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Seared tuna with butter beans and roasted tomatoes

Preheat the oven to 180ºC / 350ºF / gas mark 4. Mix together the cumin, coriander seeds and chilli flakes, press into both sides of the tuna and set aside for 30 minutes to allow the flavours to develop. Meanwhile, heat the oil in a small pan and fry the onion and garlic for 2-3 minutes. Transfer to an ovenproof dish with the butter beans and tomatoes, place in the oven for 30 minutes until the tomatoes begin to char. Heat a griddle pan until smoking and sear the tuna for about 1 m ...

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25 Jul 2012
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South Sefton Diabetes Group Update - Aug 2012
25 Jul 2012
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25 Jul 2012
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31 per cent of parents unable to identify their child as overweight
A study finds parents may not be able to spot obesity in their children, with researchers highlighting the enormity of the obesity epidemic . The research was conducted at the London School of Hygiene and Tropical Medicine (LSHTM) and the University College London Institute of Child Health. 2,976 families in the UK were given questionnaires, with 31 per cent of parents underestimating the weight of their children. Obesity is a leading cause of type 2 diabetes, with researchers concerned that public interventions to reduce type 2 diabetes, such as promoting healthier eating and getting more exercise, are not being addressed in family homes. It was only when children had a BMI over the 99th centile - which would class them as obese - that parents became more likely to accurately diagnose their child. Otherwise, children classed as very overweight (or obese) at the 95th centile, were extremely likely to be classed as a healthy weight by parents. The researchers, whose findings were published in the British Journal of General Practise, also report that parents are more likely to spot potential health complications if they can correctly recognise their children's weight. "If parents are unable to accurately classify their own child's weight, they may not be willing or motivated to enact the changes to the child's environment that promote healthy weight maintenance," said senior author Dr Sanjay Kinra, reader in clinical epidemiology at LSHTM. Professor Russell Viner, co-author and academic paediatrician at the UCL institute of Child Health, added: "Measures that decrease the gap between parental perceptions of child weight status and obesity scales used by medical professionals may now be needed in order to help parents better understand the health risks associated with overweight and increase uptake of healthier lifestyles."
MiniMed 640g insulin pump released in UK to mimic healthy pancreas
An insulin pump-based artificial pancreas has been launched for use in the United Kingdom to treat patients with type 1 diabetes. How does the device work? The Medtronic MiniMed 640G detects when blood sugar levels are falling and stops insulin from being produced. It is designed to closely mimic the way insulin is delivered to the body by a healthy pancreas. The MiniMed 640g is an insulin pump in itself, but develops the properties of an artificial pancreas when used with continuous glucose monitoring (CGM) sensors. The device attaches to the body using a number of tubes that are inserted under the skin. An algorithm to predict hypoglycemia is then run by a tiny computer inside the device. With the majority of hypoglycemic attacks reported to occur during sleep, a primary reason the MiniMed 640G has been credited is for preventing overnight hypos, The first person fitted with this artificial pancreas was an Australian boy in January, but from this week, British patients with diabetes will now able to purchase it. How much will the MiniMed 640g cost? The MiniMed 640G will reportedly cost private patients £7,000 annually, taking into account the costs of infusion sets and CGM sensors through the year. However, patients who suffer frequent severe hypoglycemia will be able to apply for eligibility to receive the system through NHS funding. Routine funding is not expected to be considered until further trials on the device have been carried out. Some hospitals, however, are offering the pump to patients with severe hypoglycemia. Between 20 and 30 patients are using the new pump at King's College London, according to Dr Pratik Choudhary, Senior Lecturer and Consultant in Diabetes. "This new MiniMed 640G system represents another important step forward towards an artificial pancreas. Our early experience is that patients love it for the peace of mind and safety it gives them overnight due to its ability to protect them against hypoglycemia," Choudhary said.
