Blood-vessel inflammation may signal diabetes, stroke

Diabetes researchers studying the mechanisms that lead to chronic illnesses are zeroing in on inflammation as a major factor in both diabetes and heart disease.

Scientists have recently noted that substances which signal inflammation, called inflammation markers, can be found in the blood of patients who have diabetes, as well as of those who have atherosclerosis, or hardening of the arteries, in which chronic inflammation of blood-vessel walls creates lesions that rupture, form clots and lead to stroke.

Now, data presented here at the American Diabetes Association suggest that inflammation is part of the disease process in both conditions and that these inflammation markers can be useful in predicting who will develop diabetes and which diabetics may suffer from heart disease.

Treating inflammation may be a way to prevent both diseases, says endocrinologist Paresh Dandona of the State University of New York-Buffalo. Dandona reported on research that shows a drug called rosiglitazone, one commonly taken by adults with diabetes to boost insulin sensitivity, appears to have anti-inflammatory properties.

That means treating diabetes with these drugs may produce two benefits: increasing insulin response and decreasing the risk of atherosclerosis. Rosiglitazone and probably other drugs in the same class, Dandona says, “can not only treat high glucose (sugar) levels in diabetes, they may actually prevent the major cause of death in diabetes.”

Other highlights from the diabetes meeting:

  • The GlucoWatch Biographer, a wristwatch-like device that tests blood sugar levels through the skin, appears to work in children as well as in adults, research suggests. A study in 40 children ages 7 to 17 who have type 1, or juvenile, diabetes found that automatic glucose monitoring significantly improved control of blood sugar. The device is licensed only for adults, but the developer, Cygnus, is seeking Food and Drug Administration approval for its use by children.
  • An international survey of 2,702 people with diabetes finds that 60% say they’re not worried about such long-term complications as blindness or limb amputation, although studies show that if untreated, 74% of people with diabetes will develop a complication that could lead to blindness, kidney failure or lower limb amputation. The study by the International Diabetes Foundation and Lions Clubs International Foundation also found a fatalism that researchers found especially disturbing. “Over 40% think nothing they do will change the course of their disease,” says James Gavin, a senior scientific officer at the Howard Hughes Medical Institute. “That’s wrong. We can prevent or delay all these complications. The fact that they don’t know that shows we have enormous work to do.”

The study points to the need for better education, says Croatian endocrinologist Zeljko Metelko, vice president of the International Diabetes Federation-Europe. “Enormous amounts of money are spent on research, and enormous amounts are spent on treatment,” he says, “but the transfer of knowledge to physicians and patients is lacking.”

 

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