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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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Bone healing in diabetics could be enhanced through human stem cells
The repair process of broken bones in patients with diabetes could be enhanced by adding stem cells from human bone marrow, researchers have suggested. These findings were presented by a National University of Galway team led by Dr. Cynthia Coleman at the European Congress of Endocrinology in Dublin. Prolonged exposure to high blood glucose levels can decrease the healing speed of broken bones in people with diabetes. The likelihood of an accident can also be increased due to nerve damage in the eyes and feet. The Galway researchers added human bone marrow stem cells from non-diabetic donors to one group of diabetic patients with bone fractures. In a second control group, patients were not given these stem cells. Significantly stronger The first group were observed to heal much faster, while the bones were observed to be significantly stronger and able to withstand more stress. The team reported that the stem cells produce signals which encourage the patient's own cells to heal the bone fracture more efficiently. The stem cells do not integrate permanently into the host tissue. This could subsequently lead to significant treatments for broken bones in patients with diabetes, and reduce the time it takes for bone fractures to heal. Dr. Coleman said: "This basic science study allows us to better understand the role of stem cells in fracture repair and potential use in treating diabetic patients. "Stem cells represent an exciting potential for improving the treatment and lessening the pain and discomfort of diabetic people who break bones," Coleman added.
Early detection and treatment of type 2 diabetes could yield health benefits
There could be substantial health benefits from the early diagnosis and treatment of type 2 diabetes, a new study finds. Screening to identify type 2 diabetes followed by early treatment was found to reduce cardiovascular risk factors within a five-year follow-up period. This was compared to patients who had no screening for type 2 diabetes. This research was conducted by scientists at the MRC Epidemiology Unit, University of Cambridge and the University of Michigan Medical School, United States. They used data from the ADDITION-Europe study of diabetes screening and treatment, in which patients aged 40-69 from three different European countries were assessed for morbidity and mortality. Researchers combined this information with a computer simulation model of diabetes progression. 10 years after the start of the study, the simulations predicted that 22.4 per cent of patients with type 2 diabetes would suffer a stroke or heart bypass surgery. This was with a delay of three years in diagnosis and treatment. When the diagnosis delay was six years, this figure rose to 25.9 per cent. However, researchers observed that if screening and routine care had previously been implemented, only 18.4 per cent would experience a cardiovascular event 10 years afterwards. William Herman, M.D., lead author and professor at University of Michigan Medical School, said: "This research shows that the early identification of diabetes has major health benefits, and supports the introduction of measures such as screening to reduce the time between development of type 2 diabetes and its treatment." Researchers acknowledged that without a diabetes diagnosis, individuals may be treated for high blood pressure and to stop smoking in the interim, but believe any distortion from their findings would not be large. The results of this study were published in Diabetes Care.
British children facing a rising tide of type 2 diabetes, says NHS chief
British children are facing a high risk of obesity-related type 2 diabetes and heart disease, according to NHS England chief Simon Stevens. Stevens has warned that Britain is experiencing a normalisation of obesity, largely due to a lack of education and awareness. Stevens also argues that the government must accept some responsibility for the obesity crisis. "Junk food, sugary fizzy drinks and couch potato lifestyles are normalising obesity - and as parents, a third of us can't now spot when our own child is seriously overweight," said Stevens. A third of children are overweight by the end of their primary school education. According to the World Health Organisation, 75 per cent of British men will be obese by 2030. The UK has the second-highest rates of obesity in Europe. Obesity, as well as being a health problem in its own right, increases the risk of other conditions, including type 2 diabetes, heart disease, stroke, and some forms of cancer. The problem is also a political one. A recent study showed that, in the last 20 years, healthy foods have become more expensive, while processed foods have become cheaper. There are also concerns about industry regulation and marketing. Government incentives to reduce rates of obesity and type 2 diabetes include Change4Life and the Responsibility Deal, which urges manufacturers to make their food healthier. "We've got a choice. Condemn our children to a rising tide of avoidable diabetes, cardiovascular disease and cancer, and burden taxpayers with an NHS bill far exceeding an extra £8 billion by 2020? Or take wide-ranging action - as families, as the health service, as Government, as industry. It's a no brainer - pull out all the stops on prevention, or face the music," said Stevens. Stevens identified the strain obesity and type 2 diabetes place on the NHS: "The health service is entering probably its most challenging period in its 67-year history. We'll certainly step up and play our part - but the NHS can't do it alone. "Because the NHS isn't just a care and repair service, it's a social movement. We're going to need active support from patients, the public and politicians of all parties."
