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Diabetes TREATMENT RESEARCH & CURE

Posted on: Wednesday, 2 March 2005, 03:00 CST

In laboratories around the country, medical experts like Dr. Kristen G. Hairston (I.) and Dr. Kristen T. Hull-both endocrinology fellows at the University of Maryland School of Medicine-say new research, new medication and new approaches offer new hope for those who have diabetes. More than 18 million people-6 percent of the U.S. population-have the disease.

IT'S the fifth deadliest disease in the United States, and it has no cure. In fact, diabetes has become so insidious-striking more people than ever, and at an earlier age than ever-that medical and nutrition experts say it has reached pandemic levels.

Look at the numbers. Nearly 3 million-or 1 out every 10-African- Americans aged 20 and older have diabetes. Perhaps the hardest hit group is AfricanAmerican women. One in 4 Black women over 55 years of age have the disease. Blacks are nearly twice as likely to have diabetes than the general population, and are twice as likely to develop some of the most life-threatening consequences of the disease.

Then there's the cost. One of the most expensive diseases to treat, diabetes-related medical costs totaled $132 billion in 2002. But more than that, it was estimated that when disability, work loss and premature mortality are added in, diabetes cost America another $40 billion. In the end, 1 out of every 10 health care dollars is spent on diabetes.

But there is hope. Cuttingedge research and earlier recognition of symptoms, combined with new combinations of medications and a team approach to tackling the disease, are helping people with diabetes live longer, and healthier lives.

FUSING RATE AMONG ADOLESCENCE

Living longer and healthier is increasingly important because diabetes is striking at a much earlier age. Hard hit are today's youth, who are vulnerable because they, on average, gain more weight and are less physically active than past generations. With more calories coming from "fast" and processed foods, and less physical activity be cause of computer games and TV, youngsters not only eat more, but also burn fewer calories.

It all adds up to an increased possibility of developing diabetes at an earlier age. While genes have always played a role in type 2 diabetes, doctors say the combination of increased weight and decreased exercise promotes diabetes, particularly in AfricanAmerican youths, that might otherwise have been kept in check.

Regular medical examinations are among the most important elements in the battle against diabetes. Routine physical activity and a balanced diet are also major factors.

One of the most recognizable signs of a child with diabetes is thick, darkened skin around the neck or on other body parts that are frequently bent or rubbed. It's a condition called acanthosis nigricans. Scientists once believed acanthosis nigricans was associated with conditions such as polycystic ovarian syndrome, but recently they found that it is a marker for high levels of insulin.

Health experts say you should also watch for signs of diabetes itself (for example, increased desire for liquids, increased urine output, unusual tiredness, or a quick but unexplained drop in weight). While there are no guarantees, an active lifestyle and healthful weight seems to be the most important factors in warding off diabetes in youths.

THE SEARCH FOR A CURE

While insulin was discovered in 1921, it's only now that scientists are really beginning to understand how it truly works. Research today focuses on understanding ways to prevent diabetes and to more effectively treat complications.

Routine eye exams are necessary to save the sight of those who experience diabetes-related eye problems. Physicians recommend a dilated eye exam at least once a year.

Scientists are using genetics to understand type 2 diabetes and obesity, particularly fat cells, to develop new therapeutic and prevention strategies. There is also interest in the research community in the growth of pancreatic beta cells and their potential clinical use for treatment of type 1 diabetes.

With diabetes medication, studies are being conducted to determine why some people respond to certain diabetes drugs while others do not. There are also trials being conducted on new noninvasive blood glucose monitors.

Meanwhile, molecular studies of fat cells and how insulin works, as well as studies of growth hormone replacement in adults, offer some promise. In addition, new video technology is allowing clinicians to watch blood flow in the eye during examination, allowing earlier diagnosis of even small changes.

A nationwide study is also underway to determine if type 1 diabetes can be prevented or delayed in high-risk individuals by the use of small amounts of insulin injected daily, and in moderate- risk people by the use of insulin crystals taken orally.

Research studies have found that lifestyle changes, such as diet and moderate-intensity physical activity (such as walking for 2 1/2 hours each week), can prevent, reverse or delay the onset of type 2 diabetes in high-risk adults. In fact, in the American Diabetes Association's Diabetes Prevention Program, which studied people at high risk for diabetes, the development of the disease was reduced 58 percent over a 3-year period.

Some of the most important scientific initiatives in the diagnosis and treatment of diabetes have been the result of research at the Joslin Diabetes Center, which works closely with the American Diabetes Association to coordinate research and develop treatments.

Dr. Alan R. Shuldiner heads the Division of Endocrinology, Diabetes and Nutrition at the Joslin Diabetes Center at the University of Maryland School of Medicine. Utilizing candidate gene and positional cloning approaches, Dr. Shuldiner, in a 5,000square- foot, state-of-the art laboratory, searches for genes susceptible to diabetes and obesity, as well as gene variants that may predict responsivity to medications used to treat diabetes. Breakthroughs in these areas will provide unique avenues for therapy and prevention.

Increasing diabetes awareness is the goal of Cyclists for Christ, members of the First Baptist Church Berkley in Norfolk, Va. The group, including the church's pastor, the Rev. William Tyree (top, I.), were participants in the American Diabetes Association's 100- mile "Tour to Cure" bicycle race for diabetes research.

Dr. Kristen Hull, an endocrinology fellow at the University of Maryland School of Medicine, works with Dr. Shuldiner. She says research must always have an eye toward patient care. "We all know that diabetes is a major problem in the African-American community," she says. "Diabetes is a multisystem chronic disease that takes its toll on the body from head to toe. My patients and I work as a team for successful management of diabetes."

CHURCHES TACKLE DISEASE

The church is increasingly a part of a person's diabetes team, particularly in the African-American community. The main goal of churches involved in the process is to instill in their congregations the mind-set that they have power over diabetes, and as a result, power over their own health. Churches help members accept and cope with diabetes, an insidious disease that is not only hard on a person's body, but mind also.

The ADA has seen a surge in African-American churches supporting healthier lifestyles for their congregations. In workshop trainings, called "Project POWER," church leaders do everything from conducting cooking classes that help members learn new ways to prepare healthier meals to starting fitness ministries called "Fit for the Master's Use."

"Within the church, many people suffer from diabetes, and they don't know the facts about this disease, especially African- American women," says Betty Gillard, a registered nurse and Project POWER Ambassador for Bridge Street African Weslyen Episcopal Church in Brooklyn, N.Y. "Project POWER is an excellent educational tool that incorporates faithbased scriptures to reinforce healthy living messages."

ADA officials say the work of groups like Project POWER will be instrumental in helping victims of diabetes. And although African- Americans have higher incidence of diabetes complications when compared to other ethnic groups, medical experts are confident that as people become more knowledgeablethanks to the continuing efforts of researchers, physicians and others who are dealing with the disease-there will be a major reduction in the impact of the disease in the African-American community.

Blacks are nearly twice as likely to have diabetes, and the hardest hit group is AfricanAmerican women.

Excessive weight and decreased physical activity are blamed for the rising rates among Black youth.

Copyright Johnson Publishing Company Mar 2005

Source: Ebony

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