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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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Site Update - Aug 2012
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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Ketogenesis prevents fatty liver disease in mice, study suggests
A new study, published in the Journal of Clinical Investigation, suggests that ketogenesis may prevent non-alcoholic fatty liver disease (NAFLD). NAFLD is a generic term used to described conditions that cause fat to build up within the liver, thereby increasing the risk of cardiovascular problems, including heart attacks and stroke. Researchers from Sanford Burnham Medical Research Institute performed their study on mice with diet-induced NAFLD. The high-fat diet feeding of the mice with dysfunctional ketogenesis - a process that disposes of much of the fat that enter the liver - resulted in a number of problematic conditions, including extensive heptocyte (the cell of the main tissue of the liver) injury, inflammation, and decreased glycemia. These results suggest that dysfunctional ketogenesis promotes NAFLD, and that ketogenesis may modulate fatty liver disease. NAFLD often occurs in people with type 2 diabetes. Lowering the risk of the disease is generally a matter of gradual weight loss and maintaining regular exercise, which also helps to lower the risk of cardiovascular problems. Other risk factors listed by the NHS include being overweight, being over the age of 50, having high cholesterol, having high blood pressure, and rapid weight loss after surgery or malnourishment. Approximately one billion people worldwide are affected by non-alcoholic fatty liver disease.
Spinal cord stimulation could ease diabetic peripheral neuropathy
Patients with diabetic peripheral neuropathy, a nerve disorder, could have their pain eased thanks to spinal cord stimulation. What is diabetic peripheral neuropathy? Diabetic peripheral neuropathy affects different nerves in the nervous system and can result in shooting pains, muscle weakness and numbness. In the UK, type 1 diabetes and type 2 diabetes are the most common causes of peripheral neuropathy. Dutch researchers at Maastricht University Medical Centre have found success from spinal cord stimulation in over half their patients with diabetic peripheral neuropathy. They conducted a multicentre randomised clinical trial among 36 patients who had previously not responded to therapy to help their severe lower limb pain . Trial stimulation was successful in 77 per cent of patients who received a combination of spinal cord stimulation and the best medical treatment, with 41 per cent reporting pain relief during the daytime. Only a 7 per cent success rate was found in the group who had the best medical treatment, but no spinal cord stimulation. Therapy risks "Our findings show that in diabetic peripheral neuropathy patients, spinal cord stimulation in combination with best medical treatment results in clinically relevant pain relief over a 6-month period," the researchers wrote. However, they also acknowledged that the therapy carries risks, with "the most common complications related to infection, subcutaneous hematomas and cerebrospinal fluid leak". Spinal cord stimulation is invasive, and patients with diabetic peripheral neuropathy should only receive the treatment as a last resort and conducted by specialists, the researchers concluded.
New drug may heal diabetic foot ulcers
A new drug discovered at Stanford University School of Medicine may help to prevent foot amputations. The study, presented this week at the American College of Surgeons Annual Clinical Congress, suggests that the drug, which is delivered through a skin patch, both accelerates the healing of foot injuries and prevents them from occurring again. Amputation is one of the most severe risks associated with poorly-managed diabetes. Geoffrey Gurtner, MD, FACS, the Johnson and Johnson Professor of Surgery and associate chairman of surgery for research at Stanford University School of Medicine, believes that foot ulcers are largely responsible for foot amputations. He also claimed that the lives of diabetic people get worse after their amputations. "It's not just having your leg surgically removed," he said. "An amputation sends these patients into a downward spiral where they are not active. Then, all the other health issues that accompany inactivity come into play. "A diabetic patient who undergoes an amputation has a 50 percent five-year mortality, which is worse than breast cancer or Hodgkin's disease." People with diabetes should be particularly wary of foot ulcers, because the decreased blood flow caused by their condition stops the wound healing properly. Moreover, diabetes impairs the protein hypoxia inducible factor-1 alpha, which is responsible for the genes that heal damaged tissue. The new drug increases the protein. The research will be developed through clinical trials, performed on diabetes patients who are at risk of foot ulcers. Dr. Gurtner concluded that "once we prove that it works, I could see this drug one day becoming the first line of treatment for diabetic ulcers and preventative foot care."