New study outlines cybersecurity risks associated with the artificial pancreas
The artificial pancreas is one the most promising developments in the treatment of type 1 diabetes. But the way that it functions - on platforms such as laptops, smartphones, and over wireless networks - poses a number of cybersecurity risks, according to new research. The study, called "Cybersecurity in Artificial Pancreas Experiments," argues that cybersecurity risks associated with the artificial pancreas have not been properly considered. There are, the study argues, several vulnerabilities in current artificial pancreas systems. If these vulnerabilities were exploited, artificial pancreas users could lose personal information, or have their device tampered with. There is also the risk of malware affecting the artificial pancreas, which could impede its function. Because of the nature of the artificial pancreas's work, it is vital that it operates as well as it possibly can. If cybersecurity threats are not properly taken into account, there could be serious consequences. The authors of the study suggest that more emphasis be placed on the cybersecurity of the artificial pancreas system. Manufacturers should provide a more consistent report of the performance of the artificial pancreas during testing. "As the technology keeps advancing, we have to be vigilant about interference with medical devices, especially those that automatically control insulin infusion in the artificial pancreas," said Diabetes Technology and Therapeutics Editor-in-Chief Satish Garg.
Type 2 diabetes diagnosis distorted through HbA1c due to anemia
New research shows that anemia could lead to a false diagnosis of type 2 diabetes if HbA1c is used as the diagnostic method. In the UK, HbA1c is advocated by the World Health Organisation (WHO) for diagnosing type 2 diabetes at a value of 6.5 per cent (48 mmol/mol). Anemia is a common condition in which a lack of iron in the body leads to decreased red blood cell count or hemoglobin in patients. An estimate from 2011 found that 29 per cent of non-pregnant women had anemia, while the latest WHO figures suggest this figure is 13 per cent in men. Researchers at the University of Nottingham investigated studies between 1990 and 2014 in which HbA1c and glucose were measured, as well as an index of anemia involving non-pregnant women not diagnosed with diabetes. 12 studies found that iron deficiency with or without anemia resulted in increased HbA1c values, while no corresponding blood glucose rise occurred. Subsequently, a diagnosis of diabetes would require further testing. The researchers recommend that when glucose and HbA1c levels differ in diabetic patients, anemia or iron deficiency should be considered. If these abnormalities are identified, correction of high hemoglobin levels should be corrected before HbA1c is again used for diagnosis or monitoring. "HbA1c is likely to be affected by iron deficiency and iron deficiency anaemia with a spurious increase in HbA1c values. This may lead to confusion when diagnosing diabetes using HbA1c," the authors say. "This review clearly identifies the need for more evidence, especially in identifying the types and degrees of anaemia likely to have significant impact on the reliability of HbA1c."
