cancer, but now it’s also been discovered to help prevent type 2 diabetes.

green tea for diabetes

“People with diabetes have problems metabolizing sugar,” says Suzanne Steinbaum, DO, a cardiologist and director of women’s heart health at Lenox Hill Hospital in New York City. “Through a complex biochemical reaction, tea — especially green tea — helps sensitize cells so they are better able to metabolize sugar. Green tea is good for people with diabetes because it helps the metabolic system function better.”

Research published in Diabetes and Metabolism Journal reviewed a Japanese study which found that people who drank six or more cups of green tea each day were 33 percent less likely to develop type 2 diabetes than were people who drank less than one cup of green tea a week. The study authors also highlighted research from Taiwan which found that people who drank green tea regularly for more than a decade had smaller waists and a lower body fat composition than those who did not drink green tea frequently.

How green tea helps prevent type 2 diabetes

Tea contains substances called polyphenols, a type of antioxidant found in many plants, and a magic bullet for good health. Polyphenols help regulate glucose, which helps to prevent or control diabetes. But polyphenols also help reduce oxidative stress and cause arteries to widen, which decreases blood pressure, prevents clotting, and reduces cholesterol. These actions reduce the risk for heart disease, which is a serious concern for diabetics.

All teas, black and green, contain polyphenols. But in green tea, the level of poyphenols is substantially higher. Look for bright colors in fruits and vegetables, and you’ll find high levels of polyphenols. Foods which pack a lot of polyphenols include pomegranates, berries, apples, grapes, broccoli, onions, tomatoes, spinach, red beans, and rhubarb. And oh yea, red wine. And cocoa (dark chocolate only).

Add brightly colored fruits and vegetables to your diet, along with nuts, fish, and green tea, and your diabetes management (and possibly prevention) will be much more successful. A little dark chocolate and red wine won’t hurt either.

NBA’s Kevin Durant Out With Jones Fracture

13 Oct

kevin durant jones fracture
The NBA’s MVP and four time scoring champ Kevin Durant has a Jones fracture in his right foot and will be sitting on the bench for 6-8 weeks, Oklahoma City Thunder Executive Vice President and General Manager Sam Presti announced over the weekend. The fracture is most likely the result of stress and occurred over time, and wasn’t due to a specific event. “From what I’ve been told, a Jones fracture is the most common surgical procedure performed on NBA players as of late,” Presti said.

A Jones fracture is a potentially serious injury for an athlete. It is a stress fracture of the fifth metatarsal of the foot, the outermost bone, which begins at the base of the small toe. The Jones fracture occurs in the midportion of the bone, causing swelling and pain. Many don’t realize they have it, try to play through the at-first mild pain, and this stress on the fracture makes it much worse. Non weight-bearing is essential for proper healing.

The Jones fracture is also particularly difficult to heal well, and frequently requires surgery to successfully repair, along with 4-6 weeks of physical rehab. The good news is, Durant informed his team trainers during practice Saturday about the aching and discomfort in his foot. They performed imaging scans on the sore area, which revealed the jones fracture. Had Durant played another game or two on the injured foot, the fracture may have become much worse and kept him out all season. At this point, it appears he’ll be back on the court sometime in December to finish out the season. Durant, entering his eighth season, has only thus far missed a total of 16 games.

Treating a Jones fracture

For those who aren’t professional athletes, the normal course of treatment for a Jones fracture is to immobilize the foot in a cast, splint, or walking boot for 6-8 weeks. This is usually sufficient treatment in 75% of cases. However, if you’re an athlete and your career depends on the health of your feet, surgery is usually performed to secure the bones in place with screws, plates, wires, or pins, so the metatarsal heals as close to perfect as possible. The 5th metatarsal has a limited blood supply due to its size, and surgery insures that the bone will set correctly and hold up under the pounding of playing on a hard court every day.

jones fracture

Jones fracture symptoms

  • Pain, swelling, and/or bruising in the region of the 5th metatarsal bone – below your small toe
  • Severe pain when walking

