In Diabetes, a Complex of Causes By AMANDA SCHAFFER / NYTimes

[Demeter]

http://www.nytimes.com/2007/10/16/health/16diab.html?ref=science


An explosion of new research is vastly changing scientists’ understanding of diabetes and giving new clues about how to attack it.

The fifth leading killer of Americans, with 73,000 deaths a year, diabetes is a disease in which the body’s failure to regulate glucose, or blood sugar, can lead to serious and even fatal complications. Until very recently, the regulation of glucose — how much sugar is present in a person’s blood, how much is taken up by cells for fuel, and how much is released from energy stores —was regarded as a conversation between a few key players: the pancreas, the liver, muscle and fat...
New research suggests that a hormone from the skeleton, of all places, may influence how the body handles sugar. Mounting evidence also demonstrates that signals from the immune system, the brain and the gut play critical roles in controlling glucose and lipid metabolism. (The findings are mainly relevant to Type 2 diabetes, the more common kind, which comes on in adulthood.)


Dr. Karsenty found that in mice prone to Type 2 diabetes, an increase in osteocalcin addressed the twin problems of insulin resistance and low insulin production. That is, it made the mice more sensitive to insulin and it increased their insulin production, thus bringing their blood sugar down. As a bonus, it also made obese mice less fat.

If osteocalcin works similarly in humans, it could turn out to be a “unique new treatment” for Type 2 diabetes, Dr. Malozowski said. (Most current diabetes drugs either raise insulin production or improve insulin sensitivity, but not both. Drugs that increase production tend to make insulin resistance worse.)

A deficiency in osteocalcin could also turn out to be a cause of Type 2 diabetes, Dr. Karsenty said. Another recent suspect in glucose regulation is the immune system. In 2003, researchers from two laboratories found that fat tissue from obese mice contained an abnormally large number of macrophages, immune cells that contribute to inflammation. The finding piqued the curiosity of researchers. “I remember reading the paper and thinking: ‘Wow, look at all those macrophages. What are they doing?’” said Dr. Jerrold M. Olefsky of the University of California, San Diego, School of Medicine.

THE ARTICLE IS LENGTHY AND DETAILED--WORTH THE READ!

[WeCanWorkItOut]

1. Very interesting article. But early Type 2 diabetics often have high insulin--

just not high enough to get the glucose into the cells readily. The very high insulin (see works of Standford's Gerald Reaven) can cause problems of its own, as the article notes.

So exercise and weight loss will still be the preferred ways of improving insulin sensitivity and getting glucose into cells, I expect. But the new discovery is sure to help some people. Fascinating stuff.

[hedgehog]

2. I talked my mother into adding a Vitamin D supplement and her

insulin dose dropped by half.