Electronic stimulation could improve wound healing in people with diabetes, study suggests
Electronic stimulation could accelerate wound healing, according to research conducted by scientists from the University of Manchester. The study, published in PLOS ONE, could lead to significant improvements in the way that diabetic wounds are treated, reducing the risk of foot ulcers and amputation. Diabetes and slow wound healing Slow healing of wounds is a typical complication of diabetes. It occurs as a result of diabetic neuropathy. Over time, prolonged exposure to high blood glucose levels can damage the nerves, which makes it harder for blood to move around the body. Blood is needed for skin repair, so poor blood circulation slows the rate of healing in cuts and wounds. Slow wound healing commonly exacerbates foot ulcers. People with diabetic neuropathy often don't notice injuries to their feet because their nerves are damaged. But because the wounds heal so slowly, even minor cuts and become infected or develop into ulcers. It is vital, therefore, that people with diabetes - especially people with diabetic neuropathy - check their feet regularly and carefully. Foot ulcers are the leading cause of amputation in people with diabetes, and diabetes is the most common cause of amputation. The NHS spends £1 billion a year on chronic wounds such as diabetic ulcers. How was the study conducted? The researchers made tiny, harmless wounds on the upper arm of each volunteer, then separated them into two groups: in the first group, the wound was left to heal on its own; in the second, electrical pulses were used to stimulate the healing process. The wounds of the second group healed much more quickly. The electronic pulses improve the rate of healing by accelerating angiogenesis, which is the process by which new blood vessels are formed. When new blood vessels form, blood flow improves, so the healing process is faster. How will the research be developed? The research team from the University of Manchester's Institute of Inflammation and Repair will now start work on a five-year project, in partnership with Oxford BioElectronics Ltd. The project will aim to develop new healing devices that stimulate wound healing in the same way. "This research has shown the effectiveness of electrical stimulation in wound healing, and therefore we believe this technology has the potential to be applied to any situation where faster wound healing is particularly desirable," said Dr Ardeshir Bayat, principal investigator from the University of Manchester. "This is an exciting partnership, working on a pioneering project with the potential to change substantially the cutaneous wounds are managed in the future. "When used in acute and chronic wounds, bandages are essentially just a covering. With this technology we hope that the dressings will be able to make a significant function contribution to healing the wounds and getting the patient back to full health as quickly as possible." Roly Allen, Managing Director of Oxford Bioelectronics, said: "We are delighted with our collaboration with Dr. Bayat and his team at the University of Manchester. Healing of wounds, in particular chronic wounds, is a global problem and we expect, through this partnership, to lead the development of the next generation of wound repair solutions."
Bionic pancreas for type 1 diabetes management set for 2017 launch
A bionic pancreas that would automatically control blood glucose levels for type 1 diabetes patients could be brought to market by late 2017. The device is being developed by researchers at Boston University, with lead researcher Edward Damiano, PhD revealing successful results from recent outpatient studies. Damiano reported during a presentation at the American Association of Clinical Endocrinologists’ (AACE) 24th Annual Scientific and Clinical Congress that in four studies, the bionic pancreas simultaneously reduced hypoglycemia and mean glucose levels. These studies were conducted on adults, adolescents and pre-adolescents, while Damiano added the bionic pancreas would deliver mean HbA1c levels of roughly 6.5 per cent in adults and children with type 1 diabetes. How does the bionic pancreas work? The device consists of a Dexcom continuous glucose monitor (CGM), two Tandem t:slim infusion pumps and mathematical algorithms that make automated decisions about insulin and glucagon every five minutes based on updated CGM readings. The two insulin pumps deliver insulin and glucagon respectively, while the algorithms run in an iPhone app. Bluetooth technology allows the pumps and the iPhone to communicate and calculate the required doses of insulin and glucagon needed. The bionic pancreas would therefore allow type 1 diabetes patients to live their lives without stressing about management anymore. The device also eases the burden for patients during sleep, or other times when they are less able to manage their diabetes. Damiano’s team are planning the final clinical trial later this year and aim to bring the bionic pancreas to market by late 2017.
Heart attack risk in HIV patients lowered through diabetes drug, researchers report
The diabetes drug sitagliptin may be able to reduce the risk of heart disease and stroke in patients with HIV. Sitagliptin, marketed as Januvia, is an oral drug for patients with type 2 diabetes which serves to lower blood glucose levels. A study by researchers at Washington University School of Medicine found it may prevent cardiovascular problems in people with HIV, who have an elevated risk of heart attacks and diabetes. Sitagliptin was observed to improve the metabolism and reduce inflammation of HIV-positive adults taking antiretroviral therapy - which aims to maximally suppress the HIV virus. 36 HIV patients were studied, aged between 18 and 65, who all had stable immune systems. Glucose levels, insulin sensitivity and several markers of inflammation were all measured. Half of the patients took sitagliptin for eight weeks, while the other half received placebo. Each patient continued with antiretroviral therapy during the study. While sitagliptin improved the blood glucose levels of patients, researchers were pleased to also observe that there was reduced inflammation among the patients in this group. Lead investigator Kevin E. Yarasheski, PhD, explained: "The goal has been to identify treatments that not only address problems with blood sugar and lipids but also can lower inflammation, which can play a substantial role in heart disease and stroke. "With sitagliptin, sugar levels fell, and several markers of immune activation and inflammation were reduced, indicating the drug may provide long-term benefits for these patients' hearts, bones and livers." The results of this study are published in The Journal of Clinical Endocrinology and Metabolism.
