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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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Five million adults in England at risk of type 2 diabetes
New Public Health England (PHE) figures suggest that up to five million people in England are at risk of developing type 2 diabetes. The new figures were taken from an analysis conducted on date collected between 2009 and 2013, which was compiled by PHE's National Cardiovascular Health Intelligence Network. In most parts of the country, one in 10 adults have prediabetes, which is characterised by higher than normal blood glucose levels. In some areas, this figure is one in seven. Prediabetes can develop into type 2 diabetes if not diagnosed or treated properly, and five million people in England face this risk. If you are over the age of 40 and belong to an ethnic group such as South Asian or Afro-Caribbean, then your prediabetes risk is enhanced. Other risk factors include obesity, high blood pressure and high triglycerides, but making positive lifestyle choices to reduce these risk factors can slow down or even half the development of type 2. A joint initiative by NHS England and PHE called the Diabetes Prevention Programme is underway in England, which focuses on healthy eating, exercise and weight loss. The nine-month scheme will be offered to patients who are at high risk of type 2 diabetes either due to elevated blood glucose levels or a prediabetes diagnosis following an NHS check-up. PHE chief executive Duncan Selbie highlighted that high-risk individuals require education and support if they are to properly treat prediabetes. "We know how to lower the risk of developing type 2 diabetes: lose weight, exercise and eat healthily, but it's hard to do it alone," Selbie said. "PHE's evidence review shows that supporting people along the way will help them protect their health, and that's what our prevention programme will do."
Novo Nordisks Victoza will not be expanded for type 1 diabetes treatment
Novo Nordisk does not plan to expand Victoza (liraglutide) for use in type 1 diabetes after disappointing results from a recent study. In the pharmaceutical company's latest phase III trial, Victoza - a GLP-1 analogue which is used to treat type 2 diabetes - was used as an add-on treatment to insulin in type 1 patients. 1,400 people were recruited for a year-long trial. Alongside insulin treatment, they were either given one of three liraglutide doses via once-daily subcutaneous injection, or placebo. The trial, known as ADJUNCT ONE, could have allowed liraglutide to be used in type 1 treatment as well as type 2, but the study reported negative findings. Those treated with the two highest doses of liraglutide (1.2mg and 1.8mg) had significantly higher rates of symptomatic hypoglycemia. While these doses performed better than placebo in reducing HbA1c, and enabled greater weight loss, the lowest dose (0.6mg) performed worse than placebo. These findings were in contrast to Novo Nordisk's 2014 SCALE study, in which a 1.8mg dose of liraglutide met HbA1c targets without increasing episodes of hypoglycemia. Earlier this month, another phase III study called ADJUNCT TWO was also conducted, but neither trial has led to liraglutide being further considered as a type 1 treatment. In a statement, Novo Nordisk announced: "Based on a risk/benefit assessment of the overall dataset from the two ADJUNCT trials, Novo Nordisk does currently not intend to submit an application to expand the label of Victoza for use in type 1 diabetes." Mads Krogsgaard Thomsen, executive vice president and chief science officer for Novo Nordisk, added: "We are disappointed, as we believed in the potential to provide people with type 1 diabetes with a new treatment option. We will continue to invest in new treatment options for this group of people."
Sugar intake accelerates development of type 1 diabetes, research finds
A high intake of sugar might accelerate the later stages of type 1 diabetes development, according to new research. The study, conducted by researchers at the Colorado School of Public Health, University of Colorado, found that a high intake of sugar - particularly sugary drinks - in children genetically predisposed to type 1 diabetes may accelerate the development of the condition. "Sugar intake may exacerbate the later stage of type 1 diabetes development," the researchers wrote. "Sugar-sweetened beverages may be especially detrimental to children with the highest risk of developing type 1 diabetes." The researchers examined records from the Diabetes Autoimmunity Study in the Young, a database established in 1993 that monitors various statistics about children with a high genetic risk of type 1 diabetes. It includes information about their intake of fructose, sucrose, sugary drinks, and juice. For this study, the researchers analysed data from 1,893 children, with an average age of 10.2. 142 children developed insulin autoantibodies (IA), and 42 of those progressed to type 1 diabetes. Although the risk of developing insulin autoantibodies was unaffected by sugar intake, there was a clear link between higher total intake of sugar and later-stage type 1 diabetes risk. The researchers concluded: "The results suggest that sugar intake may not affect the early stage of the type 1 diabetes disease process, prior to IA development. However, once the immune system has been activated by other genetic or environmental factors and the body has begun the autoimmune attack on the beta cells, the total amount of sugar that a child consumes may increase type 1 diabetes risk." The findings were published in Diabetologia.
