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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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NHS drugs costing more than GBP20 to have price written on them
Health secretary Jeremy Hunt has unveiled plans to have the price written on NHS medication that costs more than £20. The measure is intended to encourage people not to waste medication. The same medicines will also have "funded by the UK taxpayer" written on them. It is hoped that this will remind patients that the NHS is facing financial difficulties. Wasted medication costs the NHS £300 million a year; it is estimated that between 30 and 50 per cent of patients do not complete their medication courses as intended. Hunt announced the plans on Wednesday, emphasising the need for patients to take personal responsibility for their own health in order to reduce the economic burden placed on the NHS by increasing rates of complex health conditions. "We intend to publish the indicative medicine costs to the NHS on the packs of all medicines costing more than £20, which will also be marked 'funded by the UK taxpayer,'" said Hunt. "This will not just reduce waste by reminding people of the cost of medicine, but also improve patient care by boosting adherence to drug regimes." Hunt's plan has been criticised by Pharmacy Voice, which represents the interest of high street pharmacists. "Pharmacy Voice believes that although this may seem superficially attractive, there is little evidence that it will have the desired effect, and there may be unintended negative consequences," said a spokesman. "The value of a medicine to an individual is about a good deal more than the price. Research shows that some patients, particularly older people, could be deterred from taking the medicines they need because they are worried about the impact on the public purse." The spokesman added that a much more effective measure would be encouraging the proper use of medication. Neil Patel of the Royal Pharmaceutical Society echoed these concerns: "Although knowledge of the cost of medicines may play a part, it's equally important we focus on factors such as people's understanding of the side effects and benefits from medicines which will also influence whether a condition is treated effectively or the medicine ends up in the bin."
Type 1 diabetes reversed in mice using brown fat transplants
Researchers have reversed type 1 diabetes in non-obese mice using brown fat transplants. If this research is developed, it could hold great therapeutic potential for humans with type 1 diabetes. The study, which was published in the American Journal of Physiology, was conducted on 27 non-obese mice. At the beginning of the study, the mice were weighed, and their non-fasting blood glucose samples were collected. Then the mice were given brown adipose tissue (or brown fat) transplants (BAT transplants). After further testing, the researchers observed that the transplants appeared to have boosted insulin-like growth factor-1 (IGF-1) in the mice. "Adipogenic and anti-inflammatory properties of IGF-1 may stimulate regeneration of healthy white adipose tissue, which in turn secretes hypoglycemic adiokines that substitute for insulin," the authors wrote. "These data demonstrate the potential for insulin-independent reversal of autoimmune-induced T1D with BAT transplants and implicate IGF-1 as a likely mediator in the resulting equilibrium." In other words, the mice developed a hormone that substituted for insulin after being given the BAT transplants. If something similar could work in humans, it may lead to new therapeutic options for people with type 1 diabetes. That said, the research is still in a preliminary stage. More work is needed. "Although the current data demonstrate the ability of BAT transplants to correct autoimmune diabetes without insulin, the success rates were less than reported previously [...] it seems likely that failed transplants did not generate adequate amounts of anti-inflammatory and adipogenic factors to regenerate and maintain healthy adipose tissue."
Oramed enrol first type 2 diabetes participant for oral insulin pill trial
Oramed Pharmaceuticals has enrolled its first patient into the phase IIb trial of its oral insulin pill to treat type 2 diabetes. The Israeli company will recruit around 180 participants in the trial, in which the insulin pill, named ORMD-0801, will be tested for its safety and efficacy. Oramed believe ORMD-0801 will delay the need for injections in patients with diabetes and slow the progression of the disease. After first passing into the liver, the insulin pill will mimic the effects of insulin produced by the body. This cannot be achieved through injections, as insulin is destroyed by enzymes in the digestive system and cannot be broken down. The previous phase IIa trial showed that ORMD-0801 reduced insulin needs in 25 people with type 1 diabetes, meeting all of its primary and secondary endpoints. "This pivotal study is a huge step for Oramed, as it will enable us to demonstrate the potential of our oral insulin capsule in a large clinical study. We look forward to completing the study and presenting the data collected," said Oramed CEO Nadev Kidron. Is the pill just for type 2 diabetes? This phase IIb trial will only involve patients with type 2 diabetes, but Oramed are planning to initiate another study for type 1 diabetes in the future, following on from the success of the phase IIa trial. Oramed hope that ORMD-0801 could reduce the number of daily injections administered by patients with type 1 diabetes. While the oral insulin pill will not eliminate the need for injections, the delay could take many years and potentially eliminate late-stage complications. The pill is still a while away from market, though. If the safety and success of ORMD-0801 in reducing blood glucose levels is achieved, a phase III study would be next, involving an even larger number of participants.