Jones fracture treatment

  • In most cases, immobilization of the fractured foot in a walking boot or cast
  • Non weight-bearing
  • Over the counter ant-inflammatory pain relievers such as advil (ibuprofen) or aleve (naproxen)
  • Foot surgery if necessary
  • 2-3 weeks of physical rehabilitation after immobilization to insure proper healing of the bone

Type 2 Diabetes Rate Declines – Except for Blacks and Hispanics

8 Oct

Over the past two decades, the occurrence of Type 2 diabetes in adults doubled. Now for the first time, according to new research from the Centers For Disease Control, the rate has leveled off – at least for some in the population.

type-2-diabetes-rates-down-websize

The CDC reports that the total number of people living with diabetes increased an average of 0.6 percent annually between 2008 and 2012, to the current 8.3% of adults. Do the math and that’s nearly 21 million people over age 18 with diabetes, in the U.S. alone.

But the rates at which new cases are accumulating have slowed in certain population groups in recent years, a fact also confirmed in a report in the Journal of the American Medical Association (JAMA). The CDC researchers said that the change may be due to another positive trend – the stabilization of obesity rates in the U.S.

“We are still seeing new and existing cases of diabetes going up, but the speed at which they are going up is leveling off,” said Ann Albright, director of the CDC’s Division of Diabetes Translation. “It gives us hope,” she says. “It’s important that we begin to slow down this runaway train.”

Unfortunately, the rate of type 2 diabetes continues to grow among blacks and Hispanics, the elderly, and those without a college education, according to the JAMA report. Those with a high school education or less were more than twice as likely to develop Type 2 diabetes than those who have completed college.

What’s being done to slow the growth of type 2 diabetes?

Figures from the CDC show that nearly 48 percent of non-Hispanic blacks and more than 42 percent of Hispanics are obese, making them more vulnerable to developing type 2 diabetes. The CDC has had great success with its National Diabetes Prevention Program, a lifestyle change program that can cut a person’s risk of type 2 diabetes in half. However, the continued increase in diabetes rates among blacks, Hispanics and people with less than a high school education, reflects the difficulty in reaching these parts of the population with programs like the NDPP.

Albright sad, “You have to begin to look at things like poverty level, access to diabetes prevention services, and making sure that these services are culturally appropriate and easy for people to access.”

Reaching the Hispanic population

The American Diabetes Association says that roughly 13 percent of U.S. Latinos have diabetes, but many of them are undiagnosed. At Alivio Medical center, on the east side of Indianapolis, great strides have been made in educating their Hispanic patients. There, Fridays and Saturdays are known as “diabetes days”, with a focus on diabetes diagnosis and treatment. According to Dr. Alfredo Lopez-Yunez, he’s seen “… an explosion of new diagnoses. We diagnose maybe 10 new patients a month, which is staggering in this relatively small practice. Even more concerning is that we’re diagnosing them at an earlier age.” Dr. Lopez-Yunez said that type 2 diabetes among Latinos in their 20s and 30s would have been unheard of ten or twenty years ago.

“Right now I’m diagnosing people with Type 2 diabetes in their 20s, and this disease is going to be with them forever,” he said. The result of undiagnosed or unmanaged diabetes may be runaway heart disease, kidney disease, an impact on eye health, neuropathies, foot ulcers, and many other health complications.

5 Exercises to Relieve Hammer Toes

2 Oct

Hammer toes occur when the middle joint of the second, third, or fourth toes bends in an upward position, creating a claw-like or hammer look. Hammer toes are not a serious condition, but they can become quite painful, causing shooting pains and discomfort throughout your toes and feet, and soreness where the toe rubs the inside of the shoe. They can develop at any age, even adolescence.

hammer toes hammertoes
There are a number of treatment options for hammer toes, including surgery, but you can also do these 5 exercises at home to reduce your discomfort (but they won’t cure the hammer toe). The reason that normal toes become hammer toes is due to muscles and tendons tightening and pulling the toe into an upward position. Relieving this tension via stretching exercises which pull the muscles in the opposite direction, can work wonders for alleviating pain.