Obesity gene discovery could lead to cure
The discovery of how an "obesity gene" functions could lead to a cure for obesity and prevent many cases of type 2 diabetes, according to new research. The study, conducted by researchers at MIT and Harvard Medical School, builds on previous research, which discovered a link between a gene called FTO and obesity. People with higher Body Mass Index's (BMI) tend to carry a variant of FTO. Previous studies have been unable to work out how FTO actually relates to obesity. This study suggests that a "faulty version" of FTO prevents the burning of energy from food. Instead, it is all stored as fat. This occurs because fault FTO genes activate two other genes, known as IRX3 and IRX5. These genes control the conversion of energy into heat; by preventing it, they cause it to be stored as fat instead. "Obesity has traditionally been seen as the result of an imbalance between the amount of food we eat and how much we exercise, but this view ignores the contribution of genetics to each individual's metabolism," said senior author Manolis Kellis. Obesity is an increasingly common health condition, and one of the major risk factor for the development of type 2 diabetes - although it is not the only possible cause. Obesity also increases the risk of heart disease, stroke, some types of cancer, and other health conditions. The researchers hope to use their findings to develop drugs to prevent the FTO-related problems with fat storage. By doing so, they may reduce the rates of obesity and thereby prevent many cases of type 2 diabetes. The findings were published in the New England Journal of Medicine.
Long-acting insulin does not increase risk of heart attack in people with type 2 diabetes
Long-acting insulin does not increase the risk of acute myocardial infarction - or heart attack - in people with type 2 diabetes, according to new research. The study, conducted by researchers from the Leibniz Institute for Prevention Research and Epidemiology in Bremen, Germany, compared the impact of long-acting insulin analogs with other basal insulin therapies on the risk of heart attack in people with type 2 diabetes. No significant differences were observed. A previous study, however, suggested that long-acting insulin increased heart attack risk. The researchers examined data from 21,501 type 2 diabetes patients who had recently begun to take insulin; some were treated with premixed insulin, some with analog insulin, and some with human neutral protamine Hagedorn (NPH) insulin. The researchers observed no significant increase in heart attack risk from the use of either type of insulin. "In contrast to a former database study, no difference was observed for the risk of AMI between long-acting analog and NPH insulin in this study," the researchers wrote. "Neither long-acting insulin nor premix insulin appears to be associated with acute MI in patients with type 2 diabetes." The findings were published in Diabetes, Obesity and Metabolism.
200,000 patients per year experience diabetes-related complications
Roughly 200,000 patients with diabetes suffer health complications each year, such as heart attacks, stroke and amputations, according to Diabetes UK. The diabetes charity announced these figures after analysing data from the National Diabetes Audit. There were 199,537 cases of diabetes-related complications in England and Wales between 2012-2013. Further figures revealed that only 36 per cent of diabetes patients in England and Wales met the recommended levels for blood pressure, cholesterol and blood glucose. In the best performing area, still only 48 per cent achieved these targets. Diabetes UK chief executive Barbara Young said: "With the numbers of people with diabetes rising at an alarming rate, it is vital that the government and the NHS act urgently to end the postcode lottery of diabetes care, and ensure that all people living with diabetes get the support and care they need to live long healthy lives." Diabetes UK have previous claimed that diabetes could bankrupt the NHS, but Dr. Partha Kar, diabetologist and advisor for NHS Survival, believes the issue for people with diabetes-related complications is that the money the NHS has might not be spent properly. Kar told "We need to put these things in context. We have increased health checks, over-40 checks and there is better awareness of type 2 diabetes - people are coming forward to have their checks, and the fallout of that is that more people are being diagnosed. "So, how can diabetes bankrupt the NHS? We don't even know what is being done with the money that the government has right now. I think it’s a false economy to say that the NHS will be bankrupted, because we don’t know what the government is doing." It is possible for people with diabetes to start to develop complications within a few years of diagnosis, but keeping good control of your diabetes can help you live for years without complications. Eating a healthy, balanced diet is important, as is maintaining control of blood glucose levels and HbA1c. You can further reduce your risk of complications by quitting smoking and having a low alcohol intake.