New cholesterol drugs could be more effective than statins
A new class of cholesterol drugs is being developed. Preliminary research suggests that the drugs reduce levels of "bad" cholesterol more effectively than anything currently available, and significantly reduce the risk of heart attacks and stroke. The drugs have the potential to be more effective than statins, which are the currently the most common cholesterol-lowering drug. But it has not been proved that statins reduce the risk of heart disease in stroke. Furthermore, recent research has indicated that statins may increase the risk of type 2 diabetes. Heart diseases is one of the most common diabetic complications. One study concluded that statins increase the risk of type 2 diabetes by 46 per cent. The new drugs, known as evulocumab and alirocumab, reduce levels of low-density lipoprotein in the body, potentially by as much as 60 per cent. The drugs could be more effective than statins. Both drugs inhibit PCSK9, which is a protein responsible for the regulation of cholesterol. The drugs are being produced by American companies. The Food and Drug Administration (FDA) may approve them this year. But it may be several years before the drugs - if they work as intended - could be used in the UK; research is still at a preliminary stage. Healthy cholesterol levels are particularly important for people with diabetes. Over time, prolonged exposure to high blood glucose levels can damage the arteries, making them more likely to narrow and clog. This can lead to heart disease, which is one of the most common diabetic complications. Studies suggest that as many as 80 per cent of people with diabetes will die of heart failure. "The reduction in LDL was profound and that may be why we saw a marked reduction in cardiovascular events so quickly," said lead author Marc Sabatine, senior physician in the Division of Cardiovascular Medicine at Brigham and Women's hospital in Boston. "It suggests that if we can drive a patient's LDL cholesterol down a large amount to a very low level, we may start to see a benefit sooner than would be expected with a more modest intervention. "We won't have any definitive answers until this larger trial we are doing is complete, but these data now give us a sense for the potential clinical benefit of these drugs." The study was published in the New England Journal of Medicine.
Metformin and glyburide effective for managing gestational diabetes
Metformin and glyburide, two common type 2 diabetes drugs, can effectively help with blood glucose management in women with gestational diabetes, according to new research. The study, published in the Journal of Clinical Endocrinology and Metabolism, found that both drugs can be used to manage gestational diabetes, but noted that glyburide treatment was associated with several side effects. These include significant weight gain (for the mother), high birth weight, and macrosomia. The researchers analysed 18 randomly-selected clinical trials to assess whether metformin and glyburide are safe and effective for gestational diabetes management. They found no difference between the different drugs, both for fasting blood glucose levels and HbA1c levels. In other words, neither metformin nor glyburide was more effective than the other. Neither was there any significant difference between the oral diabetes drugs - metformin and glyburide - and insulin. Metformin appeared to be safer than glyburide, which was associated with weight gain, higher birth weight, higher risk of neonatal hypoglycemia (low blood sugar levels in the new born baby), and macrosomia (dangerously heavy birth weight). The researchers wrote: "In conclusion, both metformin and glyburide are suitable for use in management of [gestational diabetes] because of good glycemic control. "However, glyburide treatment is associated with increased risk of neonatal hypoglycemia, high maternal weight gain, high neonatal birth weight and macrsomia."
NHS places too much emphasis on bariatric surgery, report suggests
The NHS attitude to bariatric surgery has been described as "inexplicable." A report by the Health Select Committee criticises NHS England for spending more money on weight loss surgery than on measures to prevent obesity. It is important, the report argues, that more emphasis is placed on spreading awareness of the benefits of exercise: "The committee regards it as inexplicable and unacceptable that the NHS is now spending more on bariatric surgery for obesity than on a national roll-out of intensive lifestyle intervention programmes that were first shown to cut obesity and prevent [type 2] diabetes over a year ago." Obesity increases the risk of a number of health problems, including type 2 diabetes, heart disease, stroke, and some types of cancer. Obesity is a major (although by no means the only) cause of type 2 diabetes. By encouraging the public to eat more healthily and get more exercise, the report suggests, the government could see rates of type 2 diabetes drop significantly. The report recommends a stricter regulation of food ingredients, banning the marketing of sugary drinks to children, and providing greater support for people who are at risk of becoming obese or developing type 2 diabetes. In short, the report suggests that bariatric surgery would not be necessary if money was spent more wisely elsewhere. "It is vital that the importance of physical activity for all the population - regardless of their weight, age, gender, health, or other factors - is clearly articulated and understood." "We call on the next government to make a clear commitment, together with appropriate long-term funding, to significantly increase the levels of cycling and walking. The report highlights the significant disparity in exercise levels between men and women as an example of inadequate promotion of the benefits of exercise. On the other hand, a recent analysis by the Royal College of Surgeons indicates that bariatric surgery has become less common in the past two years, which suggests that things are being improved. John Middleton, vice-president of the Faculty of Public Health, said: "Bariatric surgery generates huge costs to patients, families and the NHS . We need public health policies that can save money by helping prevent people becoming obese in the first place." Professor John Wass, of the Royal College of Physicians, commented: "It is welcome to see the findings of this report recognise the importance and benefits of physical activity beyond just weight loss, as previous findings have shown regular physical activity of just 30 minutes, five times a week, can make a huge difference to a patient's health."