Heightened testosterone linked to diabetes and risk of prostate enlargement
A new study indicates that high levels of the hormone testosterone are linked with a raised risk of diabetes and prostate enlargement. University of California researchers conducted saliva tests on 350 adult males in the Tsimane tribe, an isolated population in the Bolivian rainforest. Advanced cases of prostate enlargement were found to be virtually non-existent, with the Tsimane also observed to have low testosterone levels and low levels of glucose in the blood - indicating a reduced risk of developing diabetes. While, on the whole, the Tsimane had low testosterone, those with higher levels were found to have larger prostates. The researchers also examined the HbA1c levels of the participants, and found those with larger prostates also had higher HbA1c readings. Type 2 diabetes is caused by overly high glucose levels on the blood, with Professor Michael Gurven, UC, reporting: "Type 2 (adult onset) diabetes is one of these illnesses that under more traditional conditions wouldn't be as prevalent as it is today in high-income countries, or becoming increasingly prevalent in urban areas of low-income countries. As groups of the Tsimane undergo change, we might very well see an increase in diabetes." Dr Benjamin Trumble added: "Among men with low testosterone and low diabetes risk, those with relatively higher testosterone or HbA1c were at higher risk of prostate enlargement." Nine in ten Tsimane men experienced prostate enlargement, clinically known as benign prostatic hyperplasia (BPH), with researchers highlighting that this places doubt over the millions of men who use supplements for low testosterone levels. The researchers suggest that more long-term studies are necessary to assess the safety and efficacy of testosterone-replacement therapy in men.
New pressure-monitoring device could prevent neuropathy-related injuries
Researchers from Germany have developed a pressure-monitoring stocking that could prevent foot wounds in people with diabetic neuropathy. The device, which was developed by researchers at the Fraunhofer Institute for Silicate Research ISC in Würzburg, uses integrated sensors to send warnings when pressure on the foot is too high, essentially performing the job of the nerves in the feet. Neuropathy and foot pressure Diabetic neuropathy is one of the most common diabetic complications. Over time, prolonged exposure to high blood glucose levels damages the nerves in the feet. Diabetic neuropathy is the leading cause of amputation in the UK. When people develop diabetic neuropathy, they lose the feeling in their feet. This can have a number of damaging effects. One such effect is the inability to notice the amount of pressure being placed on the feet. People without diabetic neuropathy have functioning nerve pathways that automatically redistribute when the person is standing up for a long time. Over time, excessive weight placed on the feet can lead to the development of pressure sores, which can in turn lead to open wounds or damaged foot tissue. How does the pressure stocking work? The stocking features 40 dielectric elastomer sensors that measures pressure distribution. The sensors are made from a special silicone film. When pressure builds on the foot - usually because of standing in the same place for a while - the sensors transmit a signal to a wireless electronics unit. The stocking will cost around £180. What makes the pressure stocking different? There are several products available to balance out pressure on the foot for people with diabetes, but this one is different, according to Dr. Bernhard Brunner, of the Fraunhofer institute: "Existing systems on the market measure the pressure distribution only on the bottom of the foot using shoe inserts. Our sensors are attached to the stocking's sole, at the hell, the top of the foot and the ankle, so they can take readings in three dimensions. This is a totally new approach." Moving forward The device is brand new, and some creases still to be ironed out. Dr. Brunner explained the challenges that face the team going forward: "With the current prototype, the electronics are attached to the end of the stocking. We're planning to relocate them to a small, button-sized housing that can be detached with a hook-and-loop fastening strip. There's no way around this until a reliable method for cleaning the electronics is developed." The sensors have to be washable, too. "The first washability tests are in planning, but cleaning using disinfectant is no problem." The researchers have filed a patent application for the stockings. From May 19 to May 20, the team will be presenting a prototype of the stockings at the SENSOR+TEST 2015 Measurement Fair in Nuremberg.