DKA continues to be a major problem among youth with established type 1 diabetes
Diabetic ketoacidosis (DKA) occurs at a rate of five to seven per cent in children with established children with type 1 diabetes, according to new research. The study, conducted by researchers from the Barbara Davis Centre for Childhood Diabetes, Aurora, Colorado, examined children with type 1 diabetes from a number of countries, including the United Kingdom, the United States, and several from Western Europe. The researchers analysed the data of nearly 50,000 patients with type 1 diabetes below the age of 18, all of whom had had type 1 diabetes for more than a year. They found that the risk of diabetic ketoacidosis was particularly high among young girls, ethnic minorities, and those with higher HbA1c levels. Dr. David M. Maahs, lead author of the study, told Medscape Medical News: "DKA continues to be a major problem in pediatric type 1 diabetes. Programs need to be developed and funded to target patients at high risk." Diabetic ketoacidosis is a severe complication of diabetes that occurs when blood sugars are allowed to rise too high for too long. Without insulin, the body cannot access glucose from the blood for energy. Without glucose from the blood, the cells have to get their energy from the body's reserves of fat, a process which leads to the production of ketones. A small amount of ketones production is perfectly normal, but when the process goes on for too long the ketones can get into the bloodstream, which can lead to coma and, in some cases, death. Type 1 diabetes in children is often undiagnosed before ketoacidosis sets in, because the lack of insulin production means that glucose levels rise and rise without being controlled at all. This study suggests that DKA remains a problem for children with established type 1 diabetes, who will be taking insulin and understand that they have the condition. And according to the researchers, there is no easy solution to the problem. "This is of course a very complex issue with many aspects besides patient education, [including] the accessibility of the healthcare system, availability of 24-hour access (for example, by telephone hotline for families with affected children), issues of insurance and reimbursement, distance between family home and emergency care as well as specialised pediatric diabetes care, [and] availability of frequent blood glucose testing," said study co-author Reinhard W. Holl, of the University of Ulm, German Centre for Diabetes research. Other causes may include the fairly common practice among diabetic teenagers of not taking insulin in order to lose weight. Without insulin, the body cannot store glucose as fat. More information about specific cases of diabetic ketoacidosis in children with established type 1 diabetes is needed before a solution can be found, according to Dr. Holl: "We [...] need more information on the psychological and social background of high-risk groups to better target prevention programs...Comparison of outcomes among different healthcare systems despite similar resources may open new ideas on how to improve long-term care in chronically ill children," Dr. Holl told Medscape Medical News. The findings were published in Diabetes Care.
