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Experts discuss and deliberate on diabetes at EASD 2013

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The 49th Annual Meeting of European Association for the Study of Diabetes (EASD) was recently held at Fira Gran Via in Barcelona, Spain. The event saw attendance from the world’s leading international forum for diabetes research.

A UK study presented at this event revealed that there have been considerable improvements in life expectancy of the population of Scotland, UK suffering from type I diabetes and recommended that this should now be reflected in life insurance and other relevant policies for those with the condition. The research has been done by professor Helen Colhoun and Shona Livingstone, University of Dundee, UK, and colleagues on behalf of the Scottish Diabetes Research Network.

The study looked at people living with type I diabetes and aged 20 years or older anytime between 2008-2010 and revealed that the remaining life expectancy of type I diabetics aged 20-24 years was 45 years and 47 years for men and women respectively compared to estimates of 56 and 61 years respectively for the male and female general populations. The remaining life expectancy for those aged 65-69 years was estimated at 12 years for both men and women compared to 17 years and 19 years for the male and female general population.

Another study on type I diabetes showed that having children lowers mortality in people with type 1 diabetes, but for women more than men. The research was conducted by Dr Lena Sjöberg, University of Helsinki, Helsinki, Finland and National Institute for Health and Welfare, Helsinki, Finland, and colleagues. Sjöberg and team examined mortality and the causes of death among subjects with childhood-onset of type I diabetes as compared to control people, with a focus on mortality differences between childless people and those having had offspring. The effect of having offspring was looked at people in four categories: no children, one child, two children, three or more children. In general, the more children a person had, the lower mortality, but this trend was less pronounced in men than in women. Overall, all-cause mortality was half in persons who had offspring, among both people with diabetes and controls, and in both genders.

Many research papers on type II diabetes were also presented at EASD. One research claimed that patients receiving sulfonylureas as first line treatment for type II diabetes have higher mortality than those receiving metformin. The researchers, led by professor Craig Currie, Cardiff University, UK, evaluated the comparative risk of all-cause mortality for patients exposed to first-line diabetes monotherapy with either sulfonylureas or metformin and found that mortality is increased by 58 per cent when sulfonylureas is used as first-line therapy. Hence, Currie and colleagues opine that it may no longer be appropriate to offer first line treatment with sulfonylureas as a result of these findings.

Yet another research looked at the ‘obesity paradox’ and surprisingly, found that older patients with type II diabetes who are obese have lower mortality than those with a lower body-mass index (BMI), a relationship not shown in younger patients. The findings could mean either of the two _ type II diabetes that develops due to obesity is different to that not related to obesity or that obesity offers metabolic protection from death in older people with type II diabetes. This study is by Dr Pierluigi Costanzo, Universities of Hull and York, UK, and colleagues.

Another study presented at EASD 2013 also looked at obesity and its relation with diabetes. Exercise can chemically alter the genes associated with obesity or type II diabetes that are present in human adipose (fat) tissue, reveals a research by Dr Tina Rönn, Lund University, Malmö, Sweden. In this study, Ronn and colleagues looked at how the DNA methylation pattern (how much the DNA had been chemically altered) in adipose tissue had changed in healthy men before and after a six months exercise intervention. The clinical and metabolic outcomes of the exercise intervention was a significant decrease in waist circumference, waist/hip ratio, diastolic blood pressure and resting heart rate, whereas a significant increase was seen for exercise capacity and ‘good’ cholesterol (HDL cholesterol).

Professor Daniela Jakubowicz, Tel Aviv University, Israel, and Dr Hadas Rabinovitz, The Hebrew University of Jerusalem, Rehovot, Israel, and colleagues also presented a study in which a big breakfast rich in protein and fat appears to offer more benefits to people with type II diabetes than a smaller low calorie breakfast. In this study, the researchers analysed the effect of breakfast size and composition on blood glucose control and its association with hormone profile in adults with type II diabetes.

In another study, an analysis of genetic variations known to be associated with type II diabetes shows that a ‘bad’ variant of KCNJ11 E23K polymorphism, also increases the risk of cardiovascular mortality by at least 20 per cent. Some 40 per cent of the type II diabetic population has this bad variant. The research is by Associate Professor Valeriya Lyssenko, Lund University, Malmö, Sweden, and Steno Diabetes Center, Gentofte, Denmark, and Dr Sami Alkayyali, Lund University, Malmö, Sweden.

EP News BureauMumbai

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