Type 1 diabetes patients more likely to have bacterial infections
People with type 1 diabetes have a significantly higher risk of developing bacterial infections compared to those without diabetes, a new study finds. 4,748 patients with type 1 diabetes were compared to 12,954 controls without diabetes by researchers at Helsinki University Central Hospital, Finland. The participants were selected from a nationwide register data collected between 1996 and 2009. This data included antibiotic drug prescription purchases and hospital discharge diagnoses. The Helsinki research team aimed to explore the incidence of bacterial infections between the two groups, and what association they had with chronic hyperglycemia and diabetic nephropathy. Increased type 1 hospitalisations 3,980 hospitalisations due to infections were reported in the diabetes patients, with 81.1 per cent bacterial. In the control group, there were 2,882 hospitalisations, 72.9 per cent of which were bacterial. Annually, there was a four per cent increase in hospitalisations among the type 1 diabetes patients, while there was a three per cent annual decrease in the control group. Hospitalisation rates were also increased when severity of diabetic nephropathy was greater. Diabetic nephropathy was classified through the rate of urinary albumin excretion. Each unit of increase in HbA1c levels was associated with a 6-10 per cent increase in the number of antibiotic purchases. The researchers concluded: "Our study shows that bacterial infections are more frequent in patients with type 1 diabetes compared with age-matched and sex-matched [non-diabetic controls], both in hospital and outpatient settings. "Although our study cannot ascertain whether bacterial infections lead to the development and progression of diabetic nephropathy, or if the nephropathy predisposes the patient to bacterial infections, it does show that there is a strong association between the two." In their findings, the researchers also noted that chronic hyperglycemia could predispose to bacterial infections, and that maintaining good blood glucose control is important to reduce this risk factor. The findings of this study were published in BMJ Open Diabetes Research and Care.
Bariatric surgery in obese type 2 diabetes patients shows greater remission than lifestyle changes
Obese patients with type 2 diabetes that underwent bariatric surgery had greater remission of the disease than through lifestyle changes alone, a new trial reports. The findings come from the University of Pittsburgh, who randomly assigned 61 obese adults with type 2 to one of two weight loss procedures, or lifestyle intervention. The first surgical treatment was a Roux-en-Y-gastric bypass (RYGB), while the second was a laparoscopic adjustable gastric banding (LAGB). Lifestyle interventions were administered to this group in years two and three. 40 per cent of those who underwent RYGB, and 29 per cent who had LABG achieved remission from type 2 diabetes. After three years, these participants no longer required medication. None of the lifestyle treatment group experienced remission. 65 per cent of RYGB, 33 per cent of LAGB and none of the lifestyle only group went from using insulin or oral medication before the study to not needing medication after three years. Regarding weight loss, the greatest average reduction after three years was found in the RYBG group, at 25 per cent. This figure was 15 per cent in the LAGB group, and 5.7 per cent in the lifestyle treatment group. The authors noted: "This study provides further important evidence that at longer-term follow-up of three years, surgical treatments, including RYGB and LAGB, are superior to lifestyle intervention alone for the remission of T2DM in obese individuals, including those with a BMI between 30 and 35." Study limitations However, the authors added that more research needs to be done regarding surgery in individuals who are less overweight. Questions also still remain about the impact of bariatric surgery in treating long-term microvascular and macrovascular complications. Another limitation of the study's findings was that the lifestyle intervention group involved adopting a low-fat diet, along with exercise. Low-fat diets can be helpful in achieving weight loss, but do not affect blood glucose levels to the degree that remission can be experienced. Conversely, studies have shown that low-carbohydrate and very low-calorie diets have a greater efficacy in achieving remission from type 2 diabetes.