Type 2 diabetes linked to inflammation in people on HIV medication
The development of type 2 diabetes has been linked to systemic inflammation among HIV-positive people taking antiretrovirals (ARVs). Type 2 diabetes study ARVs are designed to suppress the HIV virus, but findings from the Journal of Acquired Immune Deficiency Syndromes sought to analyse a link with type 2 diabetes. An investigation was conducted of the relationship between baseline levels of high sensitivity C-reactive protein (hsCRP), interleukin (IL-6) and new type 2 diabetes diagnosis. Approximately 3,700 people were studied in two large HIV treatment strategy trials - the SMART and ESPIRIT studies. ARVS were taken by all participants without any additional therapy. Diagnosis of type 2 diabetes Type 2 diabetes was diagnosed in 137 people during an average 4.6 years of follow-up, for a rate of 8.18 per 1,000 person-years. During follow-up, higher baseline hsCRP and IL-6 were associated with diagnosis for type 2 diabetes. Those who developed diabetes had significantly higher median baseline levels of the two inflammatory markers compared to those who didn't develop diabetes. A number of traditional risk factors such as higher body mass index and older age were also linked to diabetes diagnoses. The authors of the study concluded: "Our findings support the hypothesis that low-grade systemic inflammation is an underlying factor in the pathogenesis of type-2 diabetes". They also believe their findings provide "clues" as to why people with HIV on ARVs remain at increased risk of cardiovascular diseases and other chronic illnesses.
Metformin studied as optimum initial diabetes treatment
Patients with diabetes who begin lowering their glucose levels with metformin are less likely to require subsequent treatment intensification. However, research published in the Journal of the American Medical Association Internal Medicine shows that 40 per cent of patients do not start off with metformin. When compared with other oral medicines, metformin was associated with a reduced need for a second treatment without differences in hypoglycaemia rates. Glucose lowering study Niteesh K. Choudhry, MD, PhD, Executive Director, Centre for Healthcare Delivery Sciences, Brigham and Women’s Hospital, Harvard Medical School and his colleagues studied patients with diabetes between July 2009 and June 2013. They analysed the initial choice of a medication to lower glucose levels and whether the subsequent treatment intensification was in the same class of dosage. Of those 15,516 patients, 8,964 patients (57.8 per cent) began diabetes treatment with metformin. This led to the lowest percentage, 24.5 per cent, of patients who required a second oral medication. Meanwhile, the percentage of patients who later used insulin was 5.1, having begun treatment with metformin, which increased to 9.1 per cent for patients who started with sulfonylurea. Metformin guidelines Metformin is widely advocated as the initial treatment to lower glucose levels in patients with type 2 diabetes, but research suggests these guidelines are not being stuck to with vigilance. "Despite guidelines, only 57.8 percent of individuals began diabetes treatment with metformin," the researchers concluded. "Beginning treatment with metformin was associated with reduced subsequent treatment intensification, without differences in rates of hypoglycemia or other adverse clinical events. These findings have significant implications for quality of life and medication costs".
Doctors trial new type 2 diabetes screening test
Trials of a new two-part test to diagnose diabetes are to be carried out at Southampton General Hospital. The test, which would cost "pennies", has the potential to change the way the condition is treated. Currently, the only test to predict the risk of type 2 diabetes is a questionnaire containing seven questions. It gathers information of age, gender, waist circumference, body mass index, ethnic background, blood pressure, and family history. Based on this, it provides a risk score. The new test, led by Dr. Patrick Sharp, consultant diabetologist at Southampton General Hospital, combines the questionnaire with a capillary blood glucose (finger prick) test in the same appointment, which may save money by reducing the need for further testing. "NICE has recently proposed that all individuals over the age of 40 years and at risk groups over the age of 25 years are subject to a diabetes risk score via a questionnaire," explained Dr Sharp. "Unfortunately, around half of people require laboratory-based blood testing to find out if they have diabetes and this can delay the process, but is also time-consuming and expensive." Dr. Sharp explained that blood glucose testing is usually rejected as a method of diabetes diagnosis because results tend to fluctuate. Despite this, he argues that it could provide a useful screening test. Incorporating blood glucose testing might make it possible to screen out more people as being at risk of diabetes. This would reduce the need for expensive laboratory tests. The NHS spends around ten per cent of its budget managing diabetes, most of which, according to Dr. Sharp, is spent treating complications because the condition wasn't picked up earlier.
Obesity in offspring linked to gestational diabetes
A study finds that women, who were overweight before pregnancy, and developed gestational diabetes, were more likely to have children who became obese. What is gestational diabetes? Gestational diabetes occurs during pregnancy, when a woman's body cannot make enough insulin. This results in sugar staying in the blood stream and causing high blood sugars. The study, conducted between, 2005-2011 at the Kaiser Permanente Division of Research in Oakland, California, United States, was based on long-term research of 421 multi-ethnic girls and their mothers. The girls had annual clinic visits during this time to measure height, weight and other parameters, while pregnant women in the Kaiser Permanente system took glucose tolerance tests during the gestational weeks of 24-28. The study found that 27 mothers in the study had gestational diabetes. It was calculated that gestational diabetes increased the risk of children having a higher body mass index (BMI) by 3.5 times compared to those whose mothers did not have the condition. If a mother was also overweight, the risk of their child being overweight was 5.5 times higher than of mothers who did not have gestational diabetes. Preventing gestational diabetes This study is the first to directly link maternal high blood glucose levels to overweight offspring, but this is something that can be avoided. The researchers concluded that reducing weight gain and improving lifestyle could help reduce the risk of obesity in a woman’s offspring. "Once obesity happens, it's really hard and expensive to reverse. Working with mothers during and before pregnancy to make lifestyle improvements could have long-term benefits for their children as well," said Ai Kubo, an epidemiologist at the Kaiser Permanente Division.