DNA biomarker uncovered among prediabetes patients which could identify type 2 diabetes
A biomarker has been identified in people with prediabetes that could help prevent them from developing type 2 diabetes. The discovery was made by researchers at Virginia Tech, who observed that people with prediabetes that were thought to be insulin resistant also had altered mitochondrial DNA. This can result in changes to the way chemical energy is converted from food into energy that cells can use. 40 participants were used for a sub-study of the diaBEAT-it program, a long-term diabetes prevention trial. The participants all had prediabetes and showed signs of insulin resistance, but did not have fully developed diabetes or cardiovascular disease. Blood samples were taken from all the participants, with the results highlighting lower mitochondrial DNA. This was significantly reduced among patients with a BMI over 30. Lower mitochondrial DNA was strongly associated with insulin resistance, while there was a dramatic increase in DNA methylation - which can affect mitochondrial copy numbers in cells - among participants who were obese or had insulin resistance compared to insulin-sensitive subjects. The researchers concluded that increased methylation could lead to reduced mitochondrial DNA, which is associated with insulin resistance. Zhiyong Cheng, an Assistant Professor at the College of Agriculture and Life Sciences and a Fralin Life Science Institute affiliate, said: "If the body is insulin resistant, or unable to respond properly to insulin, it could affect a person's mitochondrial function and overall energy levels. "Mitochondrial alterations have previously been observed in obese individuals, but this is the first time we've made the molecular link between insulin resistance and mitochondrial DNA changes." Collaborator Fabio Almeida added: "There is no known cure for type 2 diabetes, and early diagnosis and intervention is critical to prevent this disease. Discovery of the biomarker in obese, pre-diabetic individuals advances our understanding of how diabetes develops and provides evidence important for future diagnosis and intervention." The findings of this study were published in the journal Clinical Epigenetics.
CGM accurate for closed loop insulin delivery system at home, research suggests
The Freestyle Navigator II continuous glucose monitor (CGM) is an accurate device suitable for closed-loop insulin delivery at home, according to a new study. The researchers examined the data of 41 adults and 16 teenagers with type 1 diabetes, all of whom had been using an insulin pump for at least three months. The participants combined insulin pump therapy with a CGM system of insulin delivery overnight for two nights, and over the course of a whole day using closed-loop control. All of the treatment was unsupervised. They found that the Freestyle Navigator II was a suitably accurate device for closed-loop insulin delivery at home, with its readings falling within the accuracy standards of the International Organisation for Standardisation (ISO) 70 per cent of the time. A closed-loop insulin delivery system is one in which the person has a CGM, an insulin pump, and a program that works out how much insulin is needed in response to the glucose readings from the CGM. "Our analysis suggests that in ambulatory, real-life conditions, the Freestyle Navigator II CGM achieved nearly comparable scores with those reported in the manufacturer's labelling and in controlled research facility settings," the researchers wrote. "In the hyperglycemic range, the improved numerical accuracy facilitates safe operation of [closed-loop] by avoiding hypoglycemia from CGM sensor over-reading. Conversely, sensor inaccuracy in the hypoglycemic range is mitigated by insulin delivery suspension during [closed-loop] operation." The findings were published in Diabetes Technology and Therapeutics.
New research reveals diabetes affects diaphragm differently, compared to previous findings
New findings relating to how diaphragm muscle cells behave could lead to new respiratory treatments for people with diabetes. Diabetes is known to cause breathing problems in patients who fail to maintain a healthy weight, with treatment often requiring aerobic and endurance training. M. Harold Laughlin, University of Missouri reports that in type 2 patients, the body struggles to respond to insulin - this includes cells that make up the diaphragm - due to small blood vessels essentially disappearing. Laughlin's team challenged previous studies that investigated diaphragm muscle cells alongside other skeletal muscle cells. As these two cell types are similarly arranged, they have often been studied together. "Previous research on respiratory distress has focused on the similarities in limb skeletal muscle cells and diaphragm cells," said lead researcher M. Harold Laughlin. "What we found essentially contradicts previous findings and could guide future research in respiratory distress in diabetics." In their study, rats were genetically engineered to be predisposed to insulin resistance and obesity. They were then assigned to two types of exercise programs: one was an endurance training program in which rats ran on a treadmill for longer periods, the second was an interval training program that required rats to run on the treadmill for shorter bursts. It was then assessed which genes in diaphragm arteries were turned on or off in the rats during the exercise. Laughlin concluded: "We found that smooth muscle cells in the arteries of the diaphragm do undergo adaptive changes in response to exercise training. "Common knowledge among researchers is that limb skeletal muscle and diaphragm muscle behave in the same manner and can thus be studied jointly. Our results indicate just the opposite - in obese patients suffering from diabetes skeletal muscle arteries and diaphragm arteries adapt to exercise in different ways." The team hope their findings lead to causes of respiratory distress in the diaphragm among those with insulin-dependence being investigated independently of other skeletal muscles.