Type 2 drug thiazolidinediones linked to weight gain
Researchers believe they know why thiazolidinediones (TZDs), a drug used to treat type 2 diabetes, can cause people to gain more body fat. TZDs, which reduce the amount of glucose produced in the liver and lower insulin resistance in fat and muscle, were investigated by a team at Georgia State University. According to their findings, TZDs also activate sensors in the brain that are responsible for appetite, triggering food intake. Peroxisome proliferator-activated receptor gamma sensors, a group of nuclear receptor proteins, are linked with agouti-related protein cells, which are known as hunger-stimulating cells. When researchers activated these sensors in rodent models, the animals immediately became hungry and reportedly even woke up when sleeping to go and eat. However, the animals ate and stored less food when these sensors were blocked, with Johnny Garretson, study author and doctoral student in the Neuroscience Institute and Centre for Obesity Reversal at Georgia State, explaining: "People taking these TZDs are hungrier, and they do gain more weight. This may be a reason why. "When they're taking these drugs, it's activating these receptors, which we believe are controlling feeding through this mechanism that we found." The results of this study were published in The Journal of Neuroscience.
Type 2 drug sitagliptin could reverse cognitive function decline
An oral diabetes medication called sitagliptin could reverse the decline in cognitive function commonly associated with diabetes and Alzheimer's disease. Ulster University researchers aimed to assess whether sitagliptin, which is used to treat type 2 diabetes, could reverse memory impairment and improve metabolic control in mice. They fed mice a high-calorie diet and gave them either sitagliptin or saline over 21 days, with energy intake, glucose and insulin concentrations among the variables measured at regular intervals. Improving memory function Sitagliptin was found to improve glucose tolerance and insulin sensitivity, while decreasing dipeptidyl peptidase-4 (DPP-4) activity. This inhibition of DDP-4 activity improved recognition memory of the mice without anxiety levels and hypermoteric activity being affected. Researchers concluded that DDP-4 inhibitors may result in dual benefits by improving metabolic control as well as reducing cognitive decline. The team at Ulster now want clinical trials to be conducted on humans to assess whether sitagliptin offers a viable treatment for neurodegenerative disorders such as Alzheimer's. Professor Victor Gault said: "Our studies now show that when these mice are treated orally with Sitagliptin that this drug reverses their cognitive decline as well as their diabetes. "Ulster University believes these new findings offer enormous potential for drug repurposing and that an already licensed drug could be tested safely in humans to ascertain if the drug also offers beneficial neuroprotective effects in Diabetes and Alzheimers disease."