Researchers find new evidence that type 2 diabetes is caused by genetics
Researchers from Imperial College London have discovered a new genetic form of obesity and type 2 diabetes. The study, which was published in PLOS ONE, suggests that type 2 diabetes is largely caused by genetic factors, many of which are yet to be discovered. There are currently 30 known genetic mutations that increase the risk of obesity, and a number of other mutations that cause type 2 diabetes. There may be several more mutations that are currently undiscovered. The new findings add further evidence to the theory that type 2 diabetes and obesity are often caused by genetic factors and therefore inherited, rather than being simply caused by "laziness" and "lifestyle factors." "There are now an increasing number of single-gene causes of obesity and diabetes known," said Professor Alex Blakemore, of the Department of Medicine at Imperial College London and lead author of the study. "These are serious disorders that affect the body's ability to regulate hunger and fullness signals. They are inherited in just the same way as other genetic diseases and the sufferers should not be stigmatised for their condition. They should be offered genetic counselling and specialised lifelong support to allow them as healthy a life as possible." The research was conducted by sequencing the genome of an "extremely obese" young woman and her family. The young woman reported having a huge appetite since childhood. This had led to weight problems, which had persisted since. The woman also had type 2 diabetes, learning difficulties, and problems with her reproductive system. When the team analysed her genes, they found two inherited copies of a genetic mutation that prevented the production of carboxypeptidase-E (CPE), a protein largely responsible for the regulation of insulin and appetite. Previous research had indicated a link between CPE and obesity in mice, but this was the first to do so in humans. CPE deficiency can only be inherited if both parents have the same fault in their genetic sequence. The young woman's older brother had similar problems, and died at the age of 21. The research suggests that much of the stigmatisation of people with type 2 diabetes is misplaced. More and more evidence suggests that there are factors in the development of type 2 diabetes that are entirely beyond the individual's control. Moreover, understanding the real genetic causes of many cases of type 2 diabetes will lead to better, more focused treatment. First author of the study Dr. Suzanne Alsters said: "Finding a genetic cause for the patient's problems has helped her and her family to understand and manage her condition better. We can also look at the members of her family with one abnormal copy of the gene, to see [if] they are affected in more subtle ways that could increase their risk of obesity." Professor Blakemore echoed this: "Diagnosis is very valuable to the patient. It helps to set realistic expectations, and can help them get the best possible treatment."
T cell exhaustion could lead to better treatments for type 1 diabetes, lupus and Crohn's disease
The process of T cell "exhaustion" could be exploited to lessen the effects of autoimmune diseases, according to a new study. The research, which was conducted by researchers at the University of Cambridge, could lead to better treatments for type 1 diabetes. T cells protect the body from infection. When a foreign invader gets into the body, the immune system uses T cells to fight them off. In some cases, however, T cells are harmful. When the immune system wrongly identifies friendly cells as foreign invaders - as is the case with type 1 diabetes - it is T cells that do the damage. For people with type 1 diabetes, it is the insulin-producing beta cells in the pancreas that are attacked by T cells. Other prominent autoimmune diseases include lupus and Crohn's disease. T cells are often compared to soldiers fighting a battle with the immune system invaders. And, like a group of soldiers, T cells become exhausted after particularly intense fighting. Exhausted T cells are usually thought of as a bad thing. In most cases, T cell exhaustion prevents them from fighting off infection and other diseases. This new study, however, finds that exhausted T cells are also less able to fight useful parts of the body that the immune system has wrongly identified as an enemy. The researchers examined the patterns of turning on and turning off genes in autoimmune diseases. They found that the process of fighting is the same as for infection and cancer. But because exhausted T cells are less able to attack healthy parts of the body, the result is a milder form of the autoimmune disease. "We know that the way our bodies respond to infection and to autoimmune diseases differs between individuals," said Dr. Eoin McKinney, a Wellcome Trust-Beit Research Fellow from the department of medicine at the University of Cambridge. "In part, we believe this is due to a process known as T cell exhaustion. For effective treatment, we need to exhaust our T cell responses in autoimmune diseases - and hence limit the attack on our body - and to reverse exhaustion when the fight is against unwanted invaders, such as viruses or cancer." Although the research is at a preliminary stage, it has huge potential. By assessing the level of exhaustion in a patient's T cells at the point of diagnosis with an autoimmune disease, doctors could target their treatment much more accurately, leading to better outcomes. Professor Ken Smith, lead author of the study and Head of the department of medicine, said: "We believe the clinical implications of this study could be profound. A test based on the concept is soon to enter the clinic, and we are exploring new treatments for autoimmunity based on manipulating T cell exhaustion. "A focus on T cell exhaustion in cancer has led to a revolution in treatment and a multi-billion dollar industry. We now implicate the same pathways in determining long term patient outcome in autoimmune and inflammatory disease, which afflict up to one in ten of the population over the course of their lives." The research is published in Nature.