Resveratrol improves bone formation of men with metabolic syndrome, study suggests
Drinking red wine can improve the bone formation of men with metabolic syndrome, a new study suggests. This is because red wine, along with nuts and grapes, contains a natural compound called resveratrol. It is this compound that improves the spinal bone density of men with metabolic syndrome. Metabolic syndrome is essentially the same disorder as prediabetes, but diagnosed differently. It increases the risk of heart disease and diabetes. The study, published in the Endocrine Society's Journal of Clinical Endocrinology and Metabolism, tested 66 middle-aged men with metabolic syndrome. Over a 16-week period, each man was given a 500-miligram dose of resveratrol, a 75-miligram dose, or a twice-daily placebo of the compound. Compared to the men given the placebo, the men given the 500-miligram dose had a 2.6 per cent improvement in their lumbar spine volumetric bone mineral density. "Our study is the first to reveal resveratrol’s potential as an anti-osteoporosis drug in humans," said one of the study’s authors, Marie Juul Ørnstrup, MD, of Aarhus University Hospital in Aarhus, Denmark. "Our findings suggest the compound stimulates bone-forming cells within the body." Metabolic syndrome has been linked to the kind of low-grade inflammation that can cause bone loss. The study suggests that resveratrol counters this bone loss. Ørnstrup described the results as "encouraging", and added that, "Additional research is needed to assess whether these bone protective effects occur in populations at risk of osteoporosis during the course of long-term treatment."
Diabetes related kidney failure set to double over next decade
Twice as many people will suffer from diabetes-related kidney failure over the next decade, according to the charity Diabetes UK. Kidney-failure currently costs the NHS £940m every year, with more than 18,000 people requiring dialysis to rectify problems with food digestion caused by diabetes. It is predicted that, by 2025, this will rise to 35,000. End-stage kidney failure is most commonly caused by diabetes, and often requires a kidney transplant. Careful management of blood pressure and blood glucose levels can half the risk of kidney disease. Barbara Young, Chief Executive of Diabetes UK, said: "It is a real cause for concern that, if we were to continue along the same path, our ageing population and the growing numbers of people with diabetes mean we would be faced with a huge rise in diabetes-related kidney failure. This would have awful consequences, as kidney failure has a devastating impact on people’s lives and is one of the reasons that so many people with diabetes die prematurely." One of the most important checks for kidney diseases, which involves testing the urine for the protein microalbumin, is one of the least conducted care processes. In fact, a quarter of people are not tested in this way. For people at risk of diabetes-related kidney disease, it is recommended that blood sugar levels and blood pressure are kept within a target range, and that smokers stop smoking.
Sunlight exposure could fight type 2 diabetes
Research finds that weight gain and the development of type 2 diabetes could be slowed down due to sunshine exposure. Ultraviolet light effects Scientists from Southampton, Edinburgh and Australia found that overfed mice ate less when ultraviolet (UV) light was shone on them. This UV treatment resulted in the mice displaying fewer warning signs of type 2 diabetes, such as abnormal and glucose levels. Nitric Oxide, a natural gas which is released by the skin after exposure to sunlight, was linked to the UV treatment, which can help people control their metabolism and slow weight gain. The same effect of the UV light was found when a cream containing nitric oxide was applied to the skin of the mice. The researchers added that vitamin D, which is produced by the body in response to sunlight, did not appear to play a role in the results. However, they also acknowledged that their results should be interpreted with caution. Mice are nocturnal animals, covered with fur, and generally not exposed to much sunlight. Preventing type 2 diabetes These findings have been met with optimism in regard to the prevention of type 2 diabetes, with moderate exposure to the sun’s rays is seen as greatly beneficial. "This study in mice suggests that low doses of sunlight might help to reduce risk factors for type 2 diabetes by an effect unrelated to vitamin D, but further research is needed to see if this also applies in humans," said Dr Richard Elliott, of Diabetes UK. "We know that spending more time outdoors contributes to a healthier lifestyle in other ways, such as through exercise".