Eylea approved by FDA to treat diabetic retinopathy
An injected drug called Eylea has been approved by the U.S. Food and Drug Administration (FDA) to treat diabetic retinopathy in patients with diabetic macular edema. Patients who have diabetic retinopathy with macular edema can find abnormal new blood vessels growing on the surface of the retina. This can make it hard to focus clearly. Diabetes is a leading cause of blindness, and if those blood vessels break, severe vision loss or blindness can occur in patients. What is Eylea? Eylea (aflibercept) is marketed by Regeneron Pharmaceuticals in Tarrytown, New York, and received FDA approval on Wednesday 25 June, 2014. This was based on findings where patients taking Eylea displayed significant improvements in the severity of their diabetic retinopathy compared to participants not taking the drug. Eylea is intended for use alongside appropriate measures to control blood sugar levels, cholesterol and blood pressure in patients. An injection into the eye would be administered once a month by a doctor for the first five injections - this would then be done once every two months. Among the side effects of Eylea include eye pain, cataracts and increased pressure inside the eye, while retinal detachments are among the serious adverse reactions. In February, Lucentis 0.3 mg (ranibizmub injection) was approved by the FDA to likewise treat diabetic retinopathy in patients with macular edema, with Edward Cox, M.D., M.P.H, director of the Office of Antimicrobial Products in the FDA's Centre for Drug Evaluation and Research saying approval of Eylea "gives patients with diabetic retinopathy and diabetic macular edema another therapy to treat this vision-impairing complication."
Human gene linked to insulin resistance
A human gene variant could be linked to insulin resistance, according to new research. The study, published in the Journal of Clinical Investigation suggests that a specific variant of the gene N-acetyltransferase 2 (NAT2) is associated with a number of risk factors for type 2 diabetes and heart disease, including insulin resistance. Insulin resistance is a significant risk factor in the development of type 2 diabetes and heart disease. In many cases, insulin resistance is caused by obesity, but recent studies suggest that insulin resistance can be inherited. The researchers analysed the gene variations of 5,000 participants, and found that those with lower levels of NAT2 were more likely to have insulin resistance and heart disease. The researchers then impaired NAT2 levels in mice, which negatively affected their insulin sensitivity. The results strongly suggest that mutations in the NAT2 gene cause the development of insulin resistance. People with insulin resistance are significantly more likely to go on to develop type 2 diabetes and heart disease. Joshua Knowles, assistant professor of medicine and lead author of the paper, said: "This is another step to reiterate to the community that insulin resistance is a major problem that has a real, distinct genetic basis. "Our goal was to try to get a better understanding of the foundation of insulin resistance. Ultimately, we hope this effort will lead to new drugs, new therapies and new diagnostic tests. "It's still early days. We're just scratching the surface with the handful of variants that are related to insulin resistance that have been found."
New gene discovered, determines where fat is stored on the body
The location of fat storage in the body plays a significant role in the development of type 2 diabetes and heart disease. People who store fat around their bellies have a higher risk of developing type 2 diabetes and heart disease than people with bigger hips and thighs. A new study suggests that Plexin D1, a newly-discovered gene, determines whereabouts on the body fat is stored and how fat cells are shaped. The research, published in the Proceedings of the National Academy of Sciences, could lead to the development of new strategies to prevent the onset of type 2 diabetes and reduce the risk of heart disease. The research was conducted on zebrafish. Some were engineered to be without the Plexin D1 gene, and they stored less fat around their bellies, suggesting they were less likely to develop type 2 diabetes and heart disease. Moreover, the zebrafish without the Plexin D1 gene were less likely to develop insulin resistance, even when fed an unhealthy diet. When the zebrafish were given a glucose tolerance test, they were highly effective at removing sugar from their blood. Insulin resistance is a significant risk factor for type 2 diabetes and heart disease, suggesting an added significance to the findings. Previous research indicates that people with type 2 diabetes have higher levels of Plexin D1 than people without type 2 diabetes, suggesting that the research may have even greater significance. "This work identifies a new molecular pathway that determines how fat is stored in the body, and as a result, affects overall metabolic health," said John F. Rawls, senior author of the study and associate professor of molecular genetics and microbiology at Duke University School of Medicine. "Moving forward, the components of that pathway can become potential targets to address the dangers associated with visceral fat accumulation." "Our results indicate that the genetic architecture of body fat distribution is shared between fish and humans, which represents about 450 million years of evolutionary divergence. "For these pathways to have been conserved for so long suggests that they are serving an important role."