Cranberry juice chemicals could cut risk of heart disease and type 2 diabetes
Drinking two glasses of cranberry juice a day could reduce risk of heart disease and type 2 diabetes, according to new research. The study, which was conducted by researchers from the United States Department of Agriculture (USDA), found that the polyphenols contained in cranberries can support the body's defences against disease. The researchers recruited 56 healthy adult participants, with an average age of 50. The participants were divided into two groups: the first group drank an 8oz glass of low-calorie cranberry juice twice a day; the second drank a placebo that looked and tasted the same. Then the team measured blood pressure, blood sugar levels, blood lipids, and C-reactive protein, a marker of inflammation. The higher the numbers, the higher the risk of disease such as heart disease, stroke, and type 2 diabetes. The first group, which drank two glasses of cranberry juice a day, had consistently better readings for all of the measurements. In total, the researchers noted a 10 per cent reduction in heart disease risk and a 15 per cent reduction in the risk of stroke. In particular, the researchers noted a drop in blood pressure as a result of drinking the cranberry juice, equal to top-rated heart disease-preventing diets. "These findings suggest that polyphenols help to protect our bodies, and may be adapt at keeping a large number of ailments at bay," said Christina Khoo, PhD, Director of Research Sciences at Ocean Spray. "Luckily for us, a rich source of polyphenols is only a glass of cranberry juice away. Among the commonly consumed fruits in our diets, cranberries boast some of the highest levels of polyphenols - more than apples, blueberries, grapes or cherries." For people at risk of type 2 diabetes, a twice-daily glass of cranberry juice could be a simple way to reduce type 2 risk. For people already diagnosed with type 2 diabetes, it could be a great way to reduce the risk of heart disease. That said, a typical glass of cranberry juice is quite high in calories, and two 8oz glasses a day is an excessive amount for most people with type 2 diabetes. The research emphasised the importance of drinking low-calorie cranberry juice as a way to reduce the risk of type 2 diabetes.
Repeated antibiotics use in children linked to obesity
Repeated use of common antibiotics in children may alter bacteria in the gut which could cause obesity, according to a new study. Obesity is a leading cause of type 2 diabetes, costing the NHS £5 billion annually. It was recently prioritised by the government as a major health concern. Researchers at New York University Langone Medical Centre, Unites States gave three courses of two common prescribed antibiotics - amoxicillin and tylosin - to female mice pups. The dose was the same as an average human receives in the first two years of their lives. Short, high doses of tylosin had the most pronounced, long-lasting effect on weight gain. Tylosin is not prescribed to children, but is part of an antibiotic class called macrolides, which are. Amoxicillin had the biggest effect on bone growth, which can lead to increased height. The researchers observed that both antibiotics significantly disrupted the gut microbiome, which is linked to specific metabolic functions and vital for a healthy immune system. The changes reportedly increased as mice were given more courses of the antibiotics, leading researchers to suggest that a cumulative effect may significantly disrupt early development. "We have been using antibiotics as if there was no biological cost," said Professor Martin Blaser, of New York University, who concluded that while the study was conducted on animals, similar results may be found in humans. Blaser and his team believe that reliance on antibiotics should be curbed, as there could be significant effects on children overexposed to antibiotics. The findings from this study were published in the online journal Nature Communications.
Type 2 diabetes drug VTP-30472 not effective as add-on therapy
A drug being developed as an add-on therapy to treat type 2 diabetes in overweight patients has failed to significantly reduce their blood glucose levels. VTP-30472 was co-developed between Vitae Pharmaceuticals and German drugmaker Boehringer Ingelheim. The aim of the drug is to target an enzyme that produces cortisol, a steroid hormone, that increases blood glucose levels. The drug was being tested as an add-on to metformin, a commonly prescribed drug to treat patients with type 2 diabetes. Doubts over potential However, Vitae announced in a statement that VTP-34072 has not met its main goal in the Phase II study of the drug, with questions now raised about the drug's potential. VTP-34072 is also being tested as a monotherapy, with results from a trial expected later this year. Boehringer then plan to review the data from both trials to assess how to best proceed with the drug. Richard Gregg, chief scientific officer of Vitae, said: "The metabolically complex, overweight type 2 diabetic patient population is in need of novel mechanisms of action that can address their overall risk profile. "We are anxious to learn more about VTP-34072 when the study is completed and fully analysed."