Technology Analytical News

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According to WHO estimates, India has about 70 million diabetics and is rapidly moving towards becoming the diabetes capital of the world, even though rates of the disease are increasing across the world.

Diabetes may actually be of five types and not just type 1 and type 2 as people know it, suggests new research published in The Lancet Diabetes & Endocrinology journal.

Recasting adult-onset diabetes into five types could help better tailor early treatment for patients, said the research by scientists from Lund University Diabetes Centre, Sweden, and Institute for Molecular Medicine Finland. The five types found had different characteristics, with different complications, and called for different treatment needs.
According to WHO estimates, India has about 70 million diabetics and is rapidly moving towards becoming the diabetes capital of the world, even though rates of the disease are increasing across the world.

While type 1 diabetes is generally diagnosed in childhood and caused by the body not producing enough insulin, type 2 occurs when the body cannot produce enough insulin to meet increased demand imposed by obesity and insulin resistance (dearth of hormone receptors), and typically occurs later in life. Most diagnosed cases are type 2 (75-85%).
For the new study, in 14,775 patients across Sweden and Finland, the authors analysed six measurements — age at diagnosis, body mass index, long-term glycaemic control, successful functioning of insulin-producing cells in the pancreas, insulin resistance, and presence of auto-antibodies associated with autoimmune diabetes. They also did genetic analyses, and compared disease progression, treatment, and development of complications for each type.

The authors identified one autoimmune type of diabetes (condition in which the body produced chemicals that destroyed insulin) and four distinct subtypes of type 2 diabetes. Three forms were severe and two mild. Among the severe forms, one group had severe insulin resistance and a significantly higher risk of kidney disease than the other types (affecting 11-17% of patients). Another had relatively young, insulin-deficient individuals with poor metabolic control but no auto-antibodies (9-20%). The remaining severe group was insulin-deficient patients who had auto-antibodies associated with autoimmune diabetes (6-15%), the form called type-1, or latent autoimmune diabetes in adults.

The most common was one of the more moderate forms, seen in the elderly and affecting 39-47% of the patients. The other mild form was mainly seen in obese individuals and affected 18-23% of patients.

All five types were genetically distinct.

“Evidence suggests that early treatment for diabetes is crucial to prevent life-shortening complications. More accurately diagnosing diabetes could give us valuable insights into how it will develop over time, allowing us to predict and treat complications before they develop,” said lead author Professor Leif Groop, Lund University Diabetes Centre . “Existing treatment guidelines are limited by the fact they respond to poor metabolic control when it has developed, but do not have the means to predict which patients will need intensified treatment. This study moves us towards a more clinically useful diagnosis, and represents an important step towards precision medicine in diabetes.”

The study could not confirm if the five types have different causes, nor if patients’ type changes over time. Future research will be needed to test and refine the five types.

Courtesy - Indian Express

Though the number of heart patients is on the rise world-wide, the situation in India is even more alarming, cardiology experts said.

Presidents of five major Cardiological Societies of the world who participated in the 68th annual conference of the Cardiological Society of India (CSI) here yesterday said, the Cardiology sector in India is facing several challenges with recent reports pointing out an alarming rise in heart diseases.

According to American Heart Association President Prof Mark Creager, increase in diabetes is a major factor in increasing heart disease.

"Diabetic patients who have high blood pressure and cholesterol have greater risk of heart diseases," Creager was quoted as saying in a release here.

He cautioned that the diabetic patients who do not control their sugar will end up with a diseased heart.

World Heart Foundation former President, Dr Salim Yusuf pointed out that cardiac illness is one of the major reasons for high number of deaths in India.

The number of cardiac patients in Kerala is three times more than that of the national average, he noted.

"The lifestyle of people in Kerala had led to more people becoming heart patients.
People should reduce carbohydrates and include more fruits in their daily diet for a healthy heart," he opined.

He also stressed the importance of regular exercise in preventing heart disease. When the nature of Cardiac diseases is changing, new cardio vascular technologies are also evolving and gives much hope to the patients, said President designate of European Society of Cardiology, James Blankenship.

European Society of Cardiology President Jeroen Bax said newer technologies have been developed for the detection of diseases.

But, the attitude of people towards the new technology and methods have to change, he said. President of the American College of Cardiology, Mary Norine who spoke on the occasion said the majority of cardiac problems end in heart failure when the heart cannot pump blood and this can cause death.

"However, in these circumstances there are technologies to make the heart function artificially and a prolong life," Norine said. She said though these technologies help patients to live an ordinary life, the doubts of the patients regarding the usage of these methods are yet to be cleared.

"If we are able to clear the doubts, then these treatments will be adopted widely and the number of deaths due to cardiac problems could come down," Norine suggested.

Courtesy – Deccan Herald