1. Toe Stretch

Sitting on the floor with your legs straight head of you, wrap a bath towel under your toes, and pull towards you so just the toes move. Hold for 30 seconds. This may also be done with your hands.

2. Toe Taps

Sit on a chair and remove your sock. Extend your big toe down toward the floor while at the same time extending the rest of your toes up in the air. Hold for 10 seconds and then lightly tap the floor with your toes 12 times. Then reverse your toe position so the big toe is pointed up and the remaining toes pointing down. Repeat.

 3. Toe Crunches

Sit on a chair barefoot. Place a bath towel on the floor and place the upper half of your foot on top of the towel. While keeping your heel flat on the ground, crunch the towel up with your toes. Release and repeat 12 times.

4. Toe Squeeze

Sitting in a chair, place your foot over your thigh. Slide your fingers in between your toes and squeeze your toes together, as if to pinch your fingers. Release and repeat 12 times.

5. Toe Rolls

Toe Rolls are not pastries – they’re an exercise similar to when you tap your fingers from side to side on a table. Stand barefoot on a flat surface. Lift all of your toes upwards off the ground together, then roll them down one at a time from the little toe to the big toe. Repeat 12 times, then change directions.

Read more about hammer toes and their treatment.

What’s up with the spate of foot and ankle injuries in the NFL?

25 Sep

We’re only going into the 4th week of the regular football season and already we’ve seen a huge percentage of below the knee injuries. Why? Who knows, perhaps it’s just bad luck. But we do know that the NFL team trainers have a lot to deal with this season.

Here’s a list of foot and ankle injuries suffered by NFL players so far, and this may be the biggest list we’ve seen this early in the season.

DeAngelo-Hall

DeAngelo Hall of Washington is out for the season with a ruptured Achilles tendon.

The most significant injuries, which will cause each player to miss playing time are:

DeAngelo Hall, Washington, ruptured Achilles tendon, out for the season

Robert Griffin, Washington, dislocated ankle

Kam Chancellor, Seattle, bone spurs in ankle

Geoff Schwartz, New York Giants, dislocated toe

Danny Woodhead, San Diego, high ankle sprain

Tramaine Brock, San Francisco, sprained toe

Vernon Davis, San Francisco (they’re just saying “ankle injury”)

Manti Te’o, San Diego, right foot fracture

Rod Streater, Oakland, foot fracture

Tyvon Branch, Oakland,  Jones Fracture

Jon Beason, New York Giants, foot fracture

Matt Cassel, Minnesota, fractured foot – multiple bones

Koa Misis, Miami, ankle injury

Jamaal Charles, Kansas City, high ankle sprain

Arthur Jones, Kansas City, high ankle sprain

Jonathan Goodwin, New Orleans, high ankle sprain

Matt Tobin, Philadelphia, high ankle sprain

Khaled Holmes, Indianapolis, high ankle sprain

Joe Reitz, Indianapolis, high ankle sprain

 

And there have been less serious foot and ankle injuries to:

Brandon Bair and Wesley Woodyard, Tennessee; Dri Archer, Pittsburgh;  Miles Burris, Oakland; Chris Johnson, New York Jets; Tamba Hali, Kansas City; Damien Williams, Miami; Husain Abdullah, Cyrus Gray, and Eric Berry, Kansas City, Storm Johnson, Toby Gerhart, Mickey Shuler, Paul Posluszny, and Allen Hurns, Jacksonville; T.Y. Hilton, Indianapolis; Johnathan Joseph, Garrett Graham, Andre Johnson, Houston; Calvin Johnson, Detroit; Brandon Marshall, Chicago; A.J. Green and Marvin Jones, Cincinnatti; Robert Woods, Da’Norris Searcy, and Lee Smith, Buffalo; Harry Douglas and Devin Hester, Atlanta; and Andre Ellington of Arizona.

See our point? That’s a long list, and we’re especially curious about the number of high ankle sprains. We don’t recall having ever seen that many at one time – especially